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.
ABSTRACT
This study aimed to choose top stocks through technical analysis tools specially the indicator called (ratio of William index), and test the ability of technical analysis tools in building a portfolio of shares efficient in comparison with the market portfolio. These one technical tools were used for building one portfolios in 21 companies on specific preview conditions and choose 10 companies for the period from (March 2015) to (June 2017). Applied results of the research showed that Portfolio yield for companies selected according to the ratio of William index indicator (0.0406) that
... Show MoreObjective(s): To determine the quality of life for adults with a chronic obstructive pulmonary disease.
Methodology: A descriptive study was carried out on (80) patients with a chronic obstructive pulmonary disease from
December 2008 through October 2009 with special inclusion criteria (adult paƟents from 18 years and above exclude
the patients who suffer complication related of disease and from psychological problems and other chronic illnesses.
The data were analyzed through the application of descriptive data analysis approach and inferential data approach.
Result: The study indicated that the determination of QoL for COPD depended on the level of effect .The grades
according to R.S are: "high" effect of disease in
Directional Compact Geographic Forwarding (DCGF) routing protocol promises a minimal overhead generation by utilizing a smart antenna and Quality of Service (QoS) aware aggregation. However, DCGF was tested only in the attack-free scenario without involving the security elements. Therefore, an investigation was conducted to examine the routing protocol algorithm whether it is secure against attack-based networks in the presence of Denial-of-Service (DoS) attack. This analysis on DoS attack was carried out using a single optimal attacker, A1, to investigate the impact of DoS attack on DCGF in a communication link. The study showed that DCGF does not perform efficiently in terms of packet delivery ratio and energy consumption even on a sin
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Background: Tumor associated tissue eosinophilia (TATE) has been described in a variety of neoplasms. In regard to squamous cell carcinoma, some studies worldwide done to assess stromal eosinophilia in oral and cervical squamous cell carcinoma. The objectives of this study is to evaluate the association of stromal eosinophilic infiltration of cutaneous squamous cell carcinoma and to detect the significance of this association. Aim of the study The aim of our study is to establish the relationship between the degree of stromal eosinophilia and the level of invasion and the histological grade in cutaneous squamous cell carcinoma. Methods: In this retrospective study done at the histopathology department of al Wasity teaching hospital for orth
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The research aims to investigate the existence of a direct causal relationship between selected agricultural variables: agricultural output (as a representative of growth in the agricultural sector), agricultural terms of trade as a completely new variable in agricultural studies in recent years, agricultural labour which is an important part in the total workforce for Iraq, and finally, agricultural investment because of its importance and vital role in the production process, creating job opportunities, and then raising the level of employment, then it's role to achieving agricultural growth and development. For this purpose, the researchers used the Toda-Yamamoto causality methodology for a time series covering from 1990 to 2019. The res
... Show MoreInternational news websites, including Russia Today, pay special attention to the media image of Afghan women, especially after the Taliban movement took control of Afghanistan. Therefore, it was necessary to know the image of the Afghan woman, the fate of the rights she acquired in recent years, and the transformations that affected her after the Taliban took control of the government, and studied them on international news sites, specifically Russia Today.
The researcher summarized the problem of this study in the following question: What is the media image of the Afghan woman on the Russia Today news site?
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Abstract
The study aims to know the degree of secondary school managers' practice of servant leadership in Gaza from their teachers’ perspective. It further aims to examine whether there are any statistically significant differences at (α 0.05≥) between the means of the study sample’s members attributed to variables such as (gender, educational qualification, and years of experience). To achieve the objectives of the study, the study adopted the descriptive survey method, using a questionnaire consisting of (30) items distributed to four domains: (workers service, ethical dealing, motivation & influence, and building an organized, integrated society). Then, the questionnaire was distributed to t
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The concept of narration stems from the connotation of continuous communication through which narration is manifested as a message that is exchanged between the sender and the recipient, and that narration is an educational conceptual necessity, representing the philosophy of intellectual inclusion achieved in a direct speech to the mind, but it is encapsulated in a colorful frame that attracts the soul and attracts attention, and the graphic narration is a speech A visual based on the basis of interference and sequence of the event in weaving the elements in a consensual way through a continuous communication process that begins with the embodiment of an event - an important event - to the recipient, in which an intellectual employment
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ABSTRACT
The aim of the research is to identify the impact of the areas of organizational change in strategic marketing planning in cement factories operating within the city of Al-Khums, and this effect was measured using a questionnaire consisting of 28 phrases, and it was relied on the descriptive approach that suits the nature of the subject of the research, while the research community consists of heads And members of the board of directors, authorized managers, unit managers and heads of departments in the factories under study, which numbered 55 respondents, during the month of September of the year 2021, and a sample of the compreh
... Show Moreاستهدف البحث تشخيص وتحليل الاسباب التي تجعل المرأة العراقية أكثر تأثراً من الرجل بعوامل التغيرات المناخية، فضلاً عن زيادة الوعي بقضية المرأة في هذا المجال، لأن موضوع دمجها في صياغة السياسات والاستراتيجيات المتعلقة بالتغير المناخي أصبح قضية عالمية، ويحتل مرتبة متقدمة في مؤشرات تحقيق أهداف التنمية المستدامة، وأستخدمت الباحثة المنهج الوصفي والتحليلي والاحصائي في تحليل محاور البحث، وتوصل البحث الى إستن
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