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.
Background: Major depressive disorder (MDD) is mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities. The aims of the study: were to determine the prevalence of oral manifestation among patients with major depressive disorder receiving antidepressant drugs, and detect alkaline phosphatase (ALP), Total Salivary proteins (TSP), and Interleukin-6 (IL-6) in relation to MDD patients under treatment and to compare with healthy controls. Materials and method: (50) MDD patients; between the ages of 20 years and 60 years.The depression patients are divided into (25) patients under treatment with fluoxetine (Prozac), and (25) patients under tr
... Show MoreDuring pregnancy, high blood pressure disorder is the most common medical complication in pregnancy. It is the foremost cause of maternal mortality and perinatal diseases. Vascular endothelial growth factor (VEGF) affects the growth of vascular endothelial cells, existence, and multiplying, which are known to be expressed in the human placenta. This study aimed to identify the expression VEGF in the placenta of hypertension and normotensive women. In this study, a cross-sectional study from november 2019 to February 2020. A total of 100 placentae involved 50 hypertensive cases and 50 normotensive groups were assessed. VEGF-A expression in two placentas groups was evaluated by immunohistochemistry techniques. Strong and moderate VEGF
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The aim of this research to show the role of some enzymes in pathological mechanism of rheumatoid arthritis (RA) disease. Sixty patients with RA and matched number of apparently healthy volunteers were included in the study. Spectrophotometric methods were used to determine Peroxy nitrite (ONOO), Nitric oxide (NO), Nitric oxide synthase activity (NOS) cycloxygenase-2 activity (COX-2), glutathione peroxidase (GPX) activity and superoxide dismutase (SOD) activity in serum of both groups. Colorimetric assay kits were used to determine Iron. Rheumatoid factor (RF) was determined using Imuno-Latex kit. ONOO, NO levels, and NOS activity were significantly higher in the patients compared to the control group. Conversely, Iron level, SOD
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The study aims to identify the symptoms of PTSD among displaced Yazidi women according to age, marital status, educational level, and type of status (displaced or survivor). The study also seeks to identify the effect of the relaxation program on reducing PTSD among displaced Yazidi women. The research sample included (60) Yazidis for the statistical analysis sample and (5) for the experimental sample in the Dohuk governorate. For achieving the research objectives, a scale was used from the PTSD Checklist for DSM-5 (PCL-5), as well as a relaxation program was prepared. The researchers reached the following results that there is an average level of PTSD symptoms among displaced Yazidi women, there are no statistically significant differen
... Show MoreMedicine is one of the fields where the advancement of computer science is making significant progress. Some diseases require an immediate diagnosis in order to improve patient outcomes. The usage of computers in medicine improves precision and accelerates data processing and diagnosis. In order to categorize biological images, hybrid machine learning, a combination of various deep learning approaches, was utilized, and a meta-heuristic algorithm was provided in this research. In addition, two different medical datasets were introduced, one covering the magnetic resonance imaging (MRI) of brain tumors and the other dealing with chest X-rays (CXRs) of COVID-19. These datasets were introduced to the combination network that contained deep lea
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This study aims at identifying the notion of Post-Occupancy Evaluation (POE) pertinent to the performance of three general hospitals constructed inside the Sulaimani City, tracing the relationship between the quality of the indoor environments and medical staff (doctors and nurses) satisfaction level. Using some indoor environment elements in the right way will positively influence the mood, stress level of the medical staff, and patient recovery as a result. The POE toolkits (AEDET and ASPECT) have been implemented on targeted wards at the selected hospitals. AEDET and ASPECT questionnaires were distributed among 152 medical staff to obtain their perspectives. In total, 112 valid questionnaires were received. The medica
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الانهار اصبحت مشبعة بثاني اوكسيد الكربون بشكل عالي وبذلك فهي تلعب دور مهم في كميات الكربون العالمية. لزيادة فهمنا حول مصادر الكربون المتوفرة في النظم البيئية النهرية، تم اجراء هذه الدراسة حول تأثير الكربون العضوي المذاب والحرارة (العوامل الرئيسية لتغير المناخ) كمحركات رئيسية لوفرة ثاني اوكسيد الكربون في الانهار. تم جمع العينات من خمسة واربعون موقع في ثلاثة اجزاء رئيسية لنهر دجلة داخل مدينة بغداد خلال فص
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This study explores the theory of Ecofeminism ,which elucidates how capitalism and patriarchal society treat women and nature. Moreover, it studies the effects of gender categories to show how social norms unfairly control women and the environment. This study explores how Tess Onwueme's Then She Said it dramatizes the combined tyranny of nature and women. It emphasizes the devastation caused by oil firms colluding with local authorities to exploit both. The playwright examines the historical oppression of Delta women and the environmental damage they endure, using dramatic visuals and dialogue to illustrate the harsh realities of pollution and poverty. This study examines the contradiction between the prosperity of oil companies and the po
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This research study examines the impact of information technology on firm profitability and stock returns. Using a comprehensive dataset of firms across various industries, this research employs rigorous statistical analysis techniques to investigate the relationship between IT investments, firm profitability metrics, and stock returns. The study focuses at how IT investments affect financial performance measures including return on assets (ROA) and return on equity (ROE), with P-values of 0.34 and 0.12, respectively. Furthermore, the study investigates the influence of IT on stock returns, taking into account market capitalization, industry trends, and macroeconomic variables. This study's conclusions center on the beneficial assoc
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The research aims to identify the level of awareness of student teachers in the behavioral disorders and autism specialization about the diagnosing Autism Spectrum Disorder and Social (Pragmatic) Communication Disorder according to some variables. The study was conducted on a sample of (113) student teachers. The researcher employed the awareness scale of a teacher-screening questionnaire for autism spectrum disorder and social pragmatic communication disorder. The results showed that the average of teachers in the total degree of awareness of autism spectrum disorder and social communication have recorded a moderate degree. As for the awareness of autism spectrum disorder was high. Then, the awareness of social communication disorder wa
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