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 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 MoreConcentrations 25, 50 and 100 mg of nano-capsules linolenic acid and non-capsulated fatty acid for 1kg of Milk was used for yogurt manufacture. The results showed no significant differences in the ratio of titration acidity and pH values between all processed treatments at the beginning and during of period storage. The treatments was added to it coated omega-3 by nano method were the least exposed to the oxidation process from the non-capsules omega-3, And for shield of The poly lactic acid had a significant role in the protection of alpha-linolenic acid against lipolysis by the formation of a protective layer to protect the acid from the activity of lipases enzymes, and the addition of fatty acid linolenic to milk was determined the gr
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The stories of children in Iraq during the past two decades have received a number of important scientific studies. Despite tyranny of the historical study method on most of these studies, they have been and still are very important, because they have established a chronicle of this literary style that has been neglected and based not only on the academic level and serious in-depth university studies but also on the enclosed sight that doesn’t consider studied art as an innovation with its specificity and its typical technical components. While many of the public impressions and self-reflections contributed to the dominance of some of the provisions and concepts that were circulated as critical remarks and adopted by som
... Show MoreCoronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a pandemic worldwide. On a daily basis the number of deaths associated with COVID-19 is rapidly increasing. The main transmission route of SARS-CoV-2 is through the air (airborne transmission). This review details the airborne transmission of SARS-CoV-2, the aerodynamics, and different modes of transmission (e.g. droplets, droplet nuclei, and aerosol particles). SARS-CoV-2 can be transmitted by an infected person during activities such as expiration, coughing, sneezing, and talking. During such activities and some medical procedures, aerosols and droplets contaminated with SARS-CoV-2 particles are formed. Depending on their
... Show MoreThe research aimed to test the effect of independent variables career plateaus and workaholism on employees loyalty through the influence of the mediator variable organizational socialization. Descriptive approach with survey style on a sample of managers and executives in the Iraqi Drilling Company in Basra's (123) employees. The most important findings of the research are: the existence of a significant effect of the independent variables career plateaus and workaholism in employees loyalty by having a mediator variable organizational socialization and introduced numerical from recommendations. &nbs
... Show MoreInformation and communication technology has a significant influence on employee procedures. Businesses are investing in e-CRM technologies, yet it is difficult to assess the performance of their e-CRM platforms. The DeLone and McLean Information Systems Success framework can be modified to the current e-CRM assessment difficulties. The new framework's different aspects provide a concise framework for organizing the e-CRM key metrics identified in this study. The purpose of this study is to apply and verify that the Updated DeLone and McLean IS Model can be employed to explain e-CRM adoption among employees, along with the extended Updated DeLone and McLean Model with its five output factors, namely system quality, service quality,
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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 Moreالمواقف افي الدول العربية قراءة تحليلية في مواقف لدولية من التغيير (الولايات المتحدة - الاتحاد الاوروبي - روسيا)
The study aims to determine the responsibility of nursing staff for medical errors that accompany the surgery at the hospital , which is one of the important issues that the importance of determining the responsibility of landlords nursing medical errors in the hospital was the rationale in choosing the subject. Since study included cases of errors nursing staff of (22) case. While the checklist distributed to a sample of nursing Angel Group in Sadr Teaching Hospital 's (100) nurs According to the problem, the study in determining the responsibility of nursing staff for medical errors that are not important for the hospitals. Has shown results of the study agreement members of the study sample that the clarity of the power posses
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