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.
Today we are witnessing huge scientific and technical progress so we need more skills and methods of thinking that needs to be acquired by the teacher, as the importance of computers in education there are many teachers suffering of the difficulty in teaching for pupils . researchers tried to find a good suitable way with the technological interests for now which represent by computer design software and the introduction of enrichment activities in the curriculum because it is one of a contemporary trends for the development of the Arabic language with various levels of education and knowing if this program has negative or positive impact.
So 
... Show MoreImproving the quality of health services in the health sector is an important and necessary matter that must be taken care of and improved, and this study seeks to demonstrate the role of quality costs in improving the quality of health services and achieving a high level of quality to satisfy the beneficiaries and to provide health services of good quality, and the research concluded that the main point of service provision Good health is the costs of prevention and evaluation (costs of quality conformity) and attention to it, and that technical competition contributes greatly to the development of the level of quality, as well as the use of health and medical staff with competent expertise, and that the costs of internal failure and th
... Show MoreThe flexibility of interaction between the movement of macroeconomic variables that affect and are affected by the balance of payments, especially the movement of the current account, implies a perception of the maturity of economic development and what the theory assumes from the launch of a wide range of economic movement that varies in the degree of its influence according to the level of economic development and the vitality of the internal/external overlap relations through the assumed response to the movement of the macroeconomic variables. On this basis, it is possible to estimate the soundness and rationality of the economic decision taken that takes into account the required reciprocal repercussions between the current a
... Show MoreThis research aims to identify the effectiveness of counseling by using the technique of self-talkin developing the habits of mind among middle school students by testing important hypotheses, and choosing the experimental design for the two groups (experimental - control). The classification of "Costa & Kallick" was adopted to measure the habits of the mind, and the scale consisted of (64) items, and after confirming the psychometric properties of the scale, the researcher applied it to the research sample (487) students from middle school students. One of the students who got the lowest marks after answering the scale. purpose of applying the experiment. He divided them into two groups, one of them is experimental (10) students, as
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The research included (the aesthetics of the sculptural formulations of swords in the Al-Kafeel Museum) four chapters. Al-Kafeel Museum.)
Within the time period: (1240 AH / (1824 and 1825) AD - 1312 AH / (1894 and 1895) AD). The second: the types of Islamic swords. The third chapter included (research procedures), and the analysis of samples from the sample (3) as a model according to the descriptive approach, and the fourth chapter dealt with (results, conclusions, recommendations, and proposals). As well as recommendations, proposals and sources.
The current study aimed to isolate and diagnose Candida spp yeasts that cause candidiasis with a PCR device from patients reviewed for some hospitals in Baghdad city and by 190 samples, the study recorded 123 isolates and the total percentage of infection was 64.7% .Samples were taken from different clinical cases of the vagina, blood and mouth and the Candida spp were (70.37%, 41.26%, 86.95%) respectively. Five types of yeasts were isolated and diagnosed, namely C. albicans, C. tropicalis, C. parapsilosis, C. krusei and C.glabarta. They were confirmed by PCR device and the most notable were yeast C. albicans, where 91 isolates were found, 73.98%, while the lowest infection was recorded. C.glabartawith 3 isolates, at 2.43%, significant diff
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This research aims to identify the availability of the elements of the concept of citizenship, to identify the distribution ratios of the outputs of the musical skills curriculum at the levels of educational goals associated with the elements of the concept of citizenship in the guides of teachers of musical skills for grades (12-1) in the Sultanate of Oman. A content analysis card was designed to include the teacher’s guides of musical skills for grades (12-1), which included the outputs, according to the grades with the identification of the elements of citizenship (identity, belonging, rights, participation). The results of the research revealed that the percentage of inclusion of citizenship values
... Show Morerepresenting the media and communication problems and phenomena fertile material and of great importance in the media research, especially as they relate to various aspects of life and its impact on the culture of the community and on individuals and public opinion about the behavior of the various issues. The media incitement to violence and hatred of the most prominent media phenomena that increased the danger and expanded not at the local level, but also in the world. So we found it is important to study this problem from the standpoint of academic and professional. And according to the progress of this research is trying to answer a number of questions including:
A. What are the Iraqi Satellite TV channels most watched and follow
In The Name of Allah Most Gracious Most Merciful
The characteristics of the doers of good are mentioned in the Holy Book of God, and love for them in five places, and whoever God loves, honors him and gives him victory. As for the love of the righteous, it has to do with loyalty, covenant, and integrity. Committing sins 0 Then after that he mentioned God those who fight in His cause and those who rely on Him and return to Him and turning away from everything else.
The need for participants’ performance assessments in academia and industry has been a growing concern. It has attendance, among other metrics, is a key factor in engendering a holistic approach to decision-making. For institutions or organizations where managing people is an important yet challenging task, attendance tracking and management could be employed to improve this seemingly time-consuming process while keeping an accurate attendance record. The manual/quasi-analog approach of taking attendance in some institutions could be unreliable and inefficient, leading to inaccurate computation of attendance rates and data loss. This work, therefore, proposes a system that employs embedded technology and a biometric/ w
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