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.
The worsening of environmental problems has led to them being addressed by many entities, the most important of which are the top regulators. Federal Board of supreme audit Office is one of the most important regulators in Iraq. The problem of the research was the fundamental question of the extent to which the Federal Financial Supervisory Office was committed to implementing and exercising environmental control over the audited ones. The refore, the research was based on the main objective of questioning the role of the Federal Financial Supervisory Office in the exercise of environmental control and the compliance of those under its control, by identifying the antosai standards for environmental control, particularly the stand
... Show MoreArt education is one among the fundamental subjects for elementary school students, because it contributes to assembling learners’ personalities and developing their technical skills. For this reason, this research comes, which aims to understand the effect of the task groups’ strategy in developing the performance of elementary school students in art education. to realize the goal of the research, the researcher put the subsequent hypotheses:
-There is not any statistically significant difference at the amount (5%) between the typical many students between the experimental group that studied consistent with the strategy of task groups and therefore the control group that studied in keeping with the same old method that they obt
In this research we assumed that the number of emissions by time (𝑡) of radiation particles is distributed poisson distribution with parameter (𝑡), where < 0 is the intensity of radiation. We conclude that the time of the first emission is distributed exponentially with parameter 𝜃, while the time of the k-th emission (𝑘 = 2,3,4, … . . ) is gamma distributed with parameters (𝑘, 𝜃), we used a real data to show that the Bayes estimator 𝜃 ∗ for 𝜃 is more efficient than 𝜃̂, the maximum likelihood estimator for 𝜃 by using the derived variances of both estimators as a statistical indicator for efficiency
Many studies and researchers have reported significant evidence that some physical properties of water can be changed as it passes through a magnetic field that can improve water use. This can have a promising potential for applications, especially in the fields of irrigation and drainage. In this research, magnetized water was used to leach salt-affected sandy loam soil. A test rig was designed and constructed to investigate the effects of magnetized water on leaching soil. The rig consists of a magnetization device that can provide variable intensity. Water was supplied from a constant head reservoir to the magnetization device then to the soils that were placed in plastic columns. Five different magnetic intensi
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Abstract
This study aims to identify the degree to which the first cycle teachers use different feedback patterns in the e-learning system in addition to the differences in the degree of use according to specialization, teaching experience, and in-service training in the field of classroom assessment, as well as the interaction between them. The study sample consisted of (350) female teachers of the first cycle in government schools in Muscat Governorate for the academic year 2020/2021. The study used a questionnaire that contained four different patterns of feedback, which are reinforcement, informative, corrective, and interpretive feedback. The psychometric properties of the que
... Show MoreThe infrastructure is one of the basic components of the tourism industry in Iraq in general and in Najaf in particular, in spite of there are obstacles and problems that which are hindered the development of tourism in Iraq, some of them are related to the tourism industry itself, some are related to the security and political situation, and some are related to poor management of tourism. However, the infrastructure is considered the cornerstone of the success of the tourism industry in Iraq and other countries, if it is available, it can be a potential indicator of success, and on the contrary, it is a hindrance to go forward. The aim of this research is to shed light on the availability of requirements for the s
... Show MoreSince the advent of the sunrise of the immortal message, Islamic legislation has always established justice and the right guidance, and has prevented any perversion, injustice or corruption, with a divine system that called in its course the characteristics of the legislation on its general basis and its ability to develop, progressivity, and paving the way with a collective approach, accompanied by the worldly and moral punishment. When the corrupters went too far, reformers were delayed and values were missed; Mankind has been afflicted with the scourge of injustice and loss, and has lost sight of the approach that the Creator of the world has given to the people of the world, for what would guide them in their affairs sooner and later
... Show MoreThe research aims to identify the concept of green taxes and their role in reducing environmental pollution through the poll of Abnh of taxpayers and employees of the General Authority for taxes totaling 200 individual .autam adoption of the resolution as a tool head for the collection of data and information from the sample and analyzed their responses using a statistical program (spss - 10), and calculating the percentages and the arithmetic mean, standard deviation and research found to a number of conclusions, notably the lack of legislation with the challenges and the difficulty of the existence of a measure or a standard lack of planning for the application of environmental taxes that the state taxation application between the Gene
... Show MoreThis study investigates the treatment of used lubricating oils from AL-Mussaib Gas Power Station Company-Iraq, which was treated with different extractive solvents (heptane and 2-propanol). The performance activity of these solvents in the extraction process was examined and evaluated experimentally. Operating parameters were solvent to oil ratios of (1:2, 1:4, 1:6, and 1:8), mixing time (20, 35, 50, and 65 min), temperatures (30, 40, 50, and 60 ºC), and mixing speed (500 rpm). These parameters were studied and analyzed. The quality is determined by the measuring and assessment of important characteristics specially viscosity, viscosity index, specific gravity, pour point, flash point, and ash content. The results confirm that the
... Show MoreBox-Wilson experimental design method was employed to optimized lead ions removal efficiency by bulk liquid membrane (BLM) method. The optimization procedure was primarily based on four impartial relevant parameters: pH of feed phase (4-6), pH of stripping phase (9-11), carrier concentration TBP (5-10) %, and initial metal concentration (60-120 ppm). maximum recovery efficiency of lead ions is 83.852% was virtually done following thirty one-of-a-kind experimental runs, as exact through 24-Central Composite Design (CCD). The best values for the aforementioned four parameters, corresponding to the most restoration efficiency were: 5, 10, 7.5% (v/v), and 90 mg/l, respectively. The obtained experimental data had been
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