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.
Information and communication technology has a significant influence on employee procedures. Businesses are investing in e-CRM technologies, yet it is difficult to assess the performance of their e-CRM platforms. The DeLone and McLean Information Systems Success framework can be modified to the current e-CRM assessment difficulties. The new framework's different aspects provide a concise framework for organizing the e-CRM key metrics identified in this study. The purpose of this study is to apply and verify that the Updated DeLone and McLean IS Model can be employed to explain e-CRM adoption among employees, along with the extended Updated DeLone and McLean Model with its five output factors, namely system quality, service quality,
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Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a pandemic worldwide. On a daily basis the number of deaths associated with COVID-19 is rapidly increasing. The main transmission route of SARS-CoV-2 is through the air (airborne transmission). This review details the airborne transmission of SARS-CoV-2, the aerodynamics, and different modes of transmission (e.g. droplets, droplet nuclei, and aerosol particles). SARS-CoV-2 can be transmitted by an infected person during activities such as expiration, coughing, sneezing, and talking. During such activities and some medical procedures, aerosols and droplets contaminated with SARS-CoV-2 particles are formed. Depending on their
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The research aimed to test the effect of independent variables career plateaus and workaholism on employees loyalty through the influence of the mediator variable organizational socialization. Descriptive approach with survey style on a sample of managers and executives in the Iraqi Drilling Company in Basra's (123) employees. The most important findings of the research are: the existence of a significant effect of the independent variables career plateaus and workaholism in employees loyalty by having a mediator variable organizational socialization and introduced numerical from recommendations. &nbs
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The COVID-19 pandemic has profoundly affected the healthcare sector and the productivity of medical staff and doctors. This study employs machine learning to analyze the post-COVID-19 impact on the productivity of medical staff and doctors across various specialties. A cross-sectional study was conducted on 960 participants from different specialties between June 1, 2022, and April 5, 2023. The study collected demographic data, including age, gender, and socioeconomic status, as well as information on participants' sleeping habits and any COVID-19 complications they experienced. The findings indicate a significant decline in the productivity of medical staff and doctors, with an average reduction of 23% during the post-COVID-19 period. T
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Groupwise non-rigid image alignment is a difficult non-linear optimization problem involving many parameters and often large datasets. Previous methods have explored various metrics and optimization strategies. Good results have been previously achieved with simple metrics, requiring complex optimization, often with many unintuitive parameters that require careful tuning for each dataset. In this chapter, the problem is restructured to use a simpler, iterative optimization algorithm, with very few free parameters. The warps are refined using an iterative Levenberg-Marquardt minimization to the mean, based on updating the locations of a small number of points and incorporating a stiffness constraint. This optimization approach is eff
... Show MoreObjective(s): To assess the burden of mothers` care for child with colostomy and find out relationships between child and mother socio-demographic data with mothers` burden. Methodology: a descriptive study was conducted from 1 August 2013 to 1 September 2014. The sample consisted of 100 children and their mothers at Baghdad Teaching hospital in Baghdad city. A questionnaire was prepared based on the previous literature review, meeting mothers of children with colostomy, and the Zarit Burden Interview scale. Data has collected through the application of questionnaire and interview techniques. Results: T
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Background: Assessment is an important part of the learning cascade in education. Students realize it as an influential motivator to direct and guide their learning. The method of assessment determines the way the students reach high levels of learning. It has been documented that one of factor affecting students’ choice of learning approach is the way how assessment is being performed. Many methods of assessment namely multiple choice questions, essay questions and others are mainly used to assess basic science knowledge in undergraduate education. Objectives: The aim of this study is to compare multiple choice questions (MCQ) and essay questions (EQ) (record the success and failure rate of multiple choice questions (MCQ) and essay quest
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