An anal fissure which does not heal with conservative measures as sits baths and laxatives is a chronic anal fissure. Physiologically, it is the high resting tone of the internal anal sphincter that chiefly interferes with the healing process of these fissures. Until now, the gold standard treatment modality is surgery, either digital anal dilatation or lateral sphincterotomy. However, concerns have been raised about the incidence of faecal incontinence after surgery. Therefore, pharmacological means to treat chronic anal fissures have been explored.A Medline and pub med database search from 1986-2012 was conducted to perform a literature search for articles relating to the non-surgical treatment of chronic anal fissure.Pharmacological sphincterotomy using Glyceryl trinitrate , Isosorbide dinitrate or calcium channel blockers are exciting alternative treatment , that relaxes the anal sphincter and, therefore, promote healing, the drawback of such medications are headache and poor compliance. With the introduction of Botulinum toxin as mean of chemical sphincterotom, topical injection of Botulinum toxin reduces the anal hypertonia which lasts for few months, allows the fissure to heal, thus eliminating the need for surgery without incidence of incontinence. Cure rates are over 60%, and the procedure can be repeated safely. Therefore, Botulinum toxin is a reasonable first-line management of chronic anal fissure and the relapses can be managed by surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Objective: The study aimed to determine quality of life domains for adult patients with limbs loss and to identify
the association between quality of life domains and demographic characteristics and medical information.
Methodology: A descriptive study was carried out at Baghdad artificial limb center, Al-Salam medical
rehabilitation center, Al-Ghadeer medical rehabilitation center and the rheumatoid and medical rehabilitation
center for the period from September 2007 to April 2008. A purposive ''non- probability'' sample of (200)
patients with limbs loss. Questionnaire form was constructed for the purpose of the study. Data were collected
through the application of the questionnaire and interview technique. Data were a
The temperature distributions are to be evaluated for the furnace of Al-Mussaib power plant. Monte Carlo simulation procedure is used to evaluate the radiation heat transfer inside the furnace, where the radiative transfer is the most important process occurring there. Weighted sum of gray-gases model is used to evaluate the radiative properties of the non gray gas in the enclosure. The energy balance equations are applied for each gas, and surface zones, and by solving these equations, both the temperature, and the heat flux are found.
Good degree of accuracy has been obtained, when comparing the results obtained by the simulation with the data of the designing company, and the data obtained by the zonal method. In
... Show MoreThe first chapter the importance of research and need for education scientists see that the roots of the use of a specimen Wheatley in learning and teaching back to Grayson Wheatley, one of the largest supporters of a modern construction, which lay the groundwork for the specimen stage and the form in which it is. That was attributed to him, often called his name called while some educators based learning strategy on the issue. He sees the learner in this model make him a meaningful understanding of problems during his progress, thereby acting with his colleagues to find solutions to them in small groups. He
Borders Search: Search by students is determined by th
... Show MoreEducation is a process of learning and education at the same time. As the conditions of modern life necessitate every person to keep learning, education has become a necessity to meet life needs. The society today is concerned with the educational process and aims to live up the expectations. Since education is an integral part of education and its means, it has become as a mean to achieve its purposes. The educational environment was a traditional environment limited to specific inputs, possibilities and stimulus of both teacher and student. Due to the latest advancement, the educational environment has been expanded to become a rich, with strong connections. It has expanded to encompass the entire global environment. The current
... Show MoreArabic language the timeless language of the Qur'an ((I made it read Arabic you may understand)) (Al-Zukhruf No 3). It is a way to express his thoughts and feelings and capable of giving constant absorbed the needs of the times and meet the General requirements and interactive needs of life to achieve social and intellectual aspects.
The aim of current research to identify what teaching the contemporary trends in teaching, what the nature of knowledge and teaching methods, how do you rate the modern Arabic language teaching methods, the criteria for evaluating the effectiveness of teaching where the researcher has reached some recommendations: 1. establish the basics of environmental ed
... Show MoreObjective(s): The present study describes the quality of life (QOL) among adolescents with age of (12-22) year old and identifies factors that may be associated with it. Methodology: A cross-sectional design is carried throughout to evaluate adolescents' quality of life in Hilla City for the period of September 2nd 2016 to November 6th 2016. The present study is conducted in different settings that include schools and colleges in Hilla City. A non-probability "purposive" sample of (144) participant is selected and comprised of (50%) males and (50%) females. An instrument is constructed for the intent of the st
Abstract A descriptive study was conducted in Al-Bashir teaching hospital in Amman city from 15th May 2004 to 15th August 2004 , in order to "Assess the adult asthmatic patients’ quality of life (QOL). Objective: This study aimed at identifying the domains of (Environmental, Physical, Daily Living Activity, Drug and Medication, Psychological , and Social), Methodology : A Purposive (Non-Probability) sample of (100) adult asthmatic patients visited the emergency department and outpatient clinic of chest department in Al-bashir hospital .A Questionnaire was constructed for the purpose of the study, and compris
The research aims to build a communication apprehention scale for student (females) from preparatory schools .research sample included (400)students (females) were selected from the preparatory . to build a tool for the researchers are several steps , todetermine the meaning of communication apprehention and formulation of the items of the seale according to the linkert method .
Objective(s): The aim of this study was to assess the severity of anemia among children under 5 years and to find
out relationship between severity of anemia in children with socio-demographic variables such as: child gender,
age, supplement diet, hookworm, pica, parent's education level, father's and mother's occupation, and family
monthly income with severity of anemia
Methodology: A descriptive cross sectional study was conducted at the primary health care centers in Alsadr city
for the period of 1
st July 2011 to the 1st November 2011.Non probability (purposive) sample of (630) children who
aged under 5 years and who attended to primary health care centers of Alsadr city. The data were collected
through using