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:
It is essential to provide health care directly or indirectly based on laboratory tests in order of diagnosing diseases. There is an urgent need for the results of such tests to be accurate and reliable. Therefore, the International Organization for Standardization has prepared special standards for medical laboratories to prove their efficiency, presented in standards 15189: 2012. The aim of the research is to determine the possibility of the Al-alwiya Women's Hospital in meeting the requirements of the standards 15189: 2012, which includes administrative requirements consisting of fifteen items and technical requirements consisting of ten items. The research is important because laboratories shou
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The objective of this research is to develop a method for applying financial derivatives in the local environment to reduce the risk of foreign exchange rate fluctuations to enhance quality of accounting profits through Financial reporting to local units In accordance with international financial reporting standards, To accomplish this objective was selected a sample of Iraqi units exposed to the risk of fluctuations in foreign currency rates, As the research found:
- many companies and banks in the local environment a lot of losses due to fluctuations in foreign currency exchange rates.
- that financial derivatives in the Iraqi environment represent
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Groupwise non-rigid image alignment is a difficult non-linear optimization problem involving many parameters and often large datasets. Previous methods have explored various metrics and optimization strategies. Good results have been previously achieved with simple metrics, requiring complex optimization, often with many unintuitive parameters that require careful tuning for each dataset. In this chapter, the problem is restructured to use a simpler, iterative optimization algorithm, with very few free parameters. The warps are refined using an iterative Levenberg-Marquardt minimization to the mean, based on updating the locations of a small number of points and incorporating a stiffness constraint. This optimization approach is eff
... Show MoreBackground: Assessment is an important part of the learning cascade in education. Students realize it as an influential motivator to direct and guide their learning. The method of assessment determines the way the students reach high levels of learning. It has been documented that one of factor affecting students’ choice of learning approach is the way how assessment is being performed. Many methods of assessment namely multiple choice questions, essay questions and others are mainly used to assess basic science knowledge in undergraduate education. Objectives: The aim of this study is to compare multiple choice questions (MCQ) and essay questions (EQ) (record the success and failure rate of multiple choice questions (MCQ) and essay quest
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Objective(s): To assess the burden of mothers` care for child with colostomy and find out relationships between child and mother socio-demographic data with mothers` burden. Methodology: a descriptive study was conducted from 1 August 2013 to 1 September 2014. The sample consisted of 100 children and their mothers at Baghdad Teaching hospital in Baghdad city. A questionnaire was prepared based on the previous literature review, meeting mothers of children with colostomy, and the Zarit Burden Interview scale. Data has collected through the application of questionnaire and interview techniques. Results: T
The COVID-19 pandemic has profoundly affected the healthcare sector and the productivity of medical staff and doctors. This study employs machine learning to analyze the post-COVID-19 impact on the productivity of medical staff and doctors across various specialties. A cross-sectional study was conducted on 960 participants from different specialties between June 1, 2022, and April 5, 2023. The study collected demographic data, including age, gender, and socioeconomic status, as well as information on participants' sleeping habits and any COVID-19 complications they experienced. The findings indicate a significant decline in the productivity of medical staff and doctors, with an average reduction of 23% during the post-COVID-19 period. T
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