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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
I've led an end to the Palestinian presence in the Jordan to the occurrence of a major fault line in relations between Jordan and the Palestinian on the levels of all , and as a result sought King Hussein and the initiative of the U.S. to heal the rift that solution between Jordanians , Palestinians, and the regulation of relations between the two parties announced in March 1972 for the project and unitary featuring Jordan and Palestine in the Arab kingdom united with the two countries , but that the Palestine Liberation Organization and the Palestinian resistance factions rejected by asserting that it is has the right of self-determination of the Palestinian people and no one else , and rejected by the Arab states and ( Israel ) , and l
... Show MoreThe study aims to identify how to build the media message in an artistic design style (infographic) to reach the mechanism of building the media message by infographic in the researched news sites. For the survey method, which is one of the best methods used to study the subject of the research, the researcher used the method of content analysis, the employee of the research tool, a quantitative and qualitative content analysis form for the study of 74 infographics that appeared during the research period in the research sample sites. The study revealed a number of results, most notably 1. The surveyed sites employed the information in a manner based on images, shapes and data, that is, through the use of the visual element and the
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Many people, especially among the youth or scholars, wonder about the position of Islam or the scholars of faith on the terminology used by scholars of theology in a certain period of time, and then circulated by people throughout the times and to the present day, such as the terms (the old, the maker, the updated, the cause and the cause) and so on, and this What I felt myself while teaching this subject from some of the students, some of whom consider it blasphemy, and some of them consider it an innovation of speech, and so there were many questions about this subject, which led me to write and research it, after relying on God Almighty, although the research is not long due to the nature of This topic on the one hand, and because I d
... Show MoreMeans the current research to study the organization formal and its role in demonstrating aesthetic values of the publications issued by the Telecommunications Company (Asia Cell) in Iraq, where is the organization the formal need for a mission to find the concepts and dimensions of the functional and expressive and aesthetic added to the impact of the actor in achieving the goals set for the publication.
The target is determined by the researcher to disclose the role of formal organization to show the aesthetic values of the publication to reach scientific results
Background: Myocardial infarction (MI) is distinguished by the necrosis of myocardial cells as a result of substantial and prolonged ischemia. Anxiety, problems sleeping, and feelings of depression are some of the most common psychosocial consequences of having a myocardial infarction. Aim: The purpose of this study is to evaluate the effects of post-myocardial infarction on patients' levels of anxiety, depression, and quality of sleep. Method: The collection of data from 94 individuals with MI was carried out according to a descriptive cross-sectional design. Sleep quality, depression, and anxiety were evaluated using standard questionnaires. Results: 69.1% of the participants reported having trouble getting quality sleep. The perc
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Abstract The goal of current study was to identify the relationship between addiction of self-images (Selfie) and personality disorder of narcissus, and the difference of significance the relationship between addiction self-images (selfie) and personality disorder narcissus at students of Mustansiriya university, addiction self- images (selfie) defined: a photograph that one has taken of oneself, typically one taken with a smartphone or webcam and shared via social media, edit and down lowed to social networking sites, and over time, the replacement of normal life virtual world, which is accompanied by a lack of a sense of time, and the formation of repeated patterns increase the risk of social and personal problems. To achieve the goals
... Show MoreThe objective of this study was to evaluate the alteration in levels of gonado trophins hormones i.e.,Leutizing (LH),Follicular(FSH) in sera of patients with thyroid disorders and molecular binding study of (LH ,FSH) with their antibodies The study was conducted at the specialized center for endocrinology and diabetes from January / 2009 to March / 2010.Two hundreds and twenty three Iraqi subjects, 109 patients with thyroid disorders at age range between (40-50) years and 114 healthy individuals as control group were included in this study.The majority of patients were female with hyperthyroidism and (49.54 % ) were at age range between(40 - 50) years. The levels of hormones(LH,FSH.tri iodothyronine(T3).thyroxine(T4), thy
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Objectives of the study: The study aims to assess satisfy of the coronary artery patients for the care product from
the nurse and physician and to find out the relationship between patient satisfaction with the social and the
clinical characteristics of the patients.
Methodology: A descriptive design study conducted using the evaluation approach for the duration of June 3
rd
2012 to January 31, 2013. Non-probability sample of (60) patients who were visiting or admitted (inpatient or
outpatient) to the teaching hospital in Baquba with the diagnosis of coronary artery disease. A questionnaire have
been built and develop by the researcher based on review of literature and previous research, the form included of
(3) p
The main challenge is to protect the environment from future deterioration due to pollution and the lack of natural resources. Therefore, one of the most important things to pay attention to and get rid of its negative impact is solid waste. Solid waste is a double-edged sword according to the way it is dealt with, as neglecting it causes a serious environmental risk from water, air and soil pollution, while dealing with it in the right way makes it an important resource in preserving the environment. Accordingly, the proper management of solid waste and its reuse or recycling is the most important factor. Therefore, attention has been drawn to the use of solid waste in different ways, and the most common way is to use it as an alternative
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