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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Objectives: The study objectives are to determine the impact of education program upon the academic nurses'
practice concerning documentation of nursing sheets, and to find out the relationship between nurses knowledge
and their demographic characteristics, which include age, sex, and years of experience in medical and surgical
wards.
Methodology: A quasi- experimental study was carried out at the medical and surgical wards in teaching
hospitals in Sulaimani governorate from the beginning of March up to June 2007٠
To reach the objectives of the study anon-probability (purposive) sample of (25) academic nurses who work in
the medical and surgical wards in teaching hospitals.
The data were collected through the use
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Surge pressure is supplemental pressure because of the movement of the pipes downward and the swab pressure is the pressure reduction as a result of the drill string's upward movement. Bottom hole pressure is reduced because of swabbing influence. An Investigation showed that the surge pressure has great importance for the circulation loss problem produced by unstable processes in the management pressure drilling (MPD) actions. Through Trip Margin there is an increase in the hydrostatic pressure of mud that compensates for the reduction of bottom pressure due to stop pumping and/or swabbing effect while pulling the pipe out of the hole. This overview shows suggested mathematical/numerical models for simulating surge pressure problems ins
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Foreign direct investment (FDI) has been viewed as a power affecting economic growth (EG) directly and indirectly during the past few decades. This paper reviewed an amount of researches examining the relationships between FDI and EG, especially the effects of FDI on EG, from 1994 up to 2012. The results show that the main finding of the FDI-EG relation is significantly positive, but in some cases it is negative or even null. And within the relation, there exist several influencing factors such as the adequate levels of human capital, the well-developed financial markets, the complementarity between domestic and foreign investment and the open trade regimes, etc.
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The current study included a review of the registration and description of the Theretra alecto Boi, 1827 (Levant hawk moth), samples were collected from various areas of the Baghdad belt and the provinces of the Middle Euphrates, confirmation in the description was on the most important parts of the body included the head and it's appendages, pronotum, wings as well as male and female genitalia. The morphological characteristics under study were enhanced by illustrations and images. Information on the locations and date of the collection was also confirmed. This study aims to identify the most important characteristics of the diagnosis of the species and the review of appearance variations, especially the analytical style of wings, coupling
... Show MoreType 2 diabetes is a global public health problem especially in middle east countries and Iraq has not spared from this pandemic. The prevalence in Iraq. and rank in Middle East. Beside increasing in prevalence- also poor glucose control. Nutrition plays a critical role. This paper narratively review variables that affect reduce the incidence of T2DM in Iraq and affect nutritional status among Iraqi withT2DM. The factors contribute to T2DM were high rates of obesity and overweight, as well as levels of body fat indicate a high prevalence of poor glycemic control. Likewise, levels of physical activity are low among older Iraqis.
Objective: To review and see the pattern of histopathological diagnoses of one year appendectomy specimens.
Methodology: This retrospective study was carried in Sulaimani Teaching Hospital over the period of one year (from 1st
of January to 31st of December 2009). All pathological reports were reviewed retrospectively for patient’s age, sex,
histopathological diagnosis and operative findings (if present). Histopathological diagnoses then were classified into
either positive or negative for acute inflammation. Any associated findings or any surgical specimen removed with the
appendix was recorded. The obtained data were analyzed by using the statistical package social sciences (SPSS) version
19; with Chi square to test
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