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
This research aims to study human error effects in the banking risks in the private banks through the measurement and testing of human error effect in every kind of banking risks types and stand on the most closely associated with the risks in order to focus on them and make appropriate processors have with respect to and increase the availability of skills and expertise required to carry out banking operations of error-free manner.
Find dealt with human error in terms of meaning and understandable, classifications and types, causes and consequences and its approaches and theories. Also addressed placed banking risks in terms of meaning and concept, species and entr
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The issue of liquidity, profitability, and money employment, and capital fullness is one of the most important issues that gained high consideration by other authors and researchers in their attempts to find out the real relationship and how can balance be achieved, which is the main goal of each deposits.
For the sake of comprising the study variables, the research has formed the problem of the study which refers to the bank capability to enlarge profits without dissipation in liquidity of the bank which will negatively reflect on the bank's fame as well as the customers' trust. For all these matters, the researcher has proposed a set of aims, the important of which is the estimation of the bank profitability; liquid
... Show MoreIn this paper, we investigate the basic characteristics of "magnetron sputtering plasma" using the target V2O5. The "magnetron sputtering plasma" is produced using "radio frequency (RF)" power supply and Argon gas. The intensity of the light emission from atoms and radicals in the plasma measured by using "optical emission spectrophotometer", and the appeared peaks in all patterns match the standard lines from NIST database and employed are to estimate the plasma parameters, of computes electron temperature and the electrons density. The characteristics of V2O5 sputtering plasma at multiple discharge provisos are studied at the "radio frequency" (RF) power ranging from 75 - 150 Wat
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Background: While warfarin and direct oral anticoagulants (DOACs) are used to manage thromboembolic events, they possess several features that impact adherence. Objective: To assess medication adherence and self-efficacy in patients receiving warfarin or DOAC treatment. Methods: A cross-sectional study was performed at Ibn Al-Bitar Hospital in Baghdad from December 2022 to May 2023 on patients receiving either warfarin or DOACs. The Arabic version of the Adherence to Refills and Medications Scale (ARMS) questionnaire and the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6C) questionnaire were used to assess adherence and self-efficacy. Results: 181 patients were enrolled in the study, of whom 56.9% received warfarin an
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Endothelin-I (ET-I) is one of the potent vasoconstrictors secreted from endothelial cells when needed. Many studies revealed the elevation of serum ET-I with human diabetes and microangiopathies. Since insulin resistance is a case of mixed diabetic and pre-diabetic cases, many risk factors beyond obesity and inflammation are proposed. The current study aims to demonstrate the association between serum ET-I and asymmetric dimethylarginine (ADMA) and insulin resistance in type 2 diabetes mellitus (T2DM). Sera of 73 subjects were enrolled currently (control= 35 subjects, and 38 with T2DM for more than 7 years), aged (40-60) years old, with distinct body mass index (BMI) ≤ 25 for control volunteers and (BMI) ≥ 25 for obesity and diabetes
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Background: The clinical examination is one of the best suitable methods for diagnosis of low backache. Backache is one disease that the signs, clinical examination finding, and the results on imaging modalities not always related. The straight leg raising (SLR) and slump tests, can be used for diagnosis of lumber disc herniation.
Objectives: To compare the result of the slump test and SLR test in the diagnosis of lumber disc herniation.
Subjects and Methods: A prospective comparative study conducts on 280 patients in Al-Kindy teaching and private clinics complaints of backache, aging between 18-70 years old with acute or recurrent backache, sciatica pai
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In this paper the concept of (m, n)- fully stable Banach Algebra-module relative to ideal (F − (m, n) − S − B − A-module relative to ideal) is introducing, we study some properties of F − (m, n) − S − B − A-module relative to ideal and another characterization is given