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.
Vaccine hesitancy poses a significant risk to global recovery from COVID-19. To date however, there is little research exploring the psychological factors associated with vaccine acceptability and hesitancy in Iraq.
To explore attitudes towards COVID-19 vaccination in Iraq. To establish the predictors of vaccine uptake and vaccine hesitancy in an Iraqi population.
Using a cross-sectional design, 7,778 participants completed an online questionnaire exploring their vaccination status, likelihood of infection, perc
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Drones play a vital role in the fundamental aspects of Industry 4.0 by converting conventional warehouses into intelligent ones, particularly in the realm of barcode scanning. Various potential issues frequently arise during barcode scanning by drones, specifically when the drone camera has difficulty obtaining distinct images due to certain factors, such as distance, capturing the image whilst flying, noise in the environment and different barcode dimensions. In addressing these challenges, this study proposes an approach that combines a proportional–integral–derivative (PID) controller with image processing techniques. The PID controller is responsible for continuously monitoring the camera’s input, detecting the difference
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This research aims to test the relationship between "relational leadership as an independent variable and organizational energy as a dependent variable. The current research variables are among the recent and important variables for the development of organizations, and for the purpose of explaining the relationship and influence between the variables, a set of goals has been formulated, including providing the interested and scientific and theoretical information explaining the nature of the variables The research, and the extent to which its causes are reflected in the research sample to increase the interest of the research organization’s organization and make it more appropriate to the required performance in light of a cha
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Back ground: Diabetic nephropathy is rapidly becoming the leading cause of end-stage renal disease (ESRD). The onset and course of DN can be ameliorated to a very significant degree if intervention institutes at a point very early in the course of the development of this complication.
Objective: The aim of this study was to characterize risk factors associated with nephropathy in type I diabetes and construct a module for early prediction of diabetic nephropathy (DN) by analyzing their risk factors.
Methods: Case control design of 400 patients with type I diabetes mellitus (IDDM), aged 19-45 years. The cases were 200 diabetic patients with overt protein urea while the controls were 200 diabetic patients with no protein urea or micr
Negotiation is considered as one of the most important kinds of communication in the contemporary organizations, which depend on the important role of managerial information systems in providing necessary and suitable information for success of the negotiation process.
Accordingly, this study aims at measuring the extent of the variables effect of managerial information system in the negotiation process.
To achieve this study, two hypotheses were chosen; the first is the correlation relation and the second is the effect, and statistical means represented by correlation coefficient "Spearman" and (R2) were used.
A Number of conclusions were
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The aim of the research is to demonstrate the impact of the dimensions of the marketing vigilance represented by (environmental scanning, diagnostic capacity, validity and decision-making) and to attract deposits represented by (customer relationship management strategy, distribution strategy (location), promotion strategy), as the research was applied in each of Banks (Assyria International, Iraqi Middle East Investment, Business Bay, Iraqi Investment, Babel, Al Mansour Investment), and the questionnaire was adopted as a main tool for collecting data and information from a sample of (110) who are in the position (department manager, department manager, assistant Section Director, Division Officer, Unit Officer), and the statistical prog
... Show Moreتعد الملابس وسيلة هامة لكل مايقوم به الانسان في حياته العامة ، فهي الانطباع والكلمة الخارجية عن ذاته الداخلية فهي تعكس فكرة الفرد عن ذاته وعن شخصيته , كما تعد وسيلة تعبير جمالية وفنية , فهي تساعد على اخفاء عيوب الجسد وابراز محاسنه . ويتوقف اختيار الفرد لملابسه على مجموعة عوامل منها احتياجه , قدراته المالية , سنه , مركزه الاجتماعي , طبيعة عمله ,الظروف الجوية التي يعيش فيها وعلى مايُؤمن به من قيم و
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