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 study examined the tagged (the matter, its ruling, and examples of its applications in Ahmadiyya interpretations), the study of devising formulas of commissioning, especially the matter from the book of interpretation, which is: (Ahmadiyyeh’s interpretations), and the contemplative of the nature of (Ahmadiyya’s interpretations) realizes that the cognitive, linguistic and juristic knowledge product and the verses of judgments And other is the focus of this immortal travel, as it is truly a comprehensive book containing what the students of knowledge, scholars and the general public need in terms of interpreting the legal verses, and it is not possible to reach an understanding of the Book of God Almighty, and to clarify his purpo
... Show MoreObjective: To assess the impact of a social support for pregnant women upon their pregnancy outcome Methodology: A descriptive purposive study was used to assess the impact of a social support on their pregnancy outcomes. The study was conducted from (22 \ September \ 2020 to 15 \ February \ 2021). A non-probability sample (purposive sample) was selected from 100 women. Data were collected through an interview with the mother in the counseling clinic, during the third trimester of pregnancy, as well as after childbirth in the labor wards to assess the outcome of pregnancy. Data were analyzed through descriptive statistics (frequency and percentages). Results: The most important thing observed in this study was the positive pregnancy outcome
... Show MoreMaximum power point tracking (MPPT) is used in photovoltaic (PV) systems to enhance efficiency and maximize the output power of PV module, regardless the variation of temperature, irradiation, and the electrical characteristics of the load. A new MPPT system has been presented in this research, consisting of a synchronous DC-DC step-down Buck converter controlled by an Arduino microcontroller based unit. The MPPT process with Perturb and Observe method is performed with a DC-DC converter circuit to overcome the problem of voltage mismatch between the PV modules and the loads. The proposing system has high efficiency, lower cost and can be easily modified to handle more energy sources. The test results indicate that the u
... Show MoreThe outbreak of a current public health coronavirus 2019 disease is a causative agent of a serious acute respiratory syndrome and even death. COVID-19 has exposed to multi-suggested pharmaceutical agents to control this global disease. Baricitinib, a well-known antirheumatic agent, was one of them. This article reviews the likely pros and cons of baricitinib in attenuation of COVID-19 based on the mechanism of drug action as well as its pharmacokinetics. The inhibitory effect of baricitinib on receptor mediated endocytosis promoter, AKK1, and on JAK-STAT signaling pathway is benefacial in inhibition of both viral assembling and inflammation. Also, its pharmacokinetic has encouraged the physicians toward the drug
... Show MoreThe reconciliation of tax reconciliation is one of the legal methods used by the financial authority in Iraq, which is done with the taxpayer
The research dealt with the weakness of tax revenues for many reasons, including tax evasion, which led to the search for ways to reduce evasion to increase the tax revenue, and settlement reconciliation one of these means .
The research proceeded from the premise that the use of a more broadly settled settlement would govern the tax evasion of taxpayers.
The researchers used a series of studies and previous research, books and other sources related to the subject of research, and this was done through the theoretical framework, and the practical aspect that included the fin
... Show MoreSpiritual is one of modern subjects gained importance of their role in the meaning imparted to work and to promote a sense of belonging to the group and the community, including support personnel positive attitudes towards their work. The research aims to highlight the impact of the relationship between workplace spiritual and variable working attitudes to sample variant of the hospitals, health department BAGHDAD / Rusafa, and in order to achieve this, the researcher is based on the descriptive and analytical approach adopted for the analysis of the questionnaire and to test relations research and its variables. The research community (4) of hospitals in Sadr City, included've targeted 106 doctors and 222 nurses formed a whole (
... Show MoreThe present research tackles a number of historical facts and incidents with a purely legal dimension in an important stage in the contemporary history of Iraq, especially the era of the British occupation. This resulted in innumerable social, political and legal problems, particularily the judicial legislation problems in Iraq. These legislations included a set of civil laws and in force governmental procedures that will be discussed historically by examining documents issued by the Ministries of Justice and Interior Affairs in the governments of monarchy for the period from 1921-to-1958. The data of the present paper relied on the Iraqi Library and Archives, (hence DKW). The study adopted the narrative historical methodology when inves
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This study aims to identify the issue of observing media publishing and its importance for public relations in the management of special events; and its role in building the positive image of the target audience through communication messages that illustrate the political, economic and diplomatic importance of the Arab Summit. As such Summit is one of the conferences that Iraq sought to secure the requirements of its convening to re-activate its political and diplomatic role in the Arab Ocean, especially after the circumstances and crises that Iraq went through.
The convening of the Arab Summit under the auspices of Iraq was a qualitative transition, during which Iraq sought to achieve some gains b
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