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.
Abstract
The basic orientation of the research is an attempting to apply the cost determining method according in the contract sector projects for Al- Iraq ceneral company, that this subject has a big value according to its modernity and its influence on the future and the eaning of the company.
The research aims to find out the effect of the method for determining cost based on the activity in determining the cost of the construction sector projects.The research was conducted in Iraq General Company for the implementation of irrigation projects. Bani search on three assumptions, the first is (that the application of the method for determining the cost on the basis of
... Show MoreThe public budget is regarded a main tool for economic and social development. The preparation of the public budget constitute an important stream which enriches the developmental efforts and the definition of its priorities, therefore it is the focus point of many specializations. The public budget has numerous functions. It is a means to precise and to execute the political and economic goals of the executive authority, a mirror of the economic structure which reflects its strength and weakness points, specifies its revenues and others. Since the parliament is the voice of the society which expresses its interests, then, it must monitor the performance of the government so that the participation of the legislative authority in
... Show MoreObjectives:
To evaluate mothers’ attitudes toward readiness for discharge care at home for a premature baby in Intensive Care Unit at teaching hospitals in Medical City Complex and to find out the relationship between mothers’ attitudes and their socio-demographic characteristics.
Methodology: A quasi-experimental study design was carried out through the period of 6th January 2020 to 2021 to 11th March 2021, to evaluate mother’s attitude toward discharge care plan for premature babies. The study carried out in Welfare Teaching Hospital, Nursing Home Hospital and Baghdad Teaching Hospital at Medical City Complex in Baghdad City on 30 mother of premature babies in neonatal intensive care units using the nonprobability sampling
The Results of Theoretical Studies and Experiment of Advanced Economies , Have Been Proven That Investment Expenditure Is Not The Only Factor And The Main Source of Production Growth, But Efficient Using Of The Fixed Assets Is More Important In This Process, All That Depends On Groups of Factors Called The Non-Investment Economic Growth, That Are Un-bodied Technical Progress With Organizational Nature.
It's Distinguished Features That it has An Influence on The Production Growth Without Any Large Additional Investment Expenditure Or Any Additional Increment in Inputs And That Can Not Be Reached Without Activating The Factors of Non-Investment Economic Growth, Which is Still Affecting Negatively In T
... Show MoreThat corruption with all its forms, has prevailed over the whole world, but with different degrees relaying on the one who leads these countries of rulers, followers and officials who have been deemed the main reason for that corruption, but if these rulers were righteous, These countries would have blessed and elevated and were corrupt unjust tyrants who were the disaster that befell the chiefs of those countries with ruin, misery, and backwardness. This is what we sought to prove and clarify by considering the verses of the Holy Qur’an in respect with this topic. The research includes an introduction, two topics, and a conclusion.
 
... Show MoreEdward Albee (1928-2016) is an American dramatist who is notorious for his controversial works. Albee's plays generate a crisis of a restraint situation and a point of no return where characters trespass the limits and get caught up in a tragic cycle. The Goat or Who is Sylvia? )2000) is one of his controversial pieces, addressing (human-animal relations). This theatrical masterpiece unleashes man's wildest desires and ravaging behavior. Bestiality is a criminal offense placed in the domain of mental disorders attributed to the lack of emotional support, anxiety, depression, and psychological problems. It is also a serious moral infraction of communities' socio-religious traditions. In this play, Martin’s bestiality lead
... Show MoreAbstractin adult typical atrioventricular nodal reentrant tachycardia (AVNRT) consider most common paroxysmalsupraventricular tachycardia. Dual pathway idea still accepted and used widely and commonly. According tothe guide line, ablations of slow pathway still the first treatment with good success rate.Identify the electrophysiological difference of atrioventricular nodal pathways pre and post ablation.Electrophysiological study was done to 54 patients with only typical type AVNRTs; they were 40 (74%)females and 14 (26%) males. Divided into two groups G1 with 38 patients (70.4%) having one pathway andG2 with 16 patients (29.6%) with multiple pathway. After induction we study the clinical andelectrophysiological feature of tachycardia and s
... Show MoreRecent studies have revealed some conflicting results about the health effects of caffeine. These studies are inconsistent in terms of design and population and source of consumed caffeine. In the current study, we aimed to evaluate the possible health effects of dietary caffeine intake among overweight and obese individuals.
In this cross-sectional study, 488 apparently healthy individuals with overweight and obesity were participated. Dietary intake was assessed by a Food Frequency Questionnaire (FFQ) and