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: Hemorrhoids are one of the most
common surgical conditions .Conventional
haemorrhoidectomy was the traditional operation for
the treatment of hemorrhoids. Other modalities of
treatment had been used as an alternative operations
including CO2 laser haemorrhoidectomy.
Objectives: To determine the outcome of treatment
of hemorrhoids by using CO2 laser
haemorrhoidectomy and its advantages over
conventional surgery
Methods: This is a retrospective comparative
interventional study of 1024 case of third degree
haemorhoids selected out of 1300 case of
hemorrhoids of different degrees, admitted to
ALKINDY, ALYERMOUK teaching hospitals and
ABD ALMAGEED private hospital, from May 1998
to J
The expression is a prominent feature of the Arabic language, but it is one of the characteristics that are inseparable from it. The expressive aspects of each other.
The issue of Arab differences and their impact on the divergence of meaning is one of the issues that have preoccupied the minds of the Arabic language owners and their views went to various doctrines. Introduction: (Whenever I finished a question concluded with a verse related to any download, and followed by the need for expressing, interpretation and interpretation) I found him in some of the Aarabip more than the face of some of the vocabulary raised and erected and a jar, when the verses of the Koran, resulting in a research lies between Grammar and the Koran under
The investment however "was its description and meaning, it remains a resident" in the composition of capital assets located in the forefront of the creation of productive assets, and this means that the investment in the productive sectors is a priority in achieving capital accumulation, on any other investment that takes place with the stages of advanced development of formation , not forgetting "to humans and investment humans as head of real money product, the source of the economic surplus and accumulation, and the source of producing values, and if human labor was the source of value, and the human was the source of work, therefore humanitarian work on different levels and skills presents capital", so the investment in huma
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This study aims at identifying the notion of Post-Occupancy Evaluation (POE) pertinent to the performance of three general hospitals constructed inside the Sulaimani City, tracing the relationship between the quality of the indoor environments and medical staff (doctors and nurses) satisfaction level. Using some indoor environment elements in the right way will positively influence the mood, stress level of the medical staff, and patient recovery as a result. The POE toolkits (AEDET and ASPECT) have been implemented on targeted wards at the selected hospitals. AEDET and ASPECT questionnaires were distributed among 152 medical staff to obtain their perspectives. In total, 112 valid questionnaires were received. The medica
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Medicine is one of the fields where the advancement of computer science is making significant progress. Some diseases require an immediate diagnosis in order to improve patient outcomes. The usage of computers in medicine improves precision and accelerates data processing and diagnosis. In order to categorize biological images, hybrid machine learning, a combination of various deep learning approaches, was utilized, and a meta-heuristic algorithm was provided in this research. In addition, two different medical datasets were introduced, one covering the magnetic resonance imaging (MRI) of brain tumors and the other dealing with chest X-rays (CXRs) of COVID-19. These datasets were introduced to the combination network that contained deep lea
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الانهار اصبحت مشبعة بثاني اوكسيد الكربون بشكل عالي وبذلك فهي تلعب دور مهم في كميات الكربون العالمية. لزيادة فهمنا حول مصادر الكربون المتوفرة في النظم البيئية النهرية، تم اجراء هذه الدراسة حول تأثير الكربون العضوي المذاب والحرارة (العوامل الرئيسية لتغير المناخ) كمحركات رئيسية لوفرة ثاني اوكسيد الكربون في الانهار. تم جمع العينات من خمسة واربعون موقع في ثلاثة اجزاء رئيسية لنهر دجلة داخل مدينة بغداد خلال فص
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The research aims to identify the level of awareness of student teachers in the behavioral disorders and autism specialization about the diagnosing Autism Spectrum Disorder and Social (Pragmatic) Communication Disorder according to some variables. The study was conducted on a sample of (113) student teachers. The researcher employed the awareness scale of a teacher-screening questionnaire for autism spectrum disorder and social pragmatic communication disorder. The results showed that the average of teachers in the total degree of awareness of autism spectrum disorder and social communication have recorded a moderate degree. As for the awareness of autism spectrum disorder was high. Then, the awareness of social communication disorder wa
... Show MoreThis research study examines the impact of information technology on firm profitability and stock returns. Using a comprehensive dataset of firms across various industries, this research employs rigorous statistical analysis techniques to investigate the relationship between IT investments, firm profitability metrics, and stock returns. The study focuses at how IT investments affect financial performance measures including return on assets (ROA) and return on equity (ROE), with P-values of 0.34 and 0.12, respectively. Furthermore, the study investigates the influence of IT on stock returns, taking into account market capitalization, industry trends, and macroeconomic variables. This study's conclusions center on the beneficial assoc
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