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.
Abstract
The open budget means everyone in the society can get information about the government budget in order to watch the governmental works. The aim of the research is to study the concepts of open budget, its advantage, limitations, role of supporting the transparency and questioning the administrative and financial corruption. Thus reflects positively on the national economy by providing governmental information to all users whether they are individuals or belong to the political class, or any other governmental or nongovernmental organizations which are interested in these information.
In order to achieve the objectives of the research aims, we make questionnaire to see aca
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Surgical site infections are the second most common type of adverse events occurring in hospitalized patients. Surgical antibiotic prophylaxis refers to the use of preoperative and postoperative antibiotics to decrease the incidence of postoperative wound infections. The objective of this study was to evaluate the antibiotic administration pattern for surgical antibiotic prophylaxis and the adherence to American Society of Health-System Pharmacists surgical antibiotic prophylaxis guideline in Medical City Teaching Hospitals/Baghdad. The medical records of one hundred patients who underwent elective surgical procedures were reviewed. Adherence to the recommendations of American society of health‑system pharmacists guideline was ass
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This research a mining at evaluation the efficiency of the nursing performance depended on standards of W.H.O. via application standards of W.H.O on the nursing personnel in medical city office, in light of it, it has design world evaluation list, and a sample was chosen from the nursing personnel in given researched the organization whom they are evaluated according to the standards of W.H.O for the nursing performance included of ten standards, divided in to 45 question , besides the evaluation list, the researcher get assistance of some tools of collection information via actual checking and personal interviews, a number of statistical means were used to manipulate t
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This research investigates the adsorption isotherm and adsorption kinetics of nitrogen from air using packed bed of Li-LSX zeolite to get medical oxygen. Experiments were carried out to estimate the produced oxygen purity under different operating conditions: input pressure of 0.5 – 2.5 bar, feed flow rate of air of 2 – 10 L.min-1 and packing height of 9-16 cm. The adsorption isotherm was studied at the best conditions of input pressure of 2.5 bar, the height of packing 16 cm, and flow rate 6 Lmin-1 at ambient temperature, at these conditions the highest purity of oxygen by this system 73.15 vol % of outlet gas was produced. Langmuir isotherm was the best models representing the experimental data., and the m
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This presented study is to make comparison of cross sections to produce 71As, 72As, 73As and 74As via different reactions with particle incident energy up to 60 MeV of alpha 100 MeV of proton as a part of systematic studies on particle-induced activations on enriched Ge, Ga, Rb and Nb targets and neutron capture. Theoretical calculation of production yield, and suggestion of optimum reaction to produce 71As, 72As, 73As and 74As, based on the main published and approved experimental results of excitation functions were calculated.
Abstract
The research problem focuses on studying the interest of the Medical City Department of the Ministry of Health in improving the creative thinking skills of the administrative leadership through parallel & comprehensive thinking according to the of six thinking hats strategy. The research sample consisted of (170) administrative leaders in the upper & middle organizational levels, The questionnaire was used as a main tool for data collection, In addition to the observation & Interview, The research sought to answer the following questions: What is the extent to which the administrative leadership (Tpp & middle) in the organization investigated the concept of the six thinkin
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The research aims to find out the relationship between the medical and nursing staffing and its impact on the quality of provided health service in the Yarmouk Teaching Hospital, and to understand the nature of the relationship between doctors and nurses, it has been the adoption of cooperation and conflict Kmngaran independent knowledge of the relationship between doctors and nurses and the quality of health service as a variable certified by eating five dimensions (tangibility, reliability, safety, responsiveness, empathy). The research was adopted to collect data on the questionnaire prepared medical and nursing to the angel and adopted included Likert Quintet her, and distributed to doctors working in the Yarmouk hospital in
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