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.
Autorías: Nuha Mohsin Dhahi, Ahmed Thare Hani, Muwafaq Obayes Khudhair. Localización: Revista iberoamericana de psicología del ejercicio y el deporte. Nº. 6, 2022. Artículo de Revista en Dialnet.
The talk about the relationship between the media and industrialists can be the core of a bigger and deeper subject which is the role of these means in increasing sales : First, increasing the customer’s awareness of the importance of goods and the result of the promotion of products. Secondly, increasing investments which do require continuous studies and deep research in order to understand the constantly changing market conditions, and the public’s taste. In this research, we try to find out how industrialists see the role of media in the promotion of products in Iraq today, and how it develops in the future.
There was a reluctance of the industrialists to advertise in the local media, also industrialists see the role of t
... Show MoreBackground: Antibiotic resistance is a problem leading to difficulty in treating microbial infections thatmay occur due to many causes. For the important pharmacist role as a reference for the information and theability to access to medications, they are vital members in lowering the development of antibiotic resistance,and also they support the proper use and control of antibioticsmisuse. Our goal is comparing the knowledge,attitude, practice of undergraduate and postgraduate pharmacy students and their perceptions about thecausing factors of antibiotic resistance in Iraq.Method: A cross sectional study was conducted involving the final year bachelor and postgraduate (masterand Philosophical doctor) students from different private
... Show MoreThe research aims to find out the impact of wages and benefits systems on the performance of employees, which included the research community on a sample of employees in the company, and the sample consisted of (50) employees and an employee, A questionnaire composed as prepared (23) paragraph, use the promised statistically methods in data collected by the questionnaire analysis. The research reached a number of results, the most prominent of which were: There is a correlation between wage systems, benefits and performance of employees, and the presence of the impact of the systems of wages and benefits to the performance of employees. The research was presented a set of recommendations including: increasing the effectiveness of
... Show MoreThe research aims to identify the concept of financing structure and what are the determinants that affect it and the goals achieved by financing in commercial banks in addition to the sources upon which the financing structure depends consisting of internal financing sources and external financing sources and their connection to the profits of commercial banks. Baghdad, Khaleeji Commercial Bank) registered in the Iraq Stock Exchange during the period for the years (2011-2020) published in the Iraq Stock Exchange from and the research relied on financial analysis tools to analyze the independent variable the following financing structure (the ratio of equity to total assets, the ratio of deposits to Total liabilities, the ratio of loans
... Show MoreThe research aims to identify the positives formulation entrances authors depending on the setting retaining the names of the authors of Arab veterans and cons of setting the entrances to Arab authors ancient depending on the nickname by desktop diligence without reference to a setting retaining the potential to benefit other libraries disciple of retaining existing in sober university libraries. Use the survey method and adopted a questionnaire distributed to the research sample consisting of employees working in the libraries in question and the total number of forms that have been distributed (50) form .tousel search phrase conclusions from them .
1-The lack of authority control depends on it to find a
... Show MoreThe objective of the study was to identify the effectiveness of a training program based on the employment of the educational portal in the development of the skills of the administrative body in the basic education schools in Dhofar Governorate. To achieve the goal, a training program was designed that includes the skills of the educational portal to be met by the administrative body and measuring its effectiveness. A questionnaire to identify training needs, and a notecard to evaluate performance. The study sample consisted of (70) individuals of the administrative staff. The researchers used the descriptive-analytical method to identify the training needs, design and build the training program and the experimental method for applying
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