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.
This research studies the effect of addition of some nanoparticles
(MgO, CuO) and grain size (30,40nm) on some physical properties
(impact strength, hardness and thermal conductivity) for a matrix
blend of epoxy resin with SBR rubber. Hand –Lay up method was
used to prepare the samples. All samples were immersed in water for
9 weeks.
The Results showed decreased in the values of impact strength and
hardness but increased the coefficient of thermal conductivity.
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The intellectual and religious characteristics were an influential presence in the same Andalusian poet, especially among the poets of Beni El-Ahmar because they are part of the heritage of poets, and that is to push them towards the glory of this heritage and to take care of it and benefit from its inclusion, inspiration and similarity.
That this inflection on the poetic heritage is justified by the poets of the sons of the Red were inclined to preserve the inherited values, especially as it was related to their poetry, especially that the Andalusian poet did not find embarrassment in the inspiration of heritage and emerged when he mentioned the homes and the ruins and the camel and the journey, although the community Andalusian
... Show Moreknowledge management and managers have a primary school principals from the standpoint of their assistants M . Dr. Suad Vegetables Abbas Research problem: The administration school require a leader administratively The efficiency and skills of management and knowledge to make it effective in the administration follows the scientific method and knowledge of those who through administrative methods emanating from the trends of modern management in the management of educational , as well as the presence of the leaders of effective management has the knowledge and know-how administrative work and how to deal with others and investment optimized for all of the resources available through the future capable of Orientalism to the extent that ou
... Show MoreCase Report.
To present a case of a previous complicated mandibular orthognathic surgery that aimed to setback the mandible in a female cleft lip and palate (CLP) patient, which led to bone necrosis on one side with subsequent severe mandibular deviation and facial asymmetry. We additionally reviewed the previous reports of similar complications, the pathophysiology and the factors that could lead to this dreadful result.
A 27-year-old female patient presented with a severe dentofacial deformity secondary to a complicated bilateral sagittal spli
In solar-thermal adsorption/desorption processes, it is not always possible to preserve equal operating times for the adsorption/desorption modes due to the fluctuating supply nature of the source which largely affects the system’s operating conditions. This paper seeks to examine the impact of adopting unequal adsorption/desorption times on the entire cooling performance of solar adsorption systems. A cooling system with silica gel–water as adsorbent-adsorbate pair has been built and tested under the climatic condition of Iraq. A mathematical model has been established to predict the system performance, and the results are successfully validated via the experimental findings. The results show that, the system can be operational
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Background: One way to target polypharmacy and inappropriate medication in hemodialysis (HD) patients is with medication deprescribing. Objective: To assess the impact of implementing a pharmacist-led deprescribing program on medication adherence among HD patients. Method: A prospective interventional, one-group pretest-posttest-only design study was conducted at a hemodialysis center in Wasit Governorate, Iraq. Medication reconciliation followed by medication review based on the deprescribing program was done for all eligible patients, and the patients were monitored for three months for any possible complications. Results: Two hundred and seventy patients were screened for eligibility. Only one hundred and eighteen were enrolled i
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Multiple myeloma is hematological disease produces many complications in the bone, kidney, neural and other complications. The study aims to measure serum biomolecules like fetuin-A and resistin and determined the possibility to use these biomarkers as disease predictor. blood samples were isolated from 58 patients and 24 sex and age-matched control, serum then isolated, and proper ELISA kit then used to a determined level of B2 microglobulin, resistin, and fetuin-A. The result demonstrated significant increase in B2 microglobulin, fetuin-A and resistin in patients compare to control (1.3470.714 vs. 0.9130.253), p = 0.000, (14.00310.352 vs. 9.2594.264), p= 0.005, (1.9673.595 vs. 0.6040.622), p = 0.009, respectively. &
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In Iraq, because of the dramatic turnovers facing the country for three decades, pharmacists continue to experience significant professional challenges in both the public and private sectors. The present study aimed to explore the professional challenges and obstacles facing Iraqi pharmacists working in public hospitals. This qualitative study included face-to-face semi-structured interviews with open-ended questions with hospital pharmacists. The participants were selected purposefully (with ≥ 3 years of experience) to work at governmental hospitals in Karbala province between December 2022 and April 2023. The audio-recording interviews were scripted. Thematic analyses were used to generate themes and subthemes from the interview
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