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.
Abstract
The goal of current research to describe and diagnose the level of attention of doctors to design and regulatory dimensions, (strategic vision, organizational structure, organizational processes, business systems, personnel), and the performance of hospitals and dimensions, in six hospitals in medicine and selected a sample for research, as well as identify organizational design effect in the performance of hospitals and dimensions (efficiency, the development of human resources, patient satisfaction, achieve financial results, quality of health care).
Research has focused in part theoretical on key variables to look organizational des
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Objective: To find out the relationship between vaginal bleeding during third trimester and pregnancy outcomes. Methodology: A purposive sample is "Non-probability" of (100) women who had diagnostic vaginal bleeding during third trimester (27-40wk) of pregnancy, and who visited the Bint Al-Huda Hospital for the period from 15th Feb. to 17th May 2015.Validity and reliability of questionnaire are determined through pilot study. Descriptive and inferential statistical procedures were used to analyze the data, and the data were collected by using interview technique, constructed questionnaire has been desig
Background: Tumor necrosis factor-alpha (TNF-α) and interleukins play important roles in the pathogenesis of rheumatoid arthritis (RA). Genetic research has been employed to find many of the missing connections between genetic risk variations and causal genetic components. Objective: The goal of this study is to look at the genetic variations of TNF-α and interleukins in Iraqi RA patients and see how they relate to disease severity or response to biological therapy. Method: Using specific keywords, the authors conducted a systematic and comprehensive search to identify relevant Iraqi studies examining the genetic variations of TNF-α and interleukins in Iraqi RA patients and how they relate to disease severity or response to biolo
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The field study of this paper focused on the motives for lawyers to use the website
of the Supreme Judicial Council, and the gratifications achieved as a result of its use.
This study sought to achieve a number of goals, including:
1. Monitoring the patterns of lawyers’ use of the website of the Supreme Judicial Council.
2. Determining the forms that lawyers use to interact on the website of the Supreme
Judicial Council.
This study is a descriptive in kind as the researcher relied on the ‘survey method’ in
its study of the external audience (lawyers) using the questionnaire and scale toolThe questionnaire was distributed among a deliberately chosen sample, consisting of
(160) lawyers who used the website of
In this work the strain energy of tetrahedrane and its nitrogen substituted molecules were calculated by isodesmic reaction method according to DFT quantum chemical fashion, the used basis set was 6-31G/B3-LYP, in addition all structures were optimized by RM1 semi-empirical method. From the obtained data we estimate an empirical equation connect between strain energy of the molecule with charge functions represented by dipole moment of the molecule plus accumulated charge density involved within the tetrahedron frame plus the number of nitrogen atoms. The results indicate the charge spreading factors by polarization and processes are the most important factors in decreasing the strain energy.
This research aimed to definite Blending learning (BL) technique, and to know the impact of its use onacademic achievement in Biology course of second class students in secondary special schools in Omdurman Locality and attitudes towards it, to achieve this; researcher adopted the experimental method. The sample was selected of (41) students, chosen from Atabiyah school, were divided into two equals groups: one experimental group reached (26) students studied by using the BL technique, and the second control group (25) students have been taught in the traditional method.
Data has collected by using two tools: achievement test and a questionnaire for measuring the attitudes towards Blend
... Show MoreSorting and grading agricultural crops using manual sorting is a cumbersome and arduous process, in addition to the high costs and increased labor, as well as the low quality of sorting and grading compared to automatic sorting. the importance of deep learning, which includes the artificial neural network in prediction, also shows the importance of automated sorting in terms of efficiency, quality, and accuracy of sorting and grading. artificial neural network in predicting values and choosing what is good and suitable for agricultural crops, especially local lemons.
This study was conducted to make an inventory of the monocot plants that were collected before and now which stored in the herbarium of Iraq Natural History Museum for identifying them. The herbarium contains avery large and varied number of plants from different parts in Iraq and for different and varied environments. The plants collected, arranged and identified using taxonomic keys specific to these families. Currently, the plant samples are in the herbarium of Iraq Natural History Museum to be an important scientific reference for all researchers inside and outside the country. With the identification of botanical scientists for each family, gender and year in which it was first diagnosed.
This study aimed to make an inventory of leguminous plants for the purpose of identifying the plants that were collected over long periods and stored in the herbarium of Iraq Natural History Museum. It was found that the herbarium contains a large and varied number of plants from different parts of Iraq and in different and varied environments. It was collected and arranged according to a specific system in the herbarium to remain an important source for all graduate students and researchers to take advantage of these plants. Also, the flowering and fruiting periods of these plants in Iraq were recorded for different regions. Most of these plants begin to flower in the spring and thrive in fields and farms.
The "Nudge" Theory is considered one of the most recent theories, which is clear in the economic, health, and educational sectors, due to the intensity of studies on it and its applications, but it has not yet been included in crime prevention studies. The use of Nudge theory appears to enrich the theory in the field of crime prevention, and to provide modern, effective, and implementable mechanisms.
The study deals with the "integrative review" approach, which is a distinctive form of research that generates new knowledge on a topic through reviewing, criticizing, and synthesizing representative literature on the topic in an integrated manner so that new frameworks and perspectives are created around it.
The study is bas
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