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.
Background: Health information systems in most countries are inadequate in providing the needed management support and the current health information systems are therefore widely seen as management obstacles rather than as tools,Objectives: the current study is an attempt to assess the behavioral and organizational determinants of health information system performance in Iraq.Methods: A cross-sectional study was conducted by interviewed a total of 189 respondents selected from six Iraqi governorates. The Organizational and Behavioral Assessment Tool was used to measure the behavioral and organizational determinants of health information system performance, it is one of the PRISM package tools that are used to assess the health informatio
... Show MoreHeritage reflects peoples' memory and essence of nations. Thus, this divan was really the material and tool for writers in general and poets in specific both in their artificial innovations . Accordingly, modern writers have endeavored to bring heritage back in all its details and occurrences. Abdullwahab Al-Bayati's experience had reflected his innovative and strong link with the humanitarian heritage, in that heritage in view of Al-Bayati means both the humanitarian expertise and gains that are able to extend from past to future passing through the present.From this, the poet had not disconnected his strong link with the Arab poetic heritage .Thus, the poet had utilized the Arab poetic heritage in expressing on the Arab contrary realit
... Show MoreTriticale is a hybrid of wheat and rye grown for use as animal feed. In Florida, due to its soft coat, triticale is highly vulnerable to Sitophilus oryzae L. (rice weevil) and there is interest in development of methods to detect early-instar larvae so that infestations can be targeted before they become economically damaging. The objective of this study was to develop prediction models of the infestation degree for triticale seed infested with rice weevils of different growth stages. Spectral signatures were tested as a method to detect rice weevils in triticale seed. Groups of seeds at 11 different levels (degrees) of infestation, 0–62%, were obtained by combining different ratios of infested and uninfested seeds. A spectrophotometer wa
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Thsst researcher problem of delays faced by researchers are all waiting to evaluate their standards by the experts who must take their views to extract the truth Virtual important step first step in building standards whatsoever, then the difference of opinion among experts about the paragraphs Whatever the scope of their functions, leading to confusion in maintaining these paragraphs or delete? Or ignore the views and opinion of the researcher to maintain the same? Or as agreed upon with the supervisor if he was a student? Especially if the concepts of a modern new building.
Therefore, the researcher sought to try to find a solution to her problem to conduct an experiment to test building steps
In this paper, the density of state (DOS) at Fe metal contact to Titanium dioxide semiconductor (TiO2) has been studied and investigated using quantum consideration approaches. The study and calculations of (DOS) depended on the orientation and driving energies. was a function of TiO2 and Fe materials' refractive index and dielectric constant. Attention has focused on the effect of on the characteristic of (DOS), which increased with the increasing of refractive index and dielectric constant of Fe metal and vice versa. The results of (DOS) and its relation with and values of system have been discussed. As for contact system is increased, (DOS) values increased at first, but the relation is disturbed later and transforms into an inve
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The idea of the design of combination Between split – plot and split block means that an experiment conducted with a design
formed by combination Between split – plot and split block, and it presents a precise manner to analytic who aimed to make appropriate statistical analysis for the experiment because such design contains four random errors , it make a high precision rather than another designs. The plan and the theoretical analysis were presented with application to show its idia and the ability to use it in many fields especially in agricultural experiments field .
The time spent in drilling ahead is usually a significant portion of total well cost. Drilling is an expensive operation including the cost of equipment and material used during the penetration of rock plus crew efforts in order to finish the well without serious problems. Knowing the rate of penetration should help in speculation of the cost and lead to optimize drilling outgoings. Ten wells in the Nasiriya oil field have been selected based on the availability of the data. Dynamic elastic properties of Mishrif formation in the selected wells were determined by using Interactive Petrophysics (IP V3.5) software based on the las files and log record provided. The average rate of penetration and average dynamic elastic propert
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Background: DVT is a very common problem with a very serious complications like pulmonary embolism (PE) which carries a high mortality,and many other chronic and annoying complications ( like chronic DVT, post-phlebitic syndrome, and chronic venous insufficiency) ,and it has many risk factors that affect its course, severity ,and response to treatment. Objectives: Most of those risk factors are modifiable, and a better understanding of the relationships between them can be beneficial for better assessment for liable pfatients , prevention of disease, and the effectiveness of our treatment modalities. Male to female ratio was nearly equal , so we didn’t discuss the gender among other risk factors. Type of the study:A cross- secti
Low bearing capacity of weak soil under shallow footings represents one of construction problems.
Kaolin with water content converges to liquid limit used to represent the weak soil under shallow
footing prototype. On the other hand, fly ash, which can be defined as undesirable industrial waste
material, was used to improve the bearing capacity of the soft soil considered in this research. The soft
soil was prepared in steel box (36×36×25) cm and shallow square footing prototype (6×6) cm were
used .Group of physical and chemical tests were conducted on kaolin and fly ash. The soft soil was
improved by a bed of compacted fly ash placed under the footing with dimensions equal to that of
footing but with different de
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The research aims to know the relation between positive thinking and self academic motivation, trend towards teaching profession. So a sample of (344) male and female student of the morning study of education colleges from the two universities of Baghdad and al Mustansria for the academic year 2012-2013.
So three tools had been used to achieve the procedures of the research which are: the scale of positive thinking constracted by Abdal satar Ibrahim year 2010, the scale of self academicmotivation constracted by (Gottfried) and adapted by Hanan Hussan year 2010, the scale of teaching profession trend constracted by Enayat Zaki year 1974.
And by using the statistical means of person
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