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.
Flow unit and reservoir rock type identification in carbonates are difficult due to the intricacy of pore networks caused by facies changes and diagenetic processes. On the other hand, these classifications of rock type are necessary for understanding a reservoir and predicting its production performance in the face of any activity. The current study focuses on rock type and flow unit classification for the Mishrif reservoir in Iraq's southeast and the study is based on data from five wells that penetrate it. Integration of several methods was used to determine the flow unit based on well log interpretation and petrophysical properties. The flow units were identified using the Quality Index of Rock and the Indicator of Flow Zone. Th
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This research aims to identify the role of external environment factors on the quality of educational services, from the academic point of view, where the distribution of a questionnaire to a random sample of (100) university professors, and then analyzing a model, and test the validity of this model using structural modeling (SEM) (Structural Equation Modeling).
And then test the relationships between variables using the software of Statistical Package for Social Sciences (SPSS V.18), the research found a number of conclusions, the most important conclusion is: the external environment factors has significant impact on the quality of educational services.
Objective: To assess the effect of six-minute walk test on health-related quality of life in patients undergone coronary artery bypass graft surgery at Iraqi center for heart diseases. Material: This descriptive study was conducted from 8th August, 2022 to 10th January, 2023. A non-probability purposive sample of 50 patients undergoing coronary artery bypass graft surgery at Iraqi center for heart diseases was included in the study. A questionnaire composed of three parts; sociodemographic and clinical data, six-minute walk test (6MWT) and health-related quality of life (HRQoL) were used. SPSS version 26 was utilized to analyze data. Results: Patient’s performance showed highly significant statistical differences at p<0.05 betw
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In this article four samples of HgBa2Ca2Cu2.4Ag0.6O8+δ were prepared and irradiated with different doses of gamma radiation 6, 8 and 10 Mrad. The effects of gamma irradiation on structure of HgBa2Ca2Cu2.4Ag0.6O8+δ samples were characterized using X-ray diffraction. It was concluded that there effect on structure by gamma irradiation. Scherrer, crystallization, and Williamson equations were applied based on the X-ray diffraction diagram and for all gamma doses, to calculate crystal size, strain, and degree of crystallinity. I
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Objective(s): This research aims at evaluating the quality of pulmonary tuberculosis patients life before and after applying the suggested instructional program, and to find out relationships among distribution of an overall assessment quality of life improvement and socio-demographic characteristics variables. Methodology: Self controlled design studying effectiveness of applying instructional program on quality of life for pulmonary tuberculosis patients among sample size (65) patients from primary health care centers/AL-Sadur City sector-the consultation clinic of chest and respiratory diseases at AL
The research aims to determine the required rate of return according to the Fama and French five-factor model, after strengthening it by adding the indebtedness factor to build the Fama and French six-factor model FF6M-DLE. The effect of the indebtedness factor on the company's profitability and the real value of the ordinary shares calculated according to the (equivalent ascertainment) model and its suitability with the company's situation, and an analysis of the fluctuation between the market value and the real value of the ordinary stocks.
The aim of this study is to get practical evidence from the Egyptian business environment The Impact of Audit Committees Effectiveness and External Audit Quality on Timeliness of annual Financial Report. Design and methodology: The study based on the content analysis technique to examine the annual reports of a sample of (30) companies listed on the Egyptian Stock Exchange (EGX100) during the period (2016-2019) with a total of (120) respondents. To test the research hypotheses, the results of the study indicate that there is a negative significant impact of audit committees on timeliness of annual financial report. Moreover, while there is a negative impact on the quality of the external audit on the timing of issuing the annual
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This study aims to identify the reality of using electronic applications in teaching language skills to people with mild intellectual disabilities from the mothers’ perspective. A descriptive approach was used. The electronic questionnaires were administered to the study sample, 122 responses were received from mothers of the students with mild intellectual disability in Hafer Al-Baten schools. The response average rate was 94%. The results showed that there are statistically significant differences that are related to the variant of monthly income as for the barriers to using electronic applications in such schools, whereas there were no differences regarding the variant of monthly income regarding t
... Show MoreThis research aims to identify the effective role of self-managed teams in the quality of service performance in the directorate of Ramadi municipality. The problematic nature of our research involves this main question of the effective role of self-managed teams in the Municipality of Ramadi in improving the services of performance quality to the beneficiaries from the Directorate service. The importance of this study lies in the role played by the work teams in the organizations that excel in their field, the attendant of the changes in the leadership, administrative roles of the institutions, and teams leaders, will be achieved by the self-managed teams in improving the quality of the service provided by the institution to whi
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Objectives: A cross sectional analytic study was carried out to identify the maternal risk factors which
contribute to occurrence of low birth weight, and to determine the statistical significant differences between low
birth weight and maternal risk factors.
Methodology: A purposive sample of (400) woman was selected from AL-Elwyia Maternity Teaching Hospital
and Fatima Al-Zaharia Maternity and Pediatric Teaching Hospital. Data was collected through the interview of
mothers. Questionnaire format was designed and consisted seven parts, demographic variables, and reproductive
variables , Reproductive health variables, complications during the current pregnancy, the mother newborn
variables nutritional status for the m