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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Medication safety is an important part of the comprehensive patient safety term. Medication safety is gaining more attention as the World Health Organization set the goal of decreasing medication harm by (50%) for the next 5 years when launching the third global challenge. Studying medication safety in the risk groups such as young ages, children are crucial to learn more about the effect of medicines in this risk group since they are not included in the clinical trials. Adverse drug reaction is defined as any harm resulted from the drug itself during medical process journey, while medication errors are any harm resulted from the treatment process rather than the drug or it is the result of the failure in a step of the treatment process
... Show MoreMassive multiple-input multiple-output (massive-MIMO) is a promising technology for next generation wireless communications systems due to its capability to increase the data rate and meet the enormous ongoing data traffic explosion. However, in non-reciprocal channels, such as those encountered in frequency division duplex (FDD) systems, channel state information (CSI) estimation using downlink (DL) training sequence is to date very challenging issue, especially when the channel exhibits a shorter coherence time. In particular, the availability of sufficiently accurate CSI at the base transceiver station (BTS) allows an efficient precoding design in the DL transmission to be achieved, and thus, reliable communication systems can be obtaine
... Show MoreThis research discussed and analyzed the formulation of a strategy to manage tax compliance risks, as an applied research in the General commission for Taxes. The questionnaire was used as a research tool to identify the factors that stimulate or retard the research sample from being compliant. The K-means clustering method was also used to enable the classification of the research sample's views into four behaviors, some of these views pose tax-compliance risks. The research concluded that risk management is a continuous process and that all departments of the General commission for Taxes are responsible for its implementation to enable them to deal with the behavior of the taxpayer towards tax compliance. And it recommended
... Show MoreBackground: Young children’s oral health maintenance and outcomes are influenced by their parent’s knowledge and beliefs, which affect oral hygiene and healthy eating habits. This study aims at assessing caries risk in children aged 6 months to 6 years attending the Specialized Center of Preventive and Pediatric Dentistry Center at Al-Resafa sector in Baghdad. Materials and Methods: A cross-sectional study was conducted from 15 May – 15 June 2018, all children attended the center (80 children) were assessed by using the standard caries risk assessment tool of the American Academy of Pediatric Dentistry (AAPD). Results: The highest percentage of children was as follows: no fluoride exposure 44(55%), did not brush 46(5
... Show MoreSeveral stress-strain models were used to predict the strengths of steel fiber reinforced concrete, which are distinctive of the material. However, insufficient research has been done on the influence of hybrid fiber combinations (comprising two or more distinct fibers) on the characteristics of concrete. For this reason, the researchers conducted an experimental program to determine the stress-strain relationship of 30 concrete samples reinforced with two distinct fibers (a hybrid of polyvinyl alcohol and steel fibers), with compressive strengths ranging from 40 to 120 MPa. A total of 80% of the experimental results were used to develop a new empirical stress-strain model, which was accomplished through the application of the parti
... Show Moreتعد الملابس وسيلة هامة لكل مايقوم به الانسان في حياته العامة ، فهي الانطباع والكلمة الخارجية عن ذاته الداخلية فهي تعكس فكرة الفرد عن ذاته وعن شخصيته , كما تعد وسيلة تعبير جمالية وفنية , فهي تساعد على اخفاء عيوب الجسد وابراز محاسنه . ويتوقف اختيار الفرد لملابسه على مجموعة عوامل منها احتياجه , قدراته المالية , سنه , مركزه الاجتماعي , طبيعة عمله ,الظروف الجوية التي يعيش فيها وعلى مايُؤمن به من قيم و
... Show MoreAbstract
Objective : the aim of the study is to evaluate the effectiveness of nurse’s practices and knowledge program toward care of patient with cardiopulmonary bypass .Methodology: A pre-experimental design (one group pretest- posttest design) was used to carry out this study in three governmental hospitals in Baghdad ( Iraqi Centre for Heart Diseases , Ibn – Albitar Centre for Cardiac Surgery and Ibn – Alnafees Centre for Cardiothoracic and Vascular Surgery ) for the period from 15th of May 2022 into 20th of April 2023.The construction and development of the program and instruments had carry out by the researcher to measured the purposes of the study , twenty two nurses was purposively assigned for the study group . The
... Show MoreBackground: Human semen contains high concentrations of fructose, zinc (Zn) and copper (Cu) in bound and ionic forms for Zn and Cu. The presence of abnormal levels of fructose and those trace elements may affect spermatogenesis with regard to production, maturation, motility and fertilizing capacity of the spermatozoa.Objective: To evaluate the levels of fructose, Zn and Cu in seminal plasma in different groups of male infertility and to correlate their concentrations with various sperm parameters.Methods: The concentrations of fructose, Zn and Cu were measured in 114 semen samples from normozoospermic, oligozoospermic, astheno-zoospermic, and azoospermic men using the electrothermal-atomic absorption spectrometry for Zn and Cu determinatio
... Show MoreMany waste materials can be repurposed effectively within asphalt concrete to enhance the performance and sustainability of pavement. One of these waste materials is sawdust ash (SDA). This study explores the beneficial use of SDA as a substitute for limestone dust (LD) mineral filler in asphalt concrete. The replacement rate was 0%, 15%, 30%, 45%, and 60% by weight of total mineral filler. Scanning electron microscopy (SEM) was employed to assess the surface morphology of Sawdust (SD), SDA, and LD. In addition, a series of tests, including Marshall stability and flow, indirect tensile strength,moisture susceptibility, and repeated uniaxial loading tests, were conducted to examine the performance characteristics of asphalt mixtures of diffe
... Show More