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.
Polycystic ovary syndrome (PCOS) is the main cause of female infertility. The role of insulin resistance in the development of polycystic ovary is actively discussed here. The study included patients with PCOS without insulin resistance (n = 48) and with insulin resistance (n = 39). The comparison groups were patients with no history of PCOS: a control group without insulin resistance (n = 46) and a group of patients with insulin resistance (n = 45). The following parameters were determined in patients: FSH, LH, TSH, T3f, T4f, PRL, E2, 17-OHd, Pr, AMH, Test total, Testf, DHEAS, DHEASs, SHBG, ACTH, cortisol, IRI, IGF-1, C-peptide, and glucose level. The HOMA-IR index and the LH / FSH ratio and t
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Every researcher must say that the world in continually progress toward the best and that
the Arab and Islamic civilization had produced much of systems and virtuous educational
practices which raised from Islamic heritage. This nation was not isolated from external
world, but it was made a clear active for promote the banner of other nations which entered
under her influence to promote Islamic banner and Muslims. Consequently also Muslims are
affected and influenced, this resulted a clear impact in the civilization and educational
ideology especially in the contemporary teaching methods.
The objective of this study is to attempt to provide a quantitative analysis to the causes of unemployment in Iraq and its mechanisms of generation, as well as a review of the most important types of both visible and invisible unemployment, and an attempt to measure the disguised unemployment and analyze the causes. The problem of the research lies in the fact that the Iraqi Economy has been suffered for a long time although its characterized by abundant physical and natural resources, from the existence of the phenomenon of unemployment in the previous two types. Causing a lot of economic problems, represented by the great waste of resources and
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The research is based on a statement of the effect and nature of the relationship of elements of promotional mix represented by (advertising, personal selling, sales promotion, public relations and direct marketing) as the independent variable in the dependent variable represented in the competitive advantage in the General Company for the manufacture of medicines and medical supplies Samarra. Analytical descriptive in the theoretical side, through the use of a number of literature from scientific sources (books, research and studies published in Arab and foreign magazines) was also relied on the methodology of the case study in the practical side, Data collection using the questionnaire tool, which was designed using the triangular Like
... Show MoreObjectives: The study objectives are to determine the impact of education program upon the academic nurses'
practice concerning documentation of nursing sheets, and to find out the relationship between nurses knowledge
and their demographic characteristics, which include age, sex, and years of experience in medical and surgical
wards.
Methodology: A quasi- experimental study was carried out at the medical and surgical wards in teaching
hospitals in Sulaimani governorate from the beginning of March up to June 2007٠
To reach the objectives of the study anon-probability (purposive) sample of (25) academic nurses who work in
the medical and surgical wards in teaching hospitals.
The data were collected through the use
A large number of natural or synthetic dyes have been removed from both national and international lists of permitted food colors because of their mutagenic or carcinogenic activity. Therefore, this study aimed to use the Random Amplified Polymorphic DNA-Based Polymerase Chain Reaction (RAPD-PCR) assay as a feasible method to evaluate the ability of some food colors as genotoxin-induced DNA damage and mutations. Lactiplantibacillus plantarum was used as a bioindicator to determine the genotoxic effects by RAPD-PCR using M13 primer after treatment with some synthetic dyes currently used as food color additives, including Sunset Yellow, Carmoisine, and Tartrazine. Besides qualitative analysis, the bioinformatic GelJ software was used for clus
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Surge pressure is supplemental pressure because of the movement of the pipes downward and the swab pressure is the pressure reduction as a result of the drill string's upward movement. Bottom hole pressure is reduced because of swabbing influence. An Investigation showed that the surge pressure has great importance for the circulation loss problem produced by unstable processes in the management pressure drilling (MPD) actions. Through Trip Margin there is an increase in the hydrostatic pressure of mud that compensates for the reduction of bottom pressure due to stop pumping and/or swabbing effect while pulling the pipe out of the hole. This overview shows suggested mathematical/numerical models for simulating surge pressure problems ins
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Foreign direct investment (FDI) has been viewed as a power affecting economic growth (EG) directly and indirectly during the past few decades. This paper reviewed an amount of researches examining the relationships between FDI and EG, especially the effects of FDI on EG, from 1994 up to 2012. The results show that the main finding of the FDI-EG relation is significantly positive, but in some cases it is negative or even null. And within the relation, there exist several influencing factors such as the adequate levels of human capital, the well-developed financial markets, the complementarity between domestic and foreign investment and the open trade regimes, etc.
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