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.
Many cities suffer from the large spread of slums, especially the cities of the Middle East. The purpose of the paper is to study the reality of informal housing in Al-Barrakia and the most important problems that it suffers from. The paper also seeks to study the presence or absence of a correlation between urban safety indicators and urban containment indicators as one of the methods of developing and planning cities. This can be achieved through sustainable urban management. The slums are a source of many urban problems that threaten the security and safety of the residents and represent a focus for the concentration of crimes and drugs. The paper seeks to answer the following question: How can urban safety be improved through urban cont
... Show MoreThe researcher studies and explains the content of some pictures that are published in al-Mada newspaper. The research is important as it deals with a topic that has a relation with visual culture and its role to transfer the press letter to the audience. The researcher finds that cartoonist exposed the security services through important people who have a major role in state policy and reveals the level of corruption and the weak treatments for this phenomenon and its reflection on the whole society and individuals. In addition to that, cartoonists try to encourage the public for going on the peaceful demonstrations since it is a good tool to make pressure on the government to punish the corrupts.
The formula is effective in Surat Nisa
(A study of gramophone)
in the name of o Allah the Merciful
Praise be to Allah, Lord of the Worlds, and prayers and peace be upon the Seal of the Prophets and Messengers. The envoy is a mercy to the worlds Muhammad Sadiq Al - Amin and to the pure and good companions of the Tayyibites.
The formula of the morphological formulas, which have diverged from other meanings, whether lexicon or contextual and what this formula contains many meanings (effective source) and (effective in the sense of effective) and (effective sense reactor) and (effective sense) and ( (F) in the sense of a similar character) and ((the name of the) (collect). This was dealt with in the formula in Surat al-Nisaa
Objective: The aim of this study is to find out the impact of life events upon onset of depression, to describe the
prevalence of life events among depressed patients.
Methodology: Retrospective a case-control study conducted in AL-Diwanyia Teaching Hospital, Psychiatric
Department on A non-probability (purposive sample) of (60) depressed patients and (60) of healthy person were matched
with them from general population. The data were collected through the use of semi-structured interview by
questionnaire, which consists of two parts (1) divide, section A. cover letter and B. Sociodemographic data which consists
of 9-items, (2) Life events questionnaire consists of 51-items distributed to six dimensions include, family
Praise be to God, prayer, and peace be upon the Messenger of Allah and his God and his companions. The field of the judiciary to prove or invalidate some cases in the field of proof of descent and attachment to the plaintiff or exile, and other legal and judicial issues, especially in this era where the spread of previously unknown evidence, such as DNA, which was discovered in 1953, and the genetic fingerprint discovered 1984, blood analysis and a Saliva, sweat, poetry, etc. in the field of forensic evidence, in forensic medicine or medical expertise, it can be used to identify the killer, or verify his identity, using all the evidence in the scene, such as a point of blood or sweat, and the like So, as well as to prove the lineage is u
... Show MorePharmaceutical companies assign a budget for activities and promotions that aim to change the prescription habits of the physicians to choose the most suitable medications for their patients, which will eventually grow their sales. The study's objectives were to explore physicians' and medical representatives' perspectives on the criteria of impactful professional PP and the factors influencing the interaction between physicians and medical representatives. Qualitative in-depth interviews with flexible probing techniques were carried out in 2023. A semi-structured, open-ended interview questionnaire was used to interview physicians and medical representatives (MRs) from different private clinics in several governorates in Iraq. Ten physicia
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the Objective of study is to measure the quality of medical service level, in the Iraq public hospitals ,presented by special words ,private hospitals, and compare between them, by knowing the level of recipients satisfaction of medical service for all dimensions of quality service, and then measuring satisfaction with the quality of medical service as a whole for both of them, which have been prepared in questionnaire form, included two main directions, first to determine the level of satisfaction when, recipients of medical service is not dimensions quality of service in accordance with the Scale Servqual by (Parasurman et .al 1988), consisting of five di
... Show MoreIntroduction : Astrocytomas are the most common primary tumor of the central nervous system,the distinction between them relies mainly on both genetic and histological criteria. However, diagnosis absolutely based on histology has a high interobserver variations and remains problematic even for an experienced neurological pathologist. The objective of this study: To assess the immunohistochemical expression of Ki67 as proliferative markers to study proliferative activity and CD31 as an endothelial cell marker for the sake of studying vascular proliferation in astrocytomas interrelated with some clinicopathological parameters (age, gender, site of the tumor, and tumor grade) in Iraqi patients, will aid in identifying the prognosis for pat
... Show MoreThe bandwidth requirements of the telecommunication network users increased rapidly during the last decades. Optical access technologies must provide the bandwidth demand for each user.The passive optical