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.
As a consequence of a terrorist attack, people may experience posttraumatic stress disorder (PTSD) and lack of feeling secure in relationships. This longitudinal study aimed to examine the prevalence of PTSD symptoms over time, the relationship between adult attachment styles and PTSD, as well as their association with degree of exposure, and finally to consider the distribution and the trajectory of attachment styles. The sample consisted of 235 students (M=125, F=110) who were exposed to different levels of trauma intensity in response to a bombing attack. Participants were recruited and assessed approximately 1 month and 5 months after the attack using a battery of questionnaires. Findings revealed, as expected, that 79.5% of the part
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Comics is a visual art (Still and motion pictures) it seeks to provide a Training courses are a series of intensive important educational and complementary programs, based on previous foundation experiences. Create to development the participants in aspects of specialization according to the requirements of the educational system to continue developing the previous scientic and practical experiences. Personally, or adopted by the trainee institution, where the trainee gets a professional skill certicate that contributes to the development his work.Development and Continuous Education Center (DCEC) at the University of Baghdad (UoBaghdad) is a center dedicated to continuing education courses in which the participant is awarded a cert
... Show MoreBackground: Despite the importance of vaccines in preventing COVID-19, the willingness to receive COVID-19 vaccines is lower among RA patients than in the general population. Objective: To determine the extent of COVID-19 knowledge among RA patients and their attitudes and perceptions of COVID-19 vaccines. Methods: A qualitative study with a phenomenology approach was performed through face-to-face, individual-based, semi-structured interviews in the Baghdad Teaching Hospital, Baghdad, Iraq, rheumatology unit. A convenient sample of RA patients using disease-modifying anti-rheumatic drugs was included until the point of saturation. A thematic content analysis approach was used to analyze the obtained data. Results: Twenty-five RA pa
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Surrealism is a twentieth-century literary and artistic movement oriented toward the liberation of the mind. Surrealism is a reaction to the philosophy of rationalism which was believed to be the cause of the disaster of World War I. It emphasizes the expression of the imagination as revealed in dreams and presented without conscious control, the unexpected juxtapositions of objects, the withdrawal of the self, and the exploitation of chance effects.
Surrealism began in Paris in the early 1920s, as Europe emerged from the devastation of World War I. A group of writers, artists, and filmmakers, led by the poet André Breton, adopted the word surréaliste (meaning, roughly, "super-real") as a label for their artistic activities. Influen
The aim of this paper to study the effect of the implicit factors on the entrepreneurial spirit of the students of the Algerian university. Our structural model was proposed based on the model (Shapiro et Sokol, 1982) and the model (Ajzen, 1991). We tested it on a sample of 163 university students at the University of Algiers 3. The model consists of a set of variables (the intention of contracting as a dependent variable, structural and social educational support as independent variables). The results showed that educational and social support factors affect the entrepreneurial spirit of students more than structural support. The Applied Impacts are the enhancing of knowledge capacities of university stu
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The personality characteristics of the Leader are considered one of the main elements to reach into business organizations entrepreneurship; and because of the development of the organizations of the continuous transformations as result of huge Competition in private High Education sector, there is a great need for Leaders characterized of certain personality capable of managing their organizations and can positively effect on them. Also these organizations' success to reach into entrepreneurship requires a main significant element that is (strategic flexibility) which is considered one of the important elements for success.
Accordingly, this research is trying to fin
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This research was carried out to study the effect of plants on the wetted area for two soil types in Iraq and predict an equation to determine the wetted radius and depth for two different soil types cultivated with different types of plants, the wetting patterns for the soils were predicted at every thirty minute for a total irrigation time equal to 3 hr. Five defferent discharges of emitter and five initial volumetric soil moisture contents were used ranged between field capacity and wilting point were utilized to simulate the wetting patterns. The simulation of the water flow from a single point emitter was completed by utilized HYDRUS-2D/3D software, version 2.05. Two methods were used in developing equations to predict the domains o
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