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.
Breast cancer is the most common cancer among women over the world. To reducing reoccurrence and mortality rates, adjuvant hormonal therapy (AHT) is used for a long period. The major barrier to the effectiveness of the treatment is adherence. Adherence to medicines among patients is challenging. Patient beliefs in medications can be positively or negatively correlated to adherence. Objectives: To investigate the extent of adherence and factors affecting adherence, as well as to investigate the association between beliefs and adherence in women with breast cancer taking AHT. Method: A cross-sectional study included 124 Iraqi women with breast cancer recruited from Middle Euphrates
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The Knowledge Workers is The Largest And Most Powerful Resource Of The Organizational Excellence it is A Precious Treasure, Therefore Find Organizations at present is looking for them and seek to invest their ideas For achieving excellence, creativity and access to the excellence Organizational , As a result of their importance in terms of engagement and influence in the success or failure of the as an organizational Of The Research is Measuring The Correlation And Impact Between Knowledge Workers And Organizational Excellence in Sample Of Companies Iraqi Industrial By Standing The Dimensions Of Knowledge Workers ( Characteristics , Skills , Roles , Competencies ) And
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Mixed convection heat transfer to air inside an enclosure is investigated experimentally. The bottom wall of the enclosure is maintained at higher temperature than that of the top wall which keeps in oscillation motion, whereas the left and right walls are well insulated. The differential temperature of the bottom and top walls changed several times in order to accurately characterize the temperature distribution over a considerable range of Richardson number. Adjustable aspect ratio box was built as a test rig to determine the effects of Richardson number and aspect ratio on the flow behavior of the air inside the enclosure. The flow fields and the average Nusselt number profiles were presented in this wo
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The effect of physical and mental health on the feelings of personal welfare are known as health-related quality of life. Infection with hepatitis B virus is a major global health problem. Health-related quality of life was emerged as an important consideration in the care of patients with chronic hepatitis B infection. The aim of the current study was to measure health-related quality of life among a sample of chronic hepatitis B patients in AL-Najaf city/Iraq. The current study was cross-sectional study carried out on (104) already diagnosed chronic viral hepatitis B patients who attended the Gastroenterology and Hepatology Center/Al-Sader Medical City/Najaf during November 2018 to May
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This research deals with the attitude of oil press towards oil industry in the world and the extent of their concerns with the stages of oil industry relating to the abundance of oil and natural gas, as it is an international strategic and complementary industry. The researcher uses the survey method for content analysis of the initial article and the press news for two: years (2011-2012). The results if the study are as follows
1- Oil press is concerned with developing and the stages of the Arabic oil industry in the interest of OAPEC in the first place.
2- It is concerned with exploring, extracting, and marketing oil in the first place, then with refining operations in refineries and petrochemical plants in the second place, an
The musical sign was associated with the first appearances of acting that are based on human gestures and expressive and silent movements, and they contributed in accentuating and clarifying these gestures and explain their meanings and indications, and they remained with them until these gestures turned into artistic theatrical shows so that the musical sign would have many functions and constitute the main pillars for this kind of show.
The musical sign is a language not much different than the human language in the semiotic analysis. There has been an increased interest in it and its use in the mime shows by the graduates who realized its necessity and significance in the pantomime show intellectually, artistically and aesthetical
Communication skills are essential for health professionals to achieve a positive relationship with patients, improving their health and quality of life. Communication is the foundation for obtaining medical history and conveying a diagnosis and treatment plan.
To assess the knowledge, practice of communication skills among primary care physicians, to find out any barriers related to the communication skills, and the association between the studied variables with knowledge and practice of communicati
The variety of ideas and freedom of expression among the authors who are looking for everything new that serves the goals of musical and aesthetic expression, which calls for the use of traditional musical instruments with the great composition of musical instruments known as the orchestra represents a great challenge in several aspects. The incompetence of some of these instruments or limited capabilities or its costly method of performance sometimes forbids its use permanently in this great composition. It was necessary to have some problems facing the composer and the player on the one hand and the recipient on the other hand, who must be looking for perfection. Among those instruments that are used regularly in the works of the orche
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The aim of this study was to assess the effectiveness of listening to music or Quran in reducing cancer patients’ anxiety before chemotherapy administration. Reducing anxiety in people with cancer, prior to chemotherapy administration, is a crucial goal in nursing care.
An experimental comparative study was conducted.
A simple randomization sampling method was applied. Two hundred thirty‐eight people with cancer who underwent chemotherapy were participated. They are assigned as Quran, music and control groups.
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