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.
The investment however "was its description and meaning, it remains a resident" in the composition of capital assets located in the forefront of the creation of productive assets, and this means that the investment in the productive sectors is a priority in achieving capital accumulation, on any other investment that takes place with the stages of advanced development of formation , not forgetting "to humans and investment humans as head of real money product, the source of the economic surplus and accumulation, and the source of producing values, and if human labor was the source of value, and the human was the source of work, therefore humanitarian work on different levels and skills presents capital", so the investment in huma
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The petroleum industry, which is one of the pillars of the national economy, has the potential to generate vast wealth and employment possibilities. The transportation of petroleum products is complicated and changeable because of the hazards caused by the corrosion consequences. Hazardous chemical leaks caused by natural disasters may harm the environment, resulting in significant economic losses. It significantly threatens the aim for sustainable development. When a result, determining the likelihood of leakage and the potential for environmental harm, it becomes a top priority for decision-makers as they develop maintenance plans. This study aims to provide an in-depth understanding of the risks associated with oil and gas pipeli
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The manganese doped zinc sulfide nanoparticles were synthesized by simple aqueous chemical reaction of manganese chloride, zinc acetate and thioacitamide in aqueous solution. Thioglycolic acid is used as capping agent for controlling the nanoparticle size. The main advantage of the ZnS:Mn nanoparticles of diameter ~ 2.73 nm is that the sample is prepared by using non-toxic precursors in a cost effective and eco-friendly way. The structural, morphological and chemical composition of the nanoparticles have been investigated by X-ray diffraction (XRD), Scanning Electron Microscopy (SEM) with energy dispersion spectroscopy (EDS) and Fourier transform infrared (FTIR) spectroscopy. The nanosize of the prepared nanoparticles was elucidated by Scan
... Show Moreالانهار اصبحت مشبعة بثاني اوكسيد الكربون بشكل عالي وبذلك فهي تلعب دور مهم في كميات الكربون العالمية. لزيادة فهمنا حول مصادر الكربون المتوفرة في النظم البيئية النهرية، تم اجراء هذه الدراسة حول تأثير الكربون العضوي المذاب والحرارة (العوامل الرئيسية لتغير المناخ) كمحركات رئيسية لوفرة ثاني اوكسيد الكربون في الانهار. تم جمع العينات من خمسة واربعون موقع في ثلاثة اجزاء رئيسية لنهر دجلة داخل مدينة بغداد خلال فص
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This study aims at identifying the notion of Post-Occupancy Evaluation (POE) pertinent to the performance of three general hospitals constructed inside the Sulaimani City, tracing the relationship between the quality of the indoor environments and medical staff (doctors and nurses) satisfaction level. Using some indoor environment elements in the right way will positively influence the mood, stress level of the medical staff, and patient recovery as a result. The POE toolkits (AEDET and ASPECT) have been implemented on targeted wards at the selected hospitals. AEDET and ASPECT questionnaires were distributed among 152 medical staff to obtain their perspectives. In total, 112 valid questionnaires were received. The medica
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Medicine is one of the fields where the advancement of computer science is making significant progress. Some diseases require an immediate diagnosis in order to improve patient outcomes. The usage of computers in medicine improves precision and accelerates data processing and diagnosis. In order to categorize biological images, hybrid machine learning, a combination of various deep learning approaches, was utilized, and a meta-heuristic algorithm was provided in this research. In addition, two different medical datasets were introduced, one covering the magnetic resonance imaging (MRI) of brain tumors and the other dealing with chest X-rays (CXRs) of COVID-19. These datasets were introduced to the combination network that contained deep lea
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The research aims to identify the level of awareness of student teachers in the behavioral disorders and autism specialization about the diagnosing Autism Spectrum Disorder and Social (Pragmatic) Communication Disorder according to some variables. The study was conducted on a sample of (113) student teachers. The researcher employed the awareness scale of a teacher-screening questionnaire for autism spectrum disorder and social pragmatic communication disorder. The results showed that the average of teachers in the total degree of awareness of autism spectrum disorder and social communication have recorded a moderate degree. As for the awareness of autism spectrum disorder was high. Then, the awareness of social communication disorder wa
... Show MoreNonmissile penetrating spine injury (NMPSI) represents a small percent of spinal cord injuries (SCIs), estimated at 0.8% in Western countries. Regarding the causes, an NMPSI injury caused by a screwdriver is rare. This study reports a case of a retained double-headed screwdriver in a 37-year-old man who sustained a stab injury to the back of the neck, leaving the patient with a C4 Brown-Sequard syndrome (BSS). We discuss the intricacies of the surgical management of such cases with a literature review.
PubMed database was searched by the following combined formula of medical subjects headings,
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This research study examines the impact of information technology on firm profitability and stock returns. Using a comprehensive dataset of firms across various industries, this research employs rigorous statistical analysis techniques to investigate the relationship between IT investments, firm profitability metrics, and stock returns. The study focuses at how IT investments affect financial performance measures including return on assets (ROA) and return on equity (ROE), with P-values of 0.34 and 0.12, respectively. Furthermore, the study investigates the influence of IT on stock returns, taking into account market capitalization, industry trends, and macroeconomic variables. This study's conclusions center on the beneficial assoc
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