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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
This study was (the reality of beekeeping in Iraq and ways of developing them) as a research project in the branch of production is important branches of the productivity of the agricultural sector in Iraq, and the importance of this section, productive (beekeeping) for the agricultural sector in his contribution to increase the vegetable production and improve the quality and the various Classes of types, through its active role in the pollination of plants and indirectly (when the bees to move between plants to collect nectar and pollen grains), which contributes to reduce the losses in plant production and raise the rate of productivity per donum of various agricultural crops.
On the other hand play a
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Our description of the wxperience of any poet depends on the nature the anture of his writing or his style in terms of factors affecting his experience . We have found that al- Maghout is characterized by important poetis properties that characterized all of his poetry such as the ease in compositions that are formed the vocabulary of daily life . This is what constitutes his poetic lexicon that depends on the vocabulary of space , time , and anture . Hispoetry derives its aesthetics from revealing that strains in the text for the sake of surprise and amazement with a simple realism.
Basic Orientation and search path in determining the impact of creative thinking in cultural intelligence field research on the doctors competence, as is a theme of creative thinking great importance in spite of being a old , but his role at the individual level and / or organizational a sustainable effect toward developing a fact uncommon , any sense that one of the pillars of modernity and provide a unique future, as is the competitive weapon of the organizations in an environment dubbed fundamental change and provide all that is unfamiliar, and in the center of the field of research and objective measurement of creative thinking on doctors specialists at the construction of a state of the preference and
... Show MoreThe aim of this study is to design a proposed model for a document to insure the mistakes of the medical profession in estimating the compensation for medical errors. The medical profession is an honest profession aimed primarily at serving human and human beings. In this case, the doctor may be subject to error and error , And the research has adopted the descriptive approach and the research reached several conclusions, the most prominent of which is no one to bear the responsibility of medical error, although the responsibility shared and the doctor contributes to them, doctors do not deal with patients according to their educational level and cultural and there are some doctors do not inform patients The absence of a document to insu
... Show MoreThis paper presents a robust algorithm for the assessment of risk priority for medical equipment based on the calculation of static and dynamic risk factors and Kohnen Self Organization Maps (SOM). Four risk parameters have been calculated for 345 medical devices in two general hospitals in Baghdad. Static risk factor components (equipment function and physical risk) and dynamics risk components (maintenance requirements and risk points) have been calculated. These risk components are used as an input to the unsupervised Kohonen self organization maps. The accuracy of the network was found to be equal to 98% for the proposed system. We conclude that the proposed model gives fast and accurate assessment for risk priority and it works as p
... Show MoreOur aim was to investigate the inclusion of sexual and reproductive health and rights (SRHR) topics in medical curricula and the perceived need for, feasibility of, and barriers to teaching SRHR. We distributed a survey with questions on SRHR content, and factors regulating SRHR content, to medical universities worldwide using chain referral. Associations between high SRHR content and independent variables were analyzed using unconditional linear regression or χ2 test. Text data were analyzed by thematic analysis. We collected data from 219 respondents, 143 universities and 54 countries. Clinical SRHR topics such as safe pregnancy and childbirth (95.7%) and contraceptive methods
Huge yearly investments were made by organizations for the development and maintenance. However, it has been reported that most of the IT projects fails as it is delayed, over budget and discontinued quality. A systematic literature review (SLR) was conducted to identify the critical success factors (CSFs) for the IT projects. Nine (9) CSFs was identified from the SLR. An online survey was conducted among 103 respondents from developers and IT managers. The data was analyzed using the Statistical Package for Social Science (SPSS 22). The findings showed that the highest CSFs of IT projects is commitment and motivation. Project monitoring was found the lowest score ranked by respondents.
Idiomatic expressions in Russian journalism make one important borrowed means for making a dialogue with the receiver's intellect in so far as it has the distinct feature of having clarity and exactness of meaning. The meaning is seen as a shortcut for covering a series of concepts and details so as to arrive at the intended meaning. This is done by stimulating the reader by the use of certain clear idioms. The use of such idioms in a journalistic text is not for a linguistic purpose only, but it is a cultural and social phenomenon reflecting the type of current changes in the society and it aims at discoursing with the reader's mind. This paper is a practi
... Show MorePraise be to Allah, Lord of the Worlds, teach the pen, taught the human what he didn't know, Ihmad - Almighty - and thank him, and repent to him and ask forgiveness, which is the most forgiving, and bear witness that there is no god but Allah alone has no partner, gives and prevents, And I bear witness that Muhammad is a slave to Allah and his Messenger, who called for guidance and good speech and spoke, peace be upon him and his family and companions, and those who followed them until the Day of Judgment.
After completion of the artistic production, the artist plays the echo of this production upon the recipient. Whether this recipient is from the public, art connoisseurs, or private artists, critics and academics. In the past, the boundaries of Time and place had a great effect in limiting this echo or its quality, as the views of the recipients were largely influenced by the prevailing thought or the artistic trends that dominate the artistic scene in the surrounding environment in which the artist created. In order for the artist to show works for the widest segment of the recipient, he bears the burden of the costs of transporting the work, a keeper of damage on the move, and the material amounts that may hinder the publication of the
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