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.
That achieve a level of excellence for the quality of university education cannot be achieved only by uniting the efforts of all employees at the university and active participation by students and by alumni and the labor market and society, however we can say that the administrative and academic university staff play an active role and the largest in achieving equivalent quality of higher education, It should unite the efforts of all employees in the educational institution in order to achieve quality education. It is the concept of quality of education, quality assurance and overall management of the quality of the basic pillars on which it is based university education. That highlight the need fo
... Show MoreObjectives: To identify quality of life (QOL) in Myocardial Infarction (MI) patients, and to find out the
relationship between QOL in MI patients and demographic characteristics.
Methodology: A descriptive colTelation study which utilized an assessment approach. The study was carried out
from March 2007 through November 2007 in order to assess the quality of life for patients with myocardial
infarction. A purposive "non-probability" sample of (75) patients with myocardial infarction who were attending
to Baquba General Hospita`l through their visits to that hospital. A questionnaire was adapted and developed
from the World Health Organization Quality of Life Scale (1998). The questionnaire was designed and
consisted
The purpose of the study is to investigate the effect of the constructivist model of yager in acquiring the geographical concepts among first intermediate students in geography. The study was carried on based on the null hypothesis, which states, there is no significant difference at the level of (0.05) between the experimental group that follows yager model in learning the principles of geography, and the control group that studies the same subject considering the traditional methods of learning, the. To do so, a sample of (70) first-intermediate student were chosen purposefully from two random class for the academic year (2016-2017) divided into two groups. The selected schools located at Al-rusafa side in the city of Baghdad, as well
... Show MoreNear-ideal p-CdS/n-Si heterojunction band edge lineup has been investigated for the first time with aid of I-V and C-V measurements. The heterojunction was manufactured by deposition of CdS films prepared by chemical spray pyrolysis technique (CSP) on monocrystalline n-type silicon. The experimental data of the conduction band offset Ec and valence band offset Ec were compared with theoretical values. The band offset Ec=530meV and Ev=770meV obtained at 300K. The energy band diagram of p-CdS/n-Si HJ was constructed. C-V measurements depict that the junction was an abrupt type and the built-in voltage was determined from C-2-V plot
The study attempts to identify 1) the habits of playing video games among students, 2) the effect of playing video games on students’ academic achievement, 3) the statistically significant differences among students in regard of (gender, time of playing video games, number of hours). To this end, a five-likert scale questionnaire included four questions was applied to (250) male and female students chosen randomly from the second-intermediate stage at Al-Karakh side secondary schools. The findings revealed that students play games only on holidays and less than an hour daily, which means playing games does not affect their academic achievement. Additionally, the findings found there is a significant difference between male and female i
... Show MoreLaue back reflection patterns for quartz crystal are indexed by using Orient Express- program to simulate orientation of single crystals from assignment of principle zones. An oriented quartz single crystal was used as a substrate to deposit Zn metal by controlled thermal evaporation to achieve single crystal films of Zn that are subsequently evaluated by x-ray powder diffraction.
The subject of children's rights in the modern era of the priorities of educators , because the child in the community is the future , which is held by the hope which is the basis for society in the renaissance and progress so quickly communities to prove these rights through its various institutions and issued legislation and held numerous conferences and taking specialists the field of childhood Aatron aspects of this rights and Aasalunha including a benefit for children until tomorrow for the rights of children , psychological and social health and educational . Therefore, the current study focused on the awareness of parents and educators of children's rights as individuals most closely satisfying their needs and rights. The
... Show MoreThe aim of the current research is to measure the sense of coherence among individuals with physical disabilities. The researcher adopted a scale of (29) paragraphs spread over three domains designed by Antonovski (1993) to measure the sense of coherence. A sample of (210) disabled individuals was chosen randomly to collect the required data. The data were analyzed using the statistical package for social sciences (SPSS). The result showed a lack of sense of coherence among the sample.
The current study aims to develop a teaching design in accordance with cluster thinking strategies and explore the effect of this teaching design on students’ achievement in science. To this end, the null hypothesis was adopted: there is no statistically significant difference at the level of (0, 05) between experimental group who adopted the teaching design in learning science and control group who follow the traditional method in learning the same subject. To test the null hypothesis, total of (74) students from Al-Alaama Hussain Mahfooth intermediate school were selected intentionally for the academic year 2016-2017. The sample divided into two equal groups when all the variables (age, prior achievement of science,
... Show MoreTaxes are an essential axis in the economy as the most effective and effective economic tool in any country (economy). Expanding the scope of taxation without adequate study has produced a dangerous result with a negative impact that is almost apparent, namely (tax evasion), which stands as a barrier preventing the state from reaching Therefore, the research sought to study strategic tax planning and its importance in reducing tax evasion, and the research aims from that to prove the importance of adopting strategic planning in the field of taxes according to modern and effective scientific foundations to reduce tax evasion to enhance the achievement of tax evasion. The financing objective is in addition to the other objectives,
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