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.
This study investigates the phonotactics of English obstruent clusters in the word-final position from a markedness theory perspective among Iraqi EFL College Students whose native language, Arabic, prefers only two-member word-final obstruent cluster as a maximum. The markedness of clusters is measured depending on Iraqi EFL College Students’ utilization of the simplification strategies. This study tries to answer whether or not word-final obstruent clusters are marked or unmarked for Iraqi EFL College Students, and whether or not the markedness of the obstruent cluster increases as to its length. In order to answer these questions, a test has been distributed among 60 Iraqi EFL Fourth-Year College students, Department of English, Colleg
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Business organizations are using the technological innovations like cloud computing (CC) as a developmental platform in order to improve the performance of their information systems. In that context, our paper discusses know-how in employing the public and private CC to serve as platforms to develop the evaluation system of annual employees' performance (ESAEP) at Iraqi universities. Therefore, we ask the paper question which is “Is it possible to adopt the innovative solutions of ICTs (Like: public and private CC) for finding the developmental vision about management information systems at business organizations?”. In addition, the paper aim
... Show MoreAbstract This study explores the extent to which public relations (PR) departments within Traqj governmental institutions are integrating artificial intelligence (AI) applications into their communication activities. The research adresses the growing importanc of AI in enhancing administrative efficieney, communication transparency, and stakeholder engagement. Adopting a descriptive research design, the study relied on an electtonic questionnaire distributed to PR profesionals across various ministries and government bodies, collecting 100 valid responses. The indings reveal that while younger PR practitioners are actively embracing AI, older employees show limited engagement. Most participants acquired AI-related skills through self- learn
... Show MoreDiabetes mellitus is a chronic illness that commonly leads to progressive and incapacitating of patients’ condition over the past 20 years.
The aim of the study was to evaluate the effects of the coughing technique, ShotBlockerTo evaluate the effects of the coughing technique, ShotBlocker and vibration device on pain intensity and patient satisfaction during subcutaneous (SC) insulin injections in hospitalised adults with Type 2 diabetes mellitus (T2DM).
This study was conducted in Diyala province for renal failure patients during the periods August 2015 - April 2016. Hundred renal failure patients were enrolled in the study after diagnosis by the consultant physician at Ibn-Sina Center for Dialysis in Baquba Teaching Hospital according to criteria adopted by the World Health Organization for diagnosis of renal failure disease. The number of males in patient’s sample was 61 (61%) and females was 39 (39%) with an age range of 10 – 88 year (44.7 ± 22.1 year). In addition, the study included 50 apparently healthy individuals and considered as a group control, in which the number of males and females was similar (25 individual), with an age range of 18 – 88 year (51.7 ± 17.3 year). The
... Show MoreThe use of the Iraqi song in the symphony orchestra is one of the pioneering and important works, which carries with it an artistic value of aesthetic specificity in how to use the Iraqi singing heritage. The research aimed to identify the employment of the song (Foug Al-Nakhl) and its works within the Iraqi national symphony orchestra music by the author Hans Count Momer whose works still have a great influence on the authors of the Iraqi orchestra. The researcher presented a brief introduction to the Iraqi Symphony Orchestra, a brief introduction about the author, and the trends of world music towards heritage. He also talked about musical composition, research procedures and tools, and applying the tool to the selected sample (F
... Show MoreCan not reach a comprehensive concept for interior design through the use of Harmonization term according transformations experienced by the terms of the variables associated with the backlog of cultures that characterize concepts according to the nature of the users of the spaces in the design output, which necessitates the meaning of the combination of knowledge, art, science, such as the type of perceptions design the Harmonization cognitive science with art to create products of the use of design configurations that help the designer to put such a product within the reality and like the fact that reliable, as well as the rational knowledge tend somehow to the objective specifically in facilitating the substance subject to perceptible
... Show MoreHerein, we report designing a new Δ (delta‐shaped) proton sponge base of 4,12‐dihydrogen‐4,8,12‐triazatriangulene (compound