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.
Objective(s): To assess the burden of mothers` care for child with colostomy and find out relationships between child and mother socio-demographic data with mothers` burden. Methodology: a descriptive study was conducted from 1 August 2013 to 1 September 2014. The sample consisted of 100 children and their mothers at Baghdad Teaching hospital in Baghdad city. A questionnaire was prepared based on the previous literature review, meeting mothers of children with colostomy, and the Zarit Burden Interview scale. Data has collected through the application of questionnaire and interview techniques. Results: T
The objective of this research is to develop a method for applying financial derivatives in the local environment to reduce the risk of foreign exchange rate fluctuations to enhance quality of accounting profits through Financial reporting to local units In accordance with international financial reporting standards, To accomplish this objective was selected a sample of Iraqi units exposed to the risk of fluctuations in foreign currency rates, As the research found:
- many companies and banks in the local environment a lot of losses due to fluctuations in foreign currency exchange rates.
- that financial derivatives in the Iraqi environment represent
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The challenges facing today's multi-customer and this is due to the multiplicity of products and speed in launching new products so search came to reveal the reveal the of the new product classification standards through a relationship (good products, low interest products, useful products and products desired) and the customer emotionally blackmail through deportation (fear, obligation and guilt). dentified the problem of the research in several questions focused on the nature of the relationship between the variables of research, and for that outline supposedly to search it expresses the head of one hypothesis and branched out of which four hypotheses subset, but in order to ensure the validity of the ass
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The research aims to show the dimensions of organizational trust represented by (administrative policies opportunities for innovation and self innovation and self- realization,availability of information,prevailing organizational values) and its reiationship to achieving the strategic position of banks represented by formation of expectations,buiiding networks,learning operations As the research was applied in each of the banks (middle east)Iraqi investment,Al-Ahly Iraqi, Business Bay, Al- Mansour investment bank),the qusestionnaire was adopted as a tool to collect data and information from the sample number (138)who are in the site (department director, division ,M.division director ,division officer, unit officer)the statistica
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Inclusive education has experienced a number of positive educational trends and developments in many different countries, typically by recognising that all students, including those who have special educational needs (SEN), have a right to education. Inclusion of children with SEN in mainstream schools, alongside their peers, has become a major concern for interested educators, professionals and parents in many countries around the world. The reasons for this trend are due to a number of factors such as the increasing attention to the role of education in achieving social justice for pupils with SEN; the right of individuals with SEN to be educated along with their typically developing peers in mainstr
... Show MoreAbstract The concept of quantum transition is based on the completion of a succession of time dependent (TD) perturbation theories in Quantum mechanics (QM). The kinetics of "quantum" transition, which are dictated by the coupled motions of a lightweight electrons and very massive nuclei, are inherent by nature in chemical and molecular physics, and the sequence of TD perturbation theory become unique. The first way involved adding an additional assumption into molecule quantum theory in the shape of the Franck-Condon rule, which use the isothermal approach. The author developed the second strategy, which involved injecting chaos to dampen the unique dynamically of the bonding movement of electrons and nuclei in the intermediary state of
... Show MoreBackground: Otitis media with effusion is a common and important pediatric clinical problem; it is the leading cause of hearing impairment in children. Medical treatment remains controversial. Aim: To evaluate the usefulness of using topical nasal steroids in the treatment of otitis media with effusion. Patients and Methods: Between November 2019 and October 2022, a prospective controlled clinical study was carried out in the department of otolaryngology at Al-Jerrahat Teaching Hospital in Medical City, Baghdad, Iraq. This study comprised 40 patients with bilateral otitis media with effusion (23 males, 17 females). Two groups were created for the patients. Patients in group A (20 patients) were treated with mometasone furoate nasal spra
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Abstract A description study was carried through out the present study aimed to assess health education provided by nurses to patient with gall stone "obstructive jaundice". The study was conducted at 4 teaching hospital, Baghdad teaching hospital, Al-Karama teaching hospital, Al-Yarmook teaching hospital, Al-Kendy teaching hospital where choloecystectomy was performed, in the period from first of June 2004 to end of July 2004. Data were collected through the use of questionnaire an interview from which was developed for the purpose of the present study. A non-probability (purposive) sample which was consist
Background: Salivary tumors are uncommon, being of low incidence worldwide. This study aimed to assess cases collected in this series of salivary gland tumors in regard to histopathological typing, in relation to age, site and gender. Materials and methods: This is a retrospective study; cases were collected from public and private laboratories. A total number of 171 cases were collected. The slides were reviewed and reclassified for histopathological typing according to WHO classification 2005. Results: Benign tumors were more common than malignant tumors. The most common histological type was benign mixed tumor, followed by Warthin’s tumor. The most common malignant tumor was adenoid cystic carcinoma. One hundred twenty three cases ou
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