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 influence of process speed (PS) and tillage depth (TD) , on growth of corn (Zea mays L) yield, for Maha cultivar, were tested at two ranges of PS of 2.483 and 4.011 km.hr-1, and three ranges of TD of 15,20 and 25cm. The experiments were conducted in a factorial experiment under complete randomized design with three replications. The results showed that the PS of 2.483 km.hr-1 was significantly better than the PS of 4.011km.hr-1 in all studied conditions. The , slippage ratio (SR) and the machine efficiency (ME), the physical soil characteristics represented by the soil density and porosity (SBD and TSP), and the plant characteristics represented the roots dry weight, PVI and the crop productivity (CP), except adjective of the fu
... Show MoreThis study examines the analysis of the contents of the international public relations campaign in confronting the Covid-19 virus, which was taken from the (Your Health is a Trust) campaign for the World Health Organization, Iraq office.The research problem revolves around a main question that is, what are the axes of the campaign (Your Health is a Trust) established by the World Health Organization (Iraq office) in the prevention of Covid 19 virus?From this main question, several sub-questions emerged that this study answered on their Facebook page, and the communication activities of the Covid-19 awareness campaign. In the content analysis form, as this form included a number of main themes and main categoriesthat were adopted in analyzin
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It is essential to provide health care directly or indirectly based on laboratory tests in order of diagnosing diseases. There is an urgent need for the results of such tests to be accurate and reliable. Therefore, the International Organization for Standardization has prepared special standards for medical laboratories to prove their efficiency, presented in standards 15189: 2012. The aim of the research is to determine the possibility of the Al-alwiya Women's Hospital in meeting the requirements of the standards 15189: 2012, which includes administrative requirements consisting of fifteen items and technical requirements consisting of ten items. The research is important because laboratories shou
... Show MoreBuildings begin to deteriorate gradually over time due to several factors, including environmental influences, improper use of the building, and neglected repairs for damages during the building's life span. Effective maintenance practices can minimize operational costs, extend the life of building systems and components, improve energy efficiency, and maintain property value. This paper aims to review articles related to building maintenance to identify factors affecting maintenance practices. After conducting the review, the result was that there were 33 factors affecting building maintenance categorized into six groups: management-related factors, manpower-related factors, technical-related factors, financial-
... Show MoreThis study presented more than twenty books that dealt with the subject of (Weights of the Tawshih art), whether their study was independent and dedicated the art of Tawshih as a part of book. Therefore, the review of the sources and references on the art of the Tawshih is not specific for place or time, it was a broad and comprehensive review of all the places where the muwashahat appeared in the east and west, Andalusia was one of the most important areas covered by the study arbic Maghreb and Iraq. The art of tawshih took different forms according to the countries in which they appeared. Muwashahat is a new art that appeared in Andalusia, its main goal was to renew the Khalilian weights and to find the poetic rhythm that fits with the so
... Show MoreThe study aimed at identifying the domains of abuse of the elderly (each field separately) of the research sample. The study sample consisted of (100) senior citizens residing in nursing homes in Baghdad and Kirkuk cities. They were selected in a simple random way. In order to achieve the research objectives, two scales were developed to measure the abuse of the elderly consisted of six domains: Neglection abuse, emotional abuse, physical abuse, social abuse, financial abuse, sexual abuse), and the other to measure the life review. The results showed that the level of abuse of older people in the sample is higher than the average in the society they belong to, the level of life review was higher than the average they belong to, and the a
... Show MoreThe Ottomans ruled Turkey for nearly six centuries, during which the Ottoman Empire passed through varying periods in terms of strength, influence, and the area of land they ruled. In the last decade of its rule, the Ottoman Empire was severely weakened in all political, military, administrative and economic aspects. In addition to the internal strife that was stirred up by the leaders of the Association (Union and Progression), that organization that led the coup movement against the Ottoman Empire later.
After the abolition of the Sultanate and the proclamation of the Turkish Republic, the social fabric in Turkey changed, and many customs and traditions alien to it emerged to society. One of the thing
... Show MoreAbstract That the child is aged 7 years, surrounded by information, knowledge and skillsvaried, which constitute the raw material of experience teaching and is in the rule of inputlearning, if received by the student of these data are positive, these data require research and audit, the style becomes more positive, effective, and then becomes the explorer, butnot done exploration efficiency without the visual, auditory and sensory owned by thechildren. So study aimed to identify the values of the optical track and explore mathematical and find the relationship between them. And use the descriptive approach in a manner the linkon the children of the first year of primary school age (6-7) years in my school Waziriya and Karkh, during the peri
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