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.
Any design subject to a set of forces contributing to the establishment of relations working to strengthen the internal elements of the design; any imbalance in these elements can make a fragmented and weak design, thus preventing it from achieving the goal or performance. Poor performance can be attributed to various factors: the extent and function of the elements and principles in the design, realization of the idea, especially in fashion design.
Moreover, there are many aspects of a design that go into achieving the realization of the designer’s idea. The design utilizes a lot of stimulants by drawing attention to its design, which is consistent with the need for psychological and material individuals. In this research, we will
This study was conducted to identify the impact of germination in the ratio Almaah of Chemical Constituents of Homs and in the organoleptic properties of the Biskt plant it and compare the results with the treatment control (seeds Almnepth) Adhrt results for a significant increase in the percentage of crude protein with the progress of the process of germination, reaching 24.5% in percentage of crude protein with the progress of the germination process Krbu hydrate college during the germination period, reaching 59.2% in the fourth day
Abstract
The basic orientation of the research is an attempting to apply the cost determining method according in the contract sector projects for Al- Iraq ceneral company, that this subject has a big value according to its modernity and its influence on the future and the eaning of the company.
The research aims to find out the effect of the method for determining cost based on the activity in determining the cost of the construction sector projects.The research was conducted in Iraq General Company for the implementation of irrigation projects. Bani search on three assumptions, the first is (that the application of the method for determining the cost on the basis of
... Show MoreWill address this research interaction and coordination between fiscal and monetary policies and the impact of this interaction and coordination on economic stability and growth، and how the financial implications of monetary policy may stimulate action monetary policy and treatment side effects and the nature of responsiveness and bounce between procedures both two policies and their impact on the balance of overall economic and explained in the folds of searchjustifications coordination and the extent necessary in order to address the imbalances in economic activity through twinning actions of monetary and fiscal، has embodied this coordination and interaction between policies and their impact m
... Show MoreThe Braille Recognition System is the process of capturing a Braille document image and turning its content into its equivalent natural language characters. The Braille Recognition System's cell transcription and Braille cell recognition are the two basic phases that follow one another. The Braille Recognition System is a technique for locating and recognizing a Braille document stored as an image, such as a jpeg, jpg, tiff, or gif image, and converting the text into a machine-readable format, such as a text file. BCR translates an image's pixel representation into its character representation. As workers at visually impaired schools and institutes, we profit from Braille recognition in a variety of ways. The Braille Recognition S
... Show MoreObjectives:
To evaluate mothers’ attitudes toward readiness for discharge care at home for a premature baby in Intensive Care Unit at teaching hospitals in Medical City Complex and to find out the relationship between mothers’ attitudes and their socio-demographic characteristics.
Methodology: A quasi-experimental study design was carried out through the period of 6th January 2020 to 2021 to 11th March 2021, to evaluate mother’s attitude toward discharge care plan for premature babies. The study carried out in Welfare Teaching Hospital, Nursing Home Hospital and Baghdad Teaching Hospital at Medical City Complex in Baghdad City on 30 mother of premature babies in neonatal intensive care units using the nonprobability sampling
This study aimed to know the impact of the capital structure measured by the ratio of financing to short-term capital and the ratio of financing to long-term capital on the profitability of companies, as measured by the rate of return on assets and the rate of return on equity. The study was applied to industrial sector companies listed in the Iraq Stock Exchange. The financial number of (14) companies, and (4) companies were selected that met the conditions for selecting the study sample. The study methodology relies on the analytical method as it is more appropriate to the nature, scope and objectives of the study, and the ready-made statistical program "SPSS" will be used to analyze the relationships and influence between the
... Show MoreApart from graduating five-star doctors, a particular medical college has the mission to motivate and offer researchers the opportunity to publish high-quality researches on various health problems and disseminate updated medical knowledge to a wide range of local and international readers. This could be accomplished by establishing a medical journal and releasing issues regularly
Abstract
Objective(s): To evaluate housekeeping services staff work environment and their health status, as well as to determine the impact of the work environment upon their health status.
Methodology: A descriptive design is employed throughout the present study to evaluate housekeeping services staff work environment and their health status, as well as to determine the impact of the work environment upon their health status from November 3rd 2017 to June 30th 2018. A purposive “nonprobability” sample of (101) housekeeping staff is selected for the present study. An instrument is constructed for the purpose of the study and it is consists of (2) parts: (I) Evaluation of work environment, and (II) Evaluation of housekeeping st