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.
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The provision of safe water for people is a human right; historically, a major number of people depend on groundwater as a source of water for their needs, such as agricultural, industrial or human activities. Water resources have recently been affected by organic and/or inorganic contaminants as a result of population growth and increased anthropogenic activity, soil leaching and pollution. Water resource remediation has become a serious environmental concern, since it has a direct impact on many aspects of people’s lives. For decades, the pump-and-treat method has been considered the predominant treatment process for the remediation of contaminated groundwater with organic and inorganic contaminants. On the other side, this tech
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This research tries to reveal how to manage and control the competitive edge for business by building managerial skills in various organizational levels. Our research aims at finding out the nature of various technical, human and in tellectual skills of a new president whose superiority is his competitive ness in the application field at general company for construe tioual industriesand testing the surveyed minor and major changes through a questionnaire to collect information from officials. The sample was composed of (45) director. The data was analyzed using some methods and statistical programs. The most prominent of these is (SPSS) that was used to extract the arithmetic mean, standard deviation, correlation coefficient
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Abstract: The research aims to assess the level of readiness of the Information and Communication Technology (ICT) infrastructure for business continuity at Earthlink Telecommunications and Internet Services Company in Iraq, in light of the requirements of the international standard ISO/IEC 27031:2025. The research adopts a case study approach as an appropriate methodological framework for understanding and analyzing the organizational and technical complexity inherent in telecommunications sector organizations. To achieve the research objectives, a set of integrated data collection tools was employed, including field interviews with technical and administrative staff, a review of organizational documents and approved policies, as well as d
... Show MoreObjective: To determine the prevalence of Posttraumatic Stress Disorder (PTSD) among Iraqi repatriated
prisoners of Iran-Iraq war, and the relationship with demographic factors.
Methodology: A descriptive study was carried out from Oct. 18th, 2009 through Jan. 10th, 2010. A nonprobability
based snowball sampling technique was used to recruit 92 Iraqi repatriated prisoners of war
(IRPOWs) who had visited Ministry of Human Rights. A data collection instrument was constructed that
consisted of six demographic characteristics, and eight items to measure the level of PTSD in POWs. Data were
collected with the constructed instrument during a brief interview. Data were analyzed through the application of
descriptive statist
Background: As a multifactorial disorder, temporomandibular joint (TMD) is difficult to diagnose, and multiple factors affect the joint and cause the temporomandibular disorder. Standardization of clinical diagnosis of TMD should be used to reach a definite clinical diagnosis; the condylar bone may degenerate in accordance with these disorders. Aims: Evaluate the correlation between the clinical diagnosis and degenerative condylar change (flattening, sclerosis, erosion, and osteophyte). Materials and Methods: A prospective study with a study group of 97 TMD patients (total of 194 joints) aged 20 to 50. Patients were sent to cone beam computed tomography (CBCT) to assess the degenerative condylar change. Results: No association was found bet
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Interleukin-38 (IL-38), an inflammatory cytokine discovered in recent years, has been implicated in the pathogenesis of systemic lupus erythematosus (SLE). IL-38 is encoded by the
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Hair is an excellent indicator for abnormal concentration of toxic elements , In this study a random samples from girls hair of 12 cm long were irradiated by a flux of neutrons (4x10^ n/ cm^.s) obtained from an Am-Be neutron source of 5-Ci activitity . The y-ray activity measurements were carried out by using a " 5x5 " well- type Nal (Tl) detector. The study indicates clearly that the maximum concentration of elements was at about 7 cm hair length.
Resumen Introducción Debido a su exigente entorno académico, el dolor lumbar crónico (DLC) es un trastorno musculoesquelético común entre los estudiantes de medicina, lo cual es particularmente preocupante. El tabaquismo es un factor de riesgo conocido por causar diversos problemas de salud y se ha asociado con el DLC, pero la relación específica entre el tabaquismo y el DLC aún no ha sido bien explorada. Objetivo Este estudio tiene como objetivo investigar la asociación entre el tabaquismo y el DLC en estudiantes de medicina en Irak. Diseño Se empleó un diseño descriptivo transversal que involucró entrevistas cara a cara con 200 estudiantes de medicina de 18 años o más. Los datos sobre características demográficas, comport
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