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.
Community pharmacists faced more complex challenges in meeting patients’ medication needs during the pandemic than previously reported in the literature. Objectives To explore the perception and abilities of community pharmacists in managing patients’ needs in terms of medication dispensing during the pandemic, and to examine its effect on improving the patients’ situations. Materials and Methods A cross-sectional study design, validated by 30 experts, was conducted using an electronic survey (Google Form) to assess the effect of the dispensing practice of Iraqi community pharmacists on the patient’s clinical outcomes during the pandemic. The survey was distributed on professional pharmacist’s social media platforms from December
... Show MoreAfter the Napoleonic Code of 1804 came without any legal rules specific to the duration of the contract, and was content to refer to it in scattered legal texts, Legislative Decree No. 2016-131 came to establish a comprehensive legal system for the duration of the contract, starting from the period of its formation, through the period of its implementation, and ending with its continuation after the expiration of its term, in the third section of the fourth chapter related to the effects of the contract (Articles 1210 - 1215), relying on judicial precedents on the one hand - which are many, as will be shown through the research pages - and contractual practices on the other hand. Perhaps the main motive that prompted the French legislator t
... Show MoreThis paper considers a new Double Integral transform called Double Sumudu-Elzaki transform DSET. The combining of the DSET with a semi-analytical method, namely the variational iteration method DSETVIM, to arrive numerical solution of nonlinear PDEs of Fractional Order derivatives. The proposed dual method property decreases the number of calculations required, so combining these two methods leads to calculating the solution's speed. The suggested technique is tested on four problems. The results demonstrated that solving these types of equations using the DSETVIM was more advantageous and efficient
A fracture is a damage to bone tissue that causes damage to the tissue surrounding the bone and may penetrate the skin. Subjects and methods: the present study included (80) fractured Iraqi patients (and 40) patients with DM2 and (40) without DM2 and compared them with (40) healthy control. Patients and control are matched in age. This study showed a significant increase in retinol-binding protein 4 (RBP4) and a considerable decrease in Vit .A GPT and GOT in fracture patients with and without DM2. In addition, there was a significant negative correlation between RBP4 with (GPT and GOT) in fracture patients with DM2 and a significant positive correlation between RBP4 with (GPT and GOT) in fracture patients without DM2.
... Show MoreBackground: The purposes of this study were to determine the photogrammetric soft tissue facial profile measurements for Iraqi adults sample with class I normal occlusion using Standardized photographic techniques and to verify the existence of possible gender differences. Materials and methods: Eighty Iraqi adult subjects (40 males and 40 females) with an age ranged between 18-25 years having class I normal occlusion were chosen for this study. Each individual was subjected to clinical examination and digital standardized right side photographic records were taken in the natural head position which is mirror position which the patient looking straight into his eyes into the mirror mounted on the stand. The photographs were analyzed using A
... Show MoreThe purpose of this study is to show the constants and variables geography in Russian
policy in light of variables geostrategic witnessed by the world, especially after the collapse
of the Soviet Union and the disintegration to fifteen Republic became the Russian Federation
and the heir to the Soviet Union, Geography particularly important because the impact of its
data in policy making less change ofothers, and explain the political choices cannot achieve
security through its relationship constants geographical (natural or human) paint forms of
economic activity and determine the points they national security. issue is the geographical
this or that country is determined by its policy also specifies the way in which
Henrik Ibsen is considered one of the greatest writers on society and its problems in the modern era, as his works deal with society in all its forms in a realistic way, in which he presents the motives and consequences of social problems and their impact on society to study these problems through them to and propose solutions through theatre. Most of his writings were very serious about addressing these social issues. The method of collecting information in the study came through reviewing a group of sources related to realistic theater and social theory, then reading the plays covered in a critical and analytical reading. Based on that, the method of writing this study came and used a group of sources that directly relate to the s
... Show MoreBackground: Prostatic adenocarcinoma is the most widely recognized malignancy in men and the second cause of cancer-related mortality encountered in male patients after lung cancer.
Aim of the study: To assess the diagnostic value of diffusion weighted imaging (DWI) and its quantitative measurement, apparent diffusion coefficient (ADC), in the identification and localization of prostatic cancer compared with T2 weighted image sequence (T2WI).
Type of the study: a prospective analytic study
Patients and methods: forty-one male patients with suspected prostatic cancer were examined by pelvic MRI at the MRI department of the Oncology Teaching Hospital/Medical City in Baghdad
... Show More