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.
The research focuses on determining the role of customer relationship management in improving financial performance by surveying the opinions of a number of employees of a number of Iraqi private banks. The customer has become the focus of attention and the most important factors of success and profitability and competition. Therefore, decisions related to the customer are important decisions that support the process of making, And follow-up of administrative decisions, including financial decisions aimed at improving the financial performance of banks and distinguish them from competitors. Thus, the techniques used in customer relations management programs to collect, analyze and use data and information have beco
... Show MoreEpithelial and stromal communications are essential for normal uterine functions and their dysregulation contributes to the pathogenesis of many diseases including infertility, endometriosis, and cancer. Although many studies have highlighted the advantages of culturing cells in 3D compared to the conventional 2D culture system, one of the major limitations of these systems is the lack of incorporation of cells from non‐epithelial lineages. In an effort to develop a culture system incorporating both stromal and epithelial cells, 3D endometrial cancer spheroids are developed by co‐culturing endometrial stromal cells with cancerous epithelial cells. The spheroids developed by this method are phenot
A simple, environmental friendly and selective sample preparation technique employing porous membrane protected micro-solid phase extraction (μ-SPE) loaded with molecularly imprinted polymer (MIP) for the determination of ochratoxin A (OTA) is described. After the extraction, the analyte was desorbed using ultrasonication and was analyzed using high performance liquid chromatography. Under the optimized conditions, the detection limits of OTA for coffee, grape juice and urine were 0.06 ng g−1, 0.02 and 0.02 ng mL−1, respectively while the quantification limits were 0.19 ng g−1, 0.06 and 0.08 ng mL−1, respectively. The recoveries of OTA from coffee spiked at 1, 25 and 50 ng g−1, grape juice and urine samples at 1, 25 and 50 ng mL
... Show MoreBackground The appropriate disposal of medication is a well-recognized issue that has convened growing recognition in several contexts. Insufficient awareness relating to appropriate methods for the disposal of unneeded medicine may result in notable consequences. The current research was conducted among the public in Iraq with the aim of examining their knowledge, attitude, and practices regarding the proper disposal of unused and expired medicines. Methods The present study used an observational cross-sectional design that was community-based. The data were obtained from using an online questionnaire. The study sample included people of diverse genders, regardless of their race or occupational status. The study mandated that all pa
... Show MoreThe enhancement of the thermal and thermo-hydraulic performance of a semi-circular solar air collector (SCSAC) is numerically investigated using porous semi-circular obstacles made of metal foam with and without longitudinal porous Y-shaped fins. Two 10 and 40 PPI porous material samples are examined. Three-dimensional models are built to simulate the performance of SCSAC: model (I) with clear air passage; model (II) with only metal foam obstacles, and model (III) with metal foam obstacles as well as porous Y-fins. COMSOL Multiphysics software version 6.2 based on finite element methodology is employed. A conjugate heat transfer with a (k-ε) turbulence model is selected to simulate both heat transfer and fluid flow across the entir
... Show MoreChronic kidney disease is one of the leading public health problems that affect millions of women and men worldwide.
This study aims to examine the effect of deep breathing to reduce discomfort amongst patient undergoing haemodialysis (HD).
This randomised controlled experimental study was conducted consisted of 108 patients (54 in each group) who undergoing HD in hospitalised adults’ patients between November 2024 an
Background: Stroke defined by diminished cerebral blood flow, results in brain damage and neurological impairments. It often leads to considerable difficulties, such as limited mobility and compromised hand function, usually manifesting as a weakening in the ability to open and shut the hand. Objective: The study evaluates the differences between opening and closing hands when utilizing a soft robot. Methods: The study was conducted in the Mosul Specialist Rehabilitation Center which involved 68 participants, all over 20 years old, with visual impairments. The Iranian Clinical Trials Registry and Ministry of Planning approved the study, The Fugl-Meyer Assessment for Upper Extremity Action Research Arm Test, and Arm Motor Ability Test were
... Show MoreThis study focused on determining the markers of Macrophage migration inhibitor (MIF), as well as the N-telopeptides of type I bone collagen (NTX), and some other parameters (alkaline phosphatase (ALP), vitamin D (Vit D), calcium (Ca), phosphorus (P), and magnesium (Mg), and their correlation with other parameters in osteoporosis. One hundred ten subjects were involved in the current study. There were two groups of patients: group I (30) women with severe osteoporosis and group II (30) women with mild osteoporosis. For comparison, 50 apparently healthy individuals were included as a control. Serum levels of MIF, and NTX were significantly higher in groups I and II as compared to the control group, which indicate that these two parameters
... Show MoreLying is considered a dangerous tendency among children if it has become a habit. It results in many social problems, such as child’s loss of confidence, lack of others’ respect to him, and his lack of respect to the desired values of the society, such as honesty and trust. Consequently, he will be led to a deviation when he becomes old; especially if the child’s socially unaccepted behavior has not been directed. The research, thus, aims to examine the causes of lying in the most important stage of children’s life; that is, between (4-6) years. Such an aim helps to know about the individual reasons of lying among males and females from teachers’ perspectives. To meet the objective of the study, a number of (128) children
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