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 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 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
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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 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,
... Show MoreRationale, aims and objectives: A review of studies published over the last six years gives update about this hot topic. In the middle of COVID-19 pandemic, this study findings can help understand how population may perceive vaccinations. The objectives of this study were to review the literature covering the perceptions about influenza vaccines and to determine factors influencing the acceptance of vaccination using Health Belief Model (HBM). Methods: A comprehensive literature search was performed utilizing PubMed and Google Scholar databases. Three keywords were used: Influenza vaccine, perceptions, and Middle East. Empirical studies that dealt with people/ HCW perceptions of influenza vaccine in the Middle East and writt
... Show MoreThe primary goal of root canal treatment (RCT) is to expel the presence of any necrotic or vital tissue, microbes and their byproducts from the canal space before press forward with the following steps of the RCT procedures. Although this is difficult to attain, various strives had been practiced by employing chemical and mechanical methods to eliminate as much microorganisms as possible and make the canal space valid for the obturation materials to be received. The aim of this review is to demonstrate some of what new remedies that could be used as root canal disinfectant by summarizing the recent studies regarding the efficacy of different natural products against the most persistence microbiota that could be responsible for most
... Show MoreThe novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a pandemic of coronavirus disease 2019 (COVID-19) which represents a global public health crisis. Based on recent published studies, this review discusses current evidence related to the transmission, clinical characteristics, diagnosis, management and prevention of COVID-19. It is hoped that this review article will provide a benefit for the public to well understand and deal with this new virus, and give a reference for future researches.