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.
This research deals with the rhetoric purposes of the passive voice in the holy Quran. First, we put an introductory to the concept of the Quran language and its difference of the spoken Arabic language during the revelation period. Besides; we gave a brief about the structure passive voice form of Arabic language. Second, we explained the purposes of passive voice used in the holly Quran with sufficient examples, commentaries and clarifications about all the cases. Rhetoric purposes that we deals with are: concision, emphasize an idea, avoid using the subject because it is known and clear for all or because it is really unknown, etc. This part has contained the most important purposes for the use of passive voice in holy Quran. At the end
... Show MoreOver the years, the issue of inclusion of students with special educational needs (SEN) in mainstream schools is controversial worldwide. Evidence from research argues that without a positive teachers’ attitude towards the inclusion of students with SEN in mainstream schools, the successful implementation of inclusion is most likely doubtable. The aim of this paper is to understand teachers’ attitudes towards the inclusion of students with SEN in mainstream schools from different perspectives and from different contexts. The conclusion drawn in this review can be that teachers’ attitude is the most important key towards the appropriate inclusion implementation in mainstream schools. The disparity of teachers’ attitudes towards th
... Show MoreAthletics are different from other games as a competition between individuals to show their competence and physical ability to achieve new record numbers in the various activities and various between the boards, jumping and throwing and each type of these activities in particular performance so found the researcher to find the method of training resistors in the development of special power and achievement In the effectiveness of javelin, where the researchers chose the sample of the athletes from the specialized school of athletics to effectively throw the spear at the ages of 15-17 years and carried out the tests of the research, which includes the strength of the speed of the arms and explosive power and The various resistance exercise
... Show MoreStream of Consciousness technique has a great impact on writing literary texts in the modern age. This technique was broadly used in the late of nineteen century as a result of thedecay of plot, especially in novel writing. Novelists began to use stream of consciousness technique as a new phenomenon, because it goes deeper into the human mind and soul through involving it in writing. Modern novel has changed after Victorian age from the traditional novel that considers themes of religion, culture, social matters, etc. to be a group of irregular events and thoughts interrogate or reveal the inner feeling of readers.
This study simplifies stream of consciousness technique through clarifying the three levels of conscious
... Show Moreيهدف البحث الحالي إلى اختبار العلاقة بين نوعية حياة العمل والإبداع التنظيمي في ديوان وزارة التخطيط ، ولبلوغ الهدف المذكور وبناء على معطيات البحث الاستطلاعي للباحث بني ألانموذج الفرضي للبحث الذي ضم المتغير المستقل والمعتمد، واعتماداً على حركية الأنموذج صيغت فرضيتان، ولاختبار صحة الفرضيات وجمع المعلومات من عينة البحث البالغة (100) مدير يمثلون مرك
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This study aims to identify the repercussions of the Corona pandemic (Covid 19) and its impact on the educational and psychological functions of the Omani family from the point of view of a number of fathers and mothers. Drive for a group of fathers and mothers, some of whom work in the government sector and others are mothers enrolled in graduate studies programs at the university, their ages range between (30-50 years) totally (28) mothers and fathers: 22 mothers and 6 fathers. The results showed that the repercussions of the transformation of e-learning, home quarantine, social distancing, and the challenges associated with them were among the most frequent responses that posed a real challenge to the
... Show MoreThis literary review addresses the status of the most famous Israeli writer, Amos Oz, through the analysis of relevant articles that highlight various aspects of his literary and political orientations, reflecting his ideological and social background. Oz's literature encompasses a mix of political orientations that many critics view as extreme, while others see them as moderate stances indicative of the author's awareness. And these are what strengthened his literary status in modern Hebrew literature.These trends emphasized the contribution of Oz's works to shaping Israeli cultural consciousness and reflect the challenges facing identity in multiple contexts. He was an advocate for equality between Palestinians and Israelis and
... Show MoreThis work addressed the assignment problem (AP) based on fuzzy costs, where the objective, in this study, is to minimize the cost. A triangular, or trapezoidal, fuzzy numbers were assigned for each fuzzy cost. In addition, the assignment models were applied on linguistic variables which were initially converted to quantitative fuzzy data by using the Yager’sorankingi method. The paper results have showed that the quantitative date have a considerable effect when considered in fuzzy-mathematic models.
Objectives To tailor composites of polyethylene–hydroxyapatite to function as a new intracanal post for the restoration of endodontically treated teeth (ETT). Methods Silanated hydroxyapatite (HA) and zirconium dioxide (ZrO2) filled low-density polyethylene (LDPE) composites were fabricated by a melt extrusion process and characterised using infrared spectroscopy (FTIR), differential scanning calorimetry (DSC) and dynamic mechanical analysis (DMA). The flexural strength and modulus were determined in dry state and post ageing in simulated body fluid and fractured surfaces analysed by SEM. The water uptake and radiographic appearance of the experimental composites were also measured and compared with a commercially known endodontic fibre
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