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 paper aims to identify how the United Nations works through its website in prioritizing audiences towards international issues، by identifying the digital PR mechanisms used in digital PR contents in prioritizing audiences towards the international issues they deal with. To achieve the objectives of this paper, the researcher used the survey method and content analysis tool with a view to identifying the ranking of international issues on the website of health، peace and security، humanitarian assistance، human rights، women، migrants، refugees and displaced persons، economic development، United Nations affairs، culture and education، environment and climate، sustainable development, and law and crime prevention. One of
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Foreign body embolization is a rare but serious iatrogenic complication that might necessitate transcatheter or even surgical retrieval. A broken double-lumen catheter was snared using a goose neck snare kit. The procedure was successful, and the patient experienced no further complications.
The importance of this research is due to its importance goals, Which are about the attempt of researchers to investigate the probability of depending on businesses, environments to transform organizations, performance in away that enhance the leading role of organizations in their environments , and through views of a number of the staff working in the foundation of technical institutes in Mosul. .
After deciding the methodology of the study that ,in one hand ,performs the goals of the study , and achieving a suitable theoretical framework to present the concepts of businesses, environments and the leadin
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The UN organization is considered one of the most important organizations at the international level. It has accomplished multiple tasks and roles of many different issues and events that hit the developing and advanced world countries. It has performed a series of procedures and laws that have had an impact on ending the wars and conflicts that plagued some countries and continued for a period of time in the past. Moreover, it has improved the level of the international relations between a number of countries due to the problems and incidents took place between them. It has relied on finding solutions and treatments for humanitarian problems such as the preservation of the environment, preventing the spread of epidemics and diseases Thi
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الغرض - تعتمد هذه الدراسة على المنهج الوصفي التحليلي من خلال جمع البيانات اللازمة وتحليلها، كون هذا المنهج يركز على استطلاع الآراء لعينة البحث وتوجهاتها ، وتهدف إلى تطوير نموذج يدرس العلاقة بين خلق المعرفة والبراعة التنظيمية في المصارف الخاصة العراقية والتحقق من صحته تجريبياً. التصميم / المنهجية / المدخل- تم إجراء مسح عبر استمارة استبيان لجمع البيانات من عينة من (113) مدير من مصارف تجارية خاصة بالإضافة إلى ذلك ا
... Show MoreThe present study aimed to asspssment the nutrition a program to sample of student from internal departments of Baghdad University (AL-Jadiriya Complex) and the University of AL-MustanSiriya four grades and aged (19-24) year study included 150 male and female students by (75) male and (75) of female register height, weight nd body mass index were study habits and food pattern of the same sample (150) and by aspecial form and take the personal information interviews and record information on food intake during 24 hour .noted adifference practie in the weights and longths of male and female (sample).
BMI rates were within the normal weight as the value of BMI for males aged (19- 21)and (22-24) and (22.21) and (23,37),respectively and th
The emergence of COVID-19 has resulted in an unprecedented escalation in different aspects of human activities, including medical education. Students and educators across academic institutions have confronted various challenges in following the guidelines of protection against the disease on one hand and accomplishing learning curricula on the other hand. In this short view, we presented our experience in implementing e-learning to the undergraduate nursing students during the present COVID-19 pandemic emphasizing the learning content, barriers, and feedback of students and educators. We hope that this view will trigger the preparedness of nursing faculties in Iraq to deal with this new modality of learning and improve it should t
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The research topic was chosen as a result of the importance of human resource in business organizations in general and the industrial process in particular. Without the human resource, business organizations cannot continue and achieve success and excellence, and the research problem has been diagnosed in the lack of sales of General Cement Company’s northern products, despite their distinctiveness, standing, and reputation in The market and its products with standard specifications, and through this problem, the following questions were raised: &nbs
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