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.
Background: Recent research indicates that persistent inflammatory responses may contribute to the rise of diabetic nephropathy (DN) and diabetic cardiovascular disease (DCVD) in type 2 diabetes mellitus patients (DM2). Numerous molecules associated with inflammation and angiogenesis have been implicated in the development and progression of DN and DCVD, respectively. Methods: The subjects were separated into five groups: healthy controls (n= 25), type 2 diabetes mellitus patients (n= 30), type 2 diabetes mellitus patients with nephropathy DN (n= 30), and type 2 diabetes mellitus patients with cardiovascular disease DCVD (n= 30). The blood levels of irisin, IL-8, HbA1C, urea, and creatinine were determined. Results: In current study there w
... Show MoreAbstract Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through evidence-based pricing decisions. O
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Abstract :
In view of the fact that high blood pressure is one of the serious human diseases that a person can get without having to feel them, which is caused by many reasons therefore it became necessary to do research in this subject and to express these many factors by specific causes through studying it using (factor analysis).
So the researcher got to the five factors that explains only 71% of the total variation in this phenomenon is the subject of the research, where ((overweight)) and ((alcohol in abundance)) and ((smoking)) and ((lack of exercise)) are the reasons that influential the most in the incidence of this disease.
Abstract
The net profit reported in the annual financial statements of the companies listed in the financial markets, is considered one of the Sources of information relied upon by users of accounting information in making their investment decisions. At the same time be relied upon in calculating the bonus (Incentives) granted to management, therefore the management of companies to manipulate those numbers in order to increase those bonuses associated to earnings, This practices are called earnings management practices. the manipulation in the figures of earnings by management will mislead the users of financial statements who depend on reported earnings in their deci
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Statistical control charts are widely used in industry for process and measurement control . in this paper we study the use of markov chain approach in calculating the average run length (ARL) of cumulative sum (Cusum) control chart for defect the shifts in the mean of process , and exponentially weighted moving average (EWMA) control charts for defect the shifts for process mean and , the standard deviation . Also ,we used the EWMA charts based on the logarithm of the sample variance for monitoring a process standard deviation when the observations (products are selected from al_mamun factory ) are identically and independently distributed (iid) from normal distribution in continuous manufacturing .
Consistent "with the thought of tax talk is unified tax natural evolution for him, as the application leads to the inclusion of tax all branches of income and its sources and through truncated part of this entry through the application of price ascending it, it means the procedures of tax reform. Taxes on total income characterized by giving a clear picture of the total income of the taxpayer and its financial situation and its burden family which allows granting exemptions, downloads, and application of prices that fit this case. This requires reconsideration of the structure of the tax system in force and the transition from a system specific taxes to the tax system on the total income of the integration of income from the rental of re
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The current research aims to :
•know the level of the chaotic behavior of the sample as a whole .
•Know the differences with statistical significance in disorderly behavior between the
disadvantaged and non-disadvantaged peers .
To achieve these objectives, the selected sample of Talbhalmrahlh medium and specifically
students of the second grade average, were chosen randomly stratified's (360) students
included sex (male, female) and (deprived of the Father and the non-deprived) for the
academic year (2013-2014) to the province Baghdad on both sides (Rusafa-Karkh (
As applied to them measurements of disorderly behavior, which is prepared by the researcher,
having achieved _khasaúsma of psychometric (valid
This study concerns the role of activated carbon (AC) from palm raceme as a support material for the enhancement of lipase-catalyzed reactions in an aqueous solution, with deep eutectic solvent (DES) as a co-solvent. The effects of carbonization temperature, impregnation ratio, and carbonization time on lipase activity were studied. The activities of Amano lipase from Burkholderia cepacia (AML) and lipase from the porcine pancreas (PPL) were used to investigate the optimum conditions for AC preparation. The results showed that AC has more interaction with PPL and effectively provides greater enzymatic activity compared with AML. The optimum treatment conditions of AC samples that yield the highest enzymatic activity were 0.5 (NaOH (
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Background: Prostatic adenocarcinoma is the most widely recognized malignancy in men and the second cause of cancer-related mortality encountered in male patients after lung cancer.
Aim of the study: To assess the diagnostic value of diffusion weighted imaging (DWI) and its quantitative measurement, apparent diffusion coefficient (ADC), in the identification and localization of prostatic cancer compared with T2 weighted image sequence (T2WI).
Type of the study: a prospective analytic study
Patients and methods: forty-one male patients with suspected prostatic cancer were examined by pelvic MRI at the MRI department of the Oncology Teaching Hospital/Medical City in Baghdad
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