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.
One of the most frightening to children ages pre-school entry , Are those concerns about natural phenomena such as (The darkness, the sound of thunder, lightning and light, and rainfall, and storms) These natural phenomena are not familiar to the child , It may have a surprise when he/ she sees , And others intimidated , The affects of panic and fears that may lead him some psychological injury symptoms.
The fear of the dark, of the most common concerns associated with the child in his daily life , As the children's fear of the dark is reasonably fear that makes him a natural to live in the unknown , We can not identify what around him and is afraid of something collision, Or injury from somet
... Show MoreThis study aims to investigate the academic leaders’ perceptions towards the degree of availability of the dimensions of organizational immunity systems at the University of Tabuk, as well as to reveal the statistically significant differences between the average responses of the study sample members about the degree of availability of these dimensions at their university due to the variables of (gender, leadership position, and college specialization). To achieve the objectives of the study, a descriptive survey method was used. The study population consisted of (200) male and female leaders who were academic leaders at the University of Tabuk. A questionnaire was used as a tool for collecting data, which its validity and reliability
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The current research aims to find out the role of administrative leadership in the implementation of public policies and their effectiveness and their ability to do so, As well as analysis and testing of influence and correlations between research variables, The researcher has the descriptive and analytical approach, And several tools used to gather information consisted of personal interviews and field visits, While distributed questionnaire tool that consists of (35) items on a sample consisting of (147) individuals formed of staff of the Baghdad Provincial Council.
The research was based on a set of assum
... Show MoreThis paper deal with the estimation of the shape parameter (a) of Generalized Exponential (GE) distribution when the scale parameter (l) is known via preliminary test single stage shrinkage estimator (SSSE) when a prior knowledge (a0) a vailable about the shape parameter as initial value due past experiences as well as suitable region (R) for testing this prior knowledge.
The Expression for the Bias, Mean squared error [MSE] and Relative Efficiency [R.Eff(×)] for the proposed estimator are derived. Numerical results about beha
... Show MoreThe trade war, of course, leads to a sharp tension in international relations because the economy is the lifeblood of the states. In the world of trade and economy, countries began to lean towards cooperation. Economic relations after World War II were more liberal, trade barriers were removed and global trade became more flexible and smooth

The current study aims to examine the level of problems faced by university students in distance learning, in addition to identify the differences in these problems in terms of the availability of internet services, gender, college, GPA, interactions, academic cohort, and family economic status. The study sample consisted of (3172) students (57.3% females). The researchers developed a questionnaire with (32) items to measure distance learning problems in four areas: Psychological (9 items), academic (10 items), technological (7 items), and study environment (6 items). The responses are scored on a (5) point Likert Scale ranging from 1 (strongly disagree) to 5 (strongly agree). Means, standard deviations, and Multivariate Analysis of Vari
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The teacher is the most able to achieve the goals of education in education because he has the ability to affect the behavior of the disciples testified and its actions and appearance and other actions that convey pupils with it sometimes in a manner unconscious or unconscious , and the importance of the role of the teacher in the educational process , it is necessary to compromise the care and attention to the extent that commensurate with the important role that the rise in the preparation of youth and composition , and as a result is needed to continue efforts to improve the quality of teacher preparation so that it can be more effective and positive in the educational process .
First - Research Goals -<
It aim current researchs֬ to identify the impact of a proposed strategy in accordance with the objectives of science in the achievement and some science processes, where the experimental method was adopted, and define the research community was students second grade averag in Education Bagdad / Rusafa third, research sample intentionally chosen as school Radwan, and (30) students experimental group and (29) of control group, research tools were achievement test and the test of science operations and use the appropriate statistical tools to process information and data, showing results, the experimental group surpassed the control group in the collection and operations science, and light it, the researcher recommended several recommendat
... Show MoreThrough an experimental program of eighteen specimens presented in this paper, the bond strength between reinforcing bar and rubberized concrete was produced by adding waste tire rubber instead of natural aggregate. The fine and coarse aggregate was replaced in 0%, 25%, and 50% with the small pieces of a waste tire. Natural aggregate replacement ratio, rebar size, embedded rebar length, the rebar yield stress of rebar, cover, and concrete compressive strength were studied in this investigation. Ultimate bond stress, bond stress-slip response, and failure modes were presented. The experimental results reported that a reduction of 19% in bond strength was noticed in 50% replaced rubberized concrete compared with convention
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