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.
In this research we present An idea of setting up same split plots experiments in many locations and many periods by Latin Square Design. This cases represents a modest contribution in area of design and analysis of experiments. we had written (theoretically) the general plans, the mathematical models for these experiments, and finding the derivations of EMS for each component (source) of sources of variation of the analysis of variance tables which uses for the statistical analysis for these expirements
The study aimed to reveal the level to which the international issues are integrated into the books of Saudi public education social studies and citizenship in the light of the principles of international education, and to know the level of continuity and integration of these issues in the books, to build a range and sequence matrix of international issues through it. The study followed the descriptive and analytical method that used the content analysis card as a tool for study when the tool achieved the necessary validity and reliability characteristics. The data of this study has been processed using the SPSS statistical program according to a set of appropriate methods of descriptive and inferential statistics.
The resu
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The research aims to build an integrated frame of knowledge for the basic research topics, represented by (assimilation of knowledge, strategic clarity) and their basic variables, by examining the most important scientific propositions on these topics in administrative thought, and framing the knowledge contained in them, in a serious attempt to provide appropriate answers to questions The research dilemma, and the research was applied in the Iraqi Airways Company, whose number is (1200) employees, and the descriptive and analytical approach was adopted in conducting the research. A valid form for statistical analysis, i.e., with a retrieval rate of (92%). The two researchers used the (SPSS & AMOS) program for
... Show MoreAmong many problems that reduced the performance of the network, especially Wide Area Network, congestion is one of these, which is caused when traffic request reaches or exceeds the available capacity of a route, resulting in blocking and less throughput per unit time. Congestion management attributes try to manage such cases. The work presented in this paper deals with an important issue that is the Quality of Service (QoS) techniques. QoS is the combination effect on service level, which locates the user's degree of contentment of the service. In this paper, packet schedulers (FIFO, WFQ, CQ and PQ) were implemented and evaluated under different applications with different priorities. The results show that WFQ scheduler gives acceptable r
... Show MoreSummary First: The importance of the study and the need for it: The society is composed of an integrated unit of groups and institutions that seek to achieve a specific goal within a system of salary, and the family remains the most influential institutions on the individual and the unity of society, with the roles and responsibilities of the individual and society, and through the continuation and strength of other social organizations derive their ability On the other hand, any break-up in the institution of the family is reflected negatively on the cohesion of society and its interdependence, and the causes of this disintegration vary from society to another, but family problems remain the main factor in obtaining it. Second: Study Ob
... Show MoreObjectives: To determine the impact of the household hazardous waste’s aspects upon the environment
pollution .and to identify the relationship between the households’ demographic characteristics and the aspects
of household hazardous waste.
Methodology: A descriptive study is conducted between December 14th 2004 to October 20th 2005that uses of
an assessment tool. A probability (simple random sampling) of (336) principal’s households which is selected
from the zones around the (14) primary health care centers as focal points, (8) in the urban and (6) in the rural
areas of Baghdad Governorate. After reliability and validity were determined Data are collected through the use
of an assessment tool that is consist
God Almighty has imposed on us obligations and set limits on us, and among these obligations is the prayer, which is considered a pillar of Islam. And recently on the statement of its importance, and through extensive explanations, they elaborated on the statement of its pillars, its obligations, its Sunnahs, its rituals, and its bodies, and it is known that the imam in prayer is an important part of the parts of prayer. Whoever assumes this responsibility must be aware of these conditions, the most important of which is jurisprudence in religion, and there has been a disagreement between the jurists, especially the owners of the four schools of thought, about who is qualified to lead the imamate, and this is within many and wide details
... Show MoreThis study aims to explore the relationship between the degree of application of digital leadership and the development of administrative work at the University of Tabuk. It further aims to examine the presence of statistically significant differences between the average responses of faculty members and employees at the University of Tabuk regarding the study axes that are attributed to the following variables: (scientific rank, gender, and job), the study used the descriptive approach in its correlative style, and the questionnaire was used as a tool for data collection, as it was applied to a simple random of (310) members of the faculty and staff. University of Tabuk. The results showed that the degree of digital leadership applicatio
... Show MoreThis research on women under the title (Empowerment of women… From value education to the creation of human morality), includes a disclosure of the reasons that prevented women from performing their human role in the development of human societies and treatments that can provide to solve this big problem in the life These communities, especially the Eastern societies and the religious ones, believe that the woman has not received the care and care to raise her human values in order to contribute to the required social contribution, for historical, economic, moral, religious, social and cultural reasons. And by shedding light on specific definitions of the most important rules on which the research relied
... Show MoreConsidering the science of speech in the light of its purposes is an accurate scientific study that looks at it from its reality in which it originated, and its topic that it dealt with and its goals that it sought, and it follows its main course in the directions of approving the belief and inferring it, and repelling the objections to it, and this study comes to show the realism of the science of speech in its emergence Its subject and method, since its launch was from the reality of the Islamic nation and based on its intellectual needs, so its presence was necessary in the life of the Islamic nation because of its role in facing the challenges faced by the Islamic faith, and the dangers it was exposed to as a result of the intellectu
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