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
Our description of the wxperience of any poet depends on the nature the anture of his writing or his style in terms of factors affecting his experience . We have found that al- Maghout is characterized by important poetis properties that characterized all of his poetry such as the ease in compositions that are formed the vocabulary of daily life . This is what constitutes his poetic lexicon that depends on the vocabulary of space , time , and anture . Hispoetry derives its aesthetics from revealing that strains in the text for the sake of surprise and amazement with a simple realism.
The Coronavirus Disease 2019 (COVID-19) pandemic has caused an unprecedented disruption in medical education and healthcare systems worldwide. The disease can cause life-threatening conditions and it presents challenges for medical education, as instructors must deliver lectures safely, while ensuring the integrity and continuity of the medical education process. It is therefore important to assess the usability of online learning methods, and to determine their feasibility and adequacy for medical students. We aimed to provide an overview of the situation experienced by medical students during the COVID-19 pandemic, and to determine the knowledge, attitudes, and practices of medical students regarding electronic medical education.
... Show MoreHTH Ahmed Dheyaa Al-Obaidi,", Ali Tarik Abdulwahid', Mustafa Najah Al-Obaidi", Abeer Mundher Ali', eNeurologicalSci, 2023
The objective of this study was to evaluate the alteration in levels of gonado trophins hormones i.e.,Leutizing (LH),Follicular(FSH) in sera of patients with thyroid disorders and molecular binding study of (LH ,FSH) with their antibodies The study was conducted at the specialized center for endocrinology and diabetes from January / 2009 to March / 2010.Two hundreds and twenty three Iraqi subjects, 109 patients with thyroid disorders at age range between (40-50) years and 114 healthy individuals as control group were included in this study.The majority of patients were female with hyperthyroidism and (49.54 % ) were at age range between(40 - 50) years. The levels of hormones(LH,FSH.tri iodothyronine(T3).thyroxine(T4), thy
... Show MoreAbstract The goal of current study was to identify the relationship between addiction of self-images (Selfie) and personality disorder of narcissus, and the difference of significance the relationship between addiction self-images (selfie) and personality disorder narcissus at students of Mustansiriya university, addiction self- images (selfie) defined: a photograph that one has taken of oneself, typically one taken with a smartphone or webcam and shared via social media, edit and down lowed to social networking sites, and over time, the replacement of normal life virtual world, which is accompanied by a lack of a sense of time, and the formation of repeated patterns increase the risk of social and personal problems. To achieve the goals
... Show MoreBackground: Myocardial infarction (MI) is distinguished by the necrosis of myocardial cells as a result of substantial and prolonged ischemia. Anxiety, problems sleeping, and feelings of depression are some of the most common psychosocial consequences of having a myocardial infarction. Aim: The purpose of this study is to evaluate the effects of post-myocardial infarction on patients' levels of anxiety, depression, and quality of sleep. Method: The collection of data from 94 individuals with MI was carried out according to a descriptive cross-sectional design. Sleep quality, depression, and anxiety were evaluated using standard questionnaires. Results: 69.1% of the participants reported having trouble getting quality sleep. The perc
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Idiomatic expressions in Russian journalism make one important borrowed means for making a dialogue with the receiver's intellect in so far as it has the distinct feature of having clarity and exactness of meaning. The meaning is seen as a shortcut for covering a series of concepts and details so as to arrive at the intended meaning. This is done by stimulating the reader by the use of certain clear idioms. The use of such idioms in a journalistic text is not for a linguistic purpose only, but it is a cultural and social phenomenon reflecting the type of current changes in the society and it aims at discoursing with the reader's mind. This paper is a practi
... Show MoreThis study is marked by: The ignorant poem and body language
Its main objective is to reveal the manifestations of this language in the text mentioned, and accordingly, the sieve poem has been read semantic (semantic) and hermeneutic, revealing the poet's ability to employ symbols and signals (body language) in the poem chosen for this purpose; The existence of such language in pre-Islamic poetry. After a long reflection and reading, the signs and symbols of the physical movement of the body, and its feminine and aesthetic manifestations were identified, and this was achieved through the use of modern critical methodologies that directly affect this language. The study consisted of an introduction and three topics, followed by t
After completion of the artistic production, the artist plays the echo of this production upon the recipient. Whether this recipient is from the public, art connoisseurs, or private artists, critics and academics. In the past, the boundaries of Time and place had a great effect in limiting this echo or its quality, as the views of the recipients were largely influenced by the prevailing thought or the artistic trends that dominate the artistic scene in the surrounding environment in which the artist created. In order for the artist to show works for the widest segment of the recipient, he bears the burden of the costs of transporting the work, a keeper of damage on the move, and the material amounts that may hinder the publication of the
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