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.
يهدف البحث إلى تشخيص أوجه القصور ونقاط الضعف في تطبيق أبعاد جودة الحياة الوظيفية ومدى تأثيرها على اتجاهات وسلوكيات الموظفين، وبالتالي علاقتها بتعزيز مقدراتهم الجوهرية. وتنبع القيمة العلمية للبحث من إبراز أهمية أبعاد جودة حياة العمل في تحسين الكفاءة الإنتاجية للعاملين في القطاع العام ورفع مستوى الأداء التنظيمي. ولأن جودة الحياة العملية تلعب دوراً مهماً في تعزيز المقدرات الأساسية للموظفين في القطاع الع
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The aim of the research is to identify the extent of the ability to ensure the integrated reports by the auditor in verifying the credibility of these reports, and their implications for the benefit of all parties dealing with the economic unit, as well as measuring the impact of the assurance procedures followed by the auditors and their role in confirming these reports.
The research methodology was designed after studying the previous literature related to the research variables, and then the relationship between these variables was tested, through the use of a questionnaire list. A questionnaire targeting the community of auditors in the local environment, and the results of the study wer
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The removal of direct blue 71 dye from a prepared wastewater was studied employing batch electrocoagulation (EC) cell. The electrodes of aluminum were used. The influence of process variables which include initial pH (2.0-12.0), wastewater conductivity (0.8 -12.57) mS/cm , initial dye concentration (30 -210) mg/L, electrolysis time (3-12) min, current density (10-50) mA/cm2 were studied in order to maximize the color removal from wastewater. Experimental results showed that the color removal yield increases with increasing pH until pH 6.0 after that it decreased with increasing pH. The color removal increased with increasing current density, wastewater conductivity, electrolysis time, and decreased with increasing the concen
... Show MoreBackground: Ankylosing spondylitis is a chronic inflammatory disease that mostly involves the spine and sacroiliac joints. It is associated with a decreased quality of life. Biological medicines such as infliximab and its biosimilar are the mainstay treatments for active ankylosing spondylitis.
Objective: The study objective was to conduct a pharmacoeconomic study comparing the cost-effectiveness of the reference infliximab with its biosimilar in ankylosing spondylitis patients visiting public hospitals.
Subjects and Method: This is a two-center pharmacoeconomic study performed at two large teaching governmental hospitals in Baghdad, Iraq, which s
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Research Objectives: The research aims to highlight the approach of Imam Al-Qaradawi in contemporary jurisprudence in the recent issues of the jurisprudence of minorities, and mentioning the foundations of jurisprudence of minorities, along with some of the practical applications of Imam Al-Qaradawi.
Study Methodology: The researcher applied the inductive, analytical and comparative approach by tracking the scientific material related to the subject of the study from the books of Al-Qaradawi in the first place, then by comparing the legal provisions with what had been stated in the four schools of jurisprudence.
Findings: The interest and need of Muslim minorities in non-
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Background: Drawing blood to measure total serum bilirubin is painful & time consuming. Transcutaneous bilirubinometer working by multiwavelength spectral reflectance from the skin surface on forehead or upper sternum is a quick & painless technique. Objectives: to compare the effectiveness of transcutaneous (over the upper sternum and forehead) and serum bilirubin measurement of neonate with jaundice. Subjects and Methods: This is a cross sectional prospective study. It enrolled 175 jaundiced neonates & excluded those exposed to phototherapy. It was conducted at Child Central Teaching Hospi |
The primary aim of this study was to find out the effect of a training program on the development of physical abilities in football goalkeepers. The current study was conducted on goalkeepers of the Academy of Espanyol Sports Club in the premises of Haifa Sports Club Stadium. The study was completed by the researchers within the timeline of May 2021 to August 2021. A total of 7 goalkeepers falling within the age group of 15-17 years were recruited as the sample participants for the study. Out of 7 goalkeepers, 5 goalkeepers were included in the primary experiment and 2 of them were excluded. The training program applied had a positive effect on the development of physical abilities in the football goalkeepers of the sa
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Two-dimensional unsteady mixed convection in a porous cavity with heated bottom wall is numerically studied in the present paper. The forced flow conditions are imposed by providing a hydrostatic pressure head at the inlet port that is located at the bottom of one of the vertical side walls and an open vent at the top of the other vertical side wall. The Darcy model is adopted to model the fluid flow in the porous medium and the combination effects of hydrostatic pressure head and the heat flux quantity parameters are carefully investigated. These governing parameters are varied over wide ranges and their effect on the heat transfer characteristics is studied in detail. It is found that the time required to reach a desired temperature at th
... Show MoreA modification to cascaded single-stage distributed amplifier (CSSDA) design by using active inductor is proposed. This modification is shown to render the amplifier suitable for high gain operation in small on-chip area. Microwave office program simulation of the Novel design approach shows that it has performance compatible with the conventional distributed amplifiers but with smaller area. The CSSDA is suitable for optical and satellite communication systems.
An oral bi layer sustained release (SR) strips of Sodium Montelukast SMLT , which is selective leukotriene antagonist , used for patients suffered from mid-night asthma , were prepared successfully ,using different polymers, like guar gum , carrageenan , and xanthan gum , by solvent casting method .
The results obtained by this study revealed ,that best fast dissolving film of SMLT was loaded in carrageenan polymer 57% w\w (30mg.) , with acceptable physical properties, like film thickness , elastic endurance and surface pH .
Besides to that , the disintegration t
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