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.
These factors, as well as disasters and wars that the Arab homeland exposed to and still under this exposure, in addition to the severe stress upon.
Iraqi Academics have been subjected to direct consequences of 2003 war. Exact figures are not known. It was mentioned. Many people were killed, sacked from their academics jobs, threatened to leave directly or indirectly their jobs, houses, and Iraq. Others have been imprisoned, tortured, or kidnapped / threatened to be kidnapped etc. Their families have been subjected to similar traumatic experiences or threats. All theses stressors may have lead to Post Traumatic (PTSD) Experiences. These Traumatic experiences have lead to Dislocation, relocation and Immigration etc. All sectors of
... Show MoreThe current research aims to measure Generalized Anxiety Disorder among students of the University of Sulaymaniyah / College of Basic Education, and to identify the significance of differences between sex, scientific specialization and age, and for that reason, the research sample of (102) male and female students was chosen in a random manner, and the researcher used the diagnostic criteria for the generalized anxiety disorder contained He mentioned it in the Statistical and Diagnostic Manual of Psychiatry, and the paragraphs of the scale were formulated according to those standards after they verify the conditions of honesty and consistency, and the use of appropriate statistical means. The results of the research indicated that genera
... Show MoreSymptoms of posttraumatic stress disorder are associated with various variables such as the exposure to traumatic events, sex and age. Such events could lead to negative cognitions towards self and the world. These cognitions, in turn, may lead to traumatic related disorders.
The present study aims to identify the percentage of traumatised individuals according to sex and age category variables. It also aims to assess the average of spreading symptoms of posttraumatic stress disorder of traumatised individuals according to sex and age category variables. Likewise, it aims to test variables significance in cognitions towards the world and the self according to the level of the spread of posttraumatic stre
... Show MoreThis paper exclusively deals with medical encounters. . Structurally and thematically, it manifests itself in five parts. The First part deals with medical encounters as well as essential speech activities which cover (a) frames (certain types of talk) (b) the patient’s account and the patient’s story or more precisely the patient telling his story and (c) the act of questioning the patient. The Second part revolves round genre and register. The former, in most cases, suggests that the format of medical encounters is conversational. With register; we have a converse reality that restrictively tries to narrow things and give them a certain flavor. The Third part realizes the technicalities of medical encounters (a) the setting of an inte
... Show MoreInformation hiding strategies have recently gained popularity in a variety of fields. Digital audio, video, and images are increasingly being labelled with distinct but undetectable marks that may contain a hidden copyright notice or serial number, or even directly help to prevent unauthorized duplication. This approach is extended to medical images by hiding secret information in them using the structure of a different file format. The hidden information may be related to the patient. In this paper, a method for hiding secret information in DICOM images is proposed based on Discrete Wavelet Transform (DWT). Firstly. segmented all slices of a 3D-image into a specific block size and collecting the host image depend on a generated key
... Show MoreThis research investigates solid waste management in Al-Kut City. It included the collection of medical and general solid waste generated in five hospitals different in their specialization and capacity through one week, starting from 03/02/2012. Samples were collected and analyzed periodically to find their generation rate, composition, and physical properties. Analysis results indicated that generation rate ranged between (1102 – 212) kg / bed / day, moisture content and density were (19.0 % - 197 kg/ m3) respectively for medical waste and (41%-255 kg/ m3) respectively for general waste. Theoretically, medical solid waste generated in Al-Kut City (like any other city), affected by capacity, number of patients in a day, and hosp
... Show MoreThis study was (the reality of beekeeping in Iraq and ways of developing them) as a research project in the branch of production is important branches of the productivity of the agricultural sector in Iraq, and the importance of this section, productive (beekeeping) for the agricultural sector in his contribution to increase the vegetable production and improve the quality and the various Classes of types, through its active role in the pollination of plants and indirectly (when the bees to move between plants to collect nectar and pollen grains), which contributes to reduce the losses in plant production and raise the rate of productivity per donum of various agricultural crops.
On the other hand play a
... Show MoreHuge yearly investments were made by organizations for the development and maintenance. However, it has been reported that most of the IT projects fails as it is delayed, over budget and discontinued quality. A systematic literature review (SLR) was conducted to identify the critical success factors (CSFs) for the IT projects. Nine (9) CSFs was identified from the SLR. An online survey was conducted among 103 respondents from developers and IT managers. The data was analyzed using the Statistical Package for Social Science (SPSS 22). The findings showed that the highest CSFs of IT projects is commitment and motivation. Project monitoring was found the lowest score ranked by respondents.
Abstract
Our description of the wxperience of any poet depends on the nature the anture of his writing or his style in terms of factors affecting his experience . We have found that al- Maghout is characterized by important poetis properties that characterized all of his poetry such as the ease in compositions that are formed the vocabulary of daily life . This is what constitutes his poetic lexicon that depends on the vocabulary of space , time , and anture . Hispoetry derives its aesthetics from revealing that strains in the text for the sake of surprise and amazement with a simple realism.
Basic Orientation and search path in determining the impact of creative thinking in cultural intelligence field research on the doctors competence, as is a theme of creative thinking great importance in spite of being a old , but his role at the individual level and / or organizational a sustainable effect toward developing a fact uncommon , any sense that one of the pillars of modernity and provide a unique future, as is the competitive weapon of the organizations in an environment dubbed fundamental change and provide all that is unfamiliar, and in the center of the field of research and objective measurement of creative thinking on doctors specialists at the construction of a state of the preference and
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