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.
ABSTRACT
This research deals with the two item namely, the monetary policy central Bank of Iraqi and money supply . that contribute in up the problem of the paper that is concerned with the fact that to what extent the effectiveness of monetary policy conducted by the central Bank of Iraqi is valid in controlling money supply as well as the possibility of applying it in practical environment restricted to the scope of financial in stitiutions particularly in research population represented by central Bank of Iraqi .
For the purpose of a practical contribution for monetary and financial institutions . To achieve this , A hypothesis has been carried out and it suggested that the mon
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Objective: To determine the prevalence of Posttraumatic Stress Disorder (PTSD) among Iraqi repatriated
prisoners of Iran-Iraq war, and the relationship with demographic factors.
Methodology: A descriptive study was carried out from Oct. 18th, 2009 through Jan. 10th, 2010. A nonprobability
based snowball sampling technique was used to recruit 92 Iraqi repatriated prisoners of war
(IRPOWs) who had visited Ministry of Human Rights. A data collection instrument was constructed that
consisted of six demographic characteristics, and eight items to measure the level of PTSD in POWs. Data were
collected with the constructed instrument during a brief interview. Data were analyzed through the application of
descriptive statist
Background: As a multifactorial disorder, temporomandibular joint (TMD) is difficult to diagnose, and multiple factors affect the joint and cause the temporomandibular disorder. Standardization of clinical diagnosis of TMD should be used to reach a definite clinical diagnosis; the condylar bone may degenerate in accordance with these disorders. Aims: Evaluate the correlation between the clinical diagnosis and degenerative condylar change (flattening, sclerosis, erosion, and osteophyte). Materials and Methods: A prospective study with a study group of 97 TMD patients (total of 194 joints) aged 20 to 50. Patients were sent to cone beam computed tomography (CBCT) to assess the degenerative condylar change. Results: No association was found bet
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Interleukin-38 (IL-38), an inflammatory cytokine discovered in recent years, has been implicated in the pathogenesis of systemic lupus erythematosus (SLE). IL-38 is encoded by the
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This research tries to reveal how to manage and control the competitive edge for business by building managerial skills in various organizational levels. Our research aims at finding out the nature of various technical, human and in tellectual skills of a new president whose superiority is his competitive ness in the application field at general company for construe tioual industriesand testing the surveyed minor and major changes through a questionnaire to collect information from officials. The sample was composed of (45) director. The data was analyzed using some methods and statistical programs. The most prominent of these is (SPSS) that was used to extract the arithmetic mean, standard deviation, correlation coefficient
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Background: Energy drinks are non alcoholic beverages which contain stimulant drugs chiefly caffeine and marketed as mental and physical stimulators. Consumption of energy drinks is popular practice among college students as they are exposed to academic stress. Caffeine which is the main constituent of energy drinks could become an addictive substance or cause intoxication. Objectives: This study aims to assess the prevalence of energy drinks consumption among medical students of alkindy college of Medicine.Type of the study: A cross sectional study.Methods: It was performed at alkindy medical college on March 2016. A total number of 600 students were contacted to participate in this study. A self administered questionnaire was used to c
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The internet has been a source of medical information, it has been used for online medical consultation (OMC). OMC is now offered by many providers internationally with diverse models and features. In OMC, consultations and treatments are available 24/7. The covid-19 pandemic across-the-board, many people unable to go to hospital or clinic because the spread of the virus. This paper tried to answer two research questions. The first one on how the OMC can help the patients during covid-19 pandemic. A literature review was conducted to answer the first research question. The second one on how to develop system in OMC related to covid-19 pandemic. The system was developed by Visual Studio 2019 using software object-oriented approach. O
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