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 book includes four main chapters: 1. Indefinite Integral. 2. Methods of Integration. 3. Definite Integral. 4. Multiple Integral. In addition to many examples and exercises for the purpose of acquiring the student's ability to think correctly in solving mathematical questions.
This study aims to identify the level of application of blue ocean leadership activities in public organizations and to build a conceptual and cognitive framework around this concept. The study adopted a descriptive-analytical approach, and the research sample consisted of (95) individuals from the senior management working at the center of the Iraqi Ministry of Communications (director general, department manager, section head). The data analysis technique used is structural equation modeling (SEM) and the Statistical Package for the Social Sciences (SPSS). The results indicate that the senior management in the Ministry of Communications is working to adopt the blue ocean leadership style through its activities, but not to the leve
... Show MoreAbstract: Background: Drug toxicity and chemotherapeutic side effects negatively impact the quality of life of breast cancer patients. Objectives: to evaluate the efficacy of pharmaceutical Interventions (PI) on quality of life (QOL)Among chemotherapy intake breast cancer women. Method: A pre-post interventional study was carried out at the chemotherapy ward of Alhabobi Hospital in Alnasiriyah City. Eligible patients received comprehensive pharmaceutical care and a self-compiled Breast Cancer Patients Medication Knowledge Guide pamphlet. Each patient received two sessions, the first at baseline and the second after 7, 14, or 21 days depending on the next taking dose of chemotherapy. Each session lasted for approximately 15-30 minutes. Par
... Show MoreThis book includes three main chapters: 1. Functions & Their Derivatives. 2. Minimum, Maximum and Inflection points. 3. Partial Derivative. In addition to many examples and exercises for the purpose of acquiring the student's ability to think correctly in solving mathematical questions.
The Research deals with the negative phenomena which appeared in the urban scenes of the Iraqi cities after 2003, particularly trespassing the architectural design of the urban Individual houses. Many academic researchers , critics, and cultural circles, drawn attention to the impact of political and cultural variable change on such phenomena without detailed analysis . The research problem is set according to central questions : If the phenomena is the trespass , what
are the sides which are being trespassed in the division of the individual house? , If the diagnosis of the phenomena denotes perceived repetition of the cases , So what's size of this transposes on the architectural design of t
Receipt date:3/13/2021 accepted date:5/26/2021 Publication date:12/31/2021
This work is licensed under a Creative Commons Attribution 4.0 International License.
energy is one of the strategic resources within international politics, and this is through the existing competition between the international powers on it, and the global powers have begun to rely on interest in new areas, such as import, depending on new projects an
... Show MoreLow 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
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
... Show MoreCompounds were prepared from In2O3 doped SnO2 with different doping ratio by mixing and sintering at 1000oC. Pulsed Laser Deposition PLD was used to deposit thin films of different doping ratio In2O3: SnO2 (0, 1, 3, 5, 7 and 9 % wt.) on glass and p-type wafer Si(111) substrates at ambient temperature under vacuum of 10-3 bar thickness of ~100nm. X-ray diffraction and atomic force microscopy were used to examine the structural type, grain size and morphology of the prepared thin films. The results show the structures of thin films was also polycrystalline, and the predominate peaks are identical with standard cards ITO. On the other side the prepared thin films declared a reduction of degree of crystallinity with the increase of doping ra
... Show MoreInfrastructure, especially wastewater projects, plays an important role in the life of residential communities. Due to the increasing population growth, there is also a significant increase in residential and commercial facilities. This research aims to develop two models for predicting the cost and time of wastewater projects according to independent variables affecting them. These variables have been determined through a questionnaire distributed to 20 projects under construction in Al-Kut City/ Wasit Governorate/Iraq. The researcher used artificial neural network technology to develop the models. The results showed that the coefficient of correlation R between actual and predicted values were 99.4% and 99 %, MAPE was
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