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.
Abstract:
Typological analysis about the negation marker in different languages is one of the fields of research that has attracted much attention. In Persian language, this constituent has been analysed from different aspects. This study aimed to analyse different aspects of negation marker in the adjectives, the noun phrases and the verb phrases based on typological analysis. Many studies have been revealed that the negation in adjectives has shown lexically and morphologically. In the noun phrases, /hich/ has used as a negative marker necessarily marking the verb phrase as negative too. In the verb phrases, negation occurs morphologically by the addition of the prefix /n
... Show MoreThis study has aimed to measure the relationship between the skills required for the labor market and the employment of graduates of community colleges at King Khalid University. For gathering the required data, a questionnaire has been designed and distributed to the faculty members of community colleges at King Khalid University in a random sample method. The chosen sample size has covered (123) individuals. Questionnaire forms have been distributed and retrieved from (117) participants. Therefore, the estimated response has reached 95 % of the total sample size. The results of the study have shown that there is not any significant relationship between the skills which the graduates acquire and the requirements of employmen
... Show MoreA field study was conducted on a sample of the public in Baghdad to study the audience's exposure to the television promotion of pharmaceutical products and their trends in order to determine the rate of exposure of the public to the television promotion of pharmaceutical products according to the theory of uses and rumors and to determine the public's attitudes towards television promotion of pharmaceutical products. A survey of (25) a questions was distributed to a sample of the audience of 150 people. The statistical program SPSS was used to unload the data and for the calculation of frequencies and percentages and correlation coefficients. The research reached several results, Most importantly, the television promotion is well receiv
... Show MorePurpose: The diagnosis and determine the level of balance between the time available for life and work with the doctors in the hospitals of t the six hospitals in the City of Medicine.
Design / methodology / Approach: It has been relying on ready-scale, to make sure the diagnosis and determine the level of balance between the time available for life and work, where they were distributed on Form 42 doctors in the six hospitals in the City of Medicine, were analyzed by software (Nvivo and SPSS v.22).
Results: The results showed that there is a good level of balance between the time available for life and work with the doctors.
Research limitations: The diffi
... Show MoreThis work studies the role of serum apelin-36 and Glutathione S-transferases (GST) activity in association with the hormonal, metabolic profiles and their link to the risk of cardiovascular disease (CVD) in healthy and patients' ladies with polycystic ovary syndrome (PCOS). A total of fifty-four (PCOS) patients and thirty-one healthy woman as a control have been studied. The PCOS patients were subdivided on the basis of body-mass-index (BMI), into 2-subgroups (the first group was obese-PCOS with BMI ≥ 30 and the second group was non-obese PCOS MBI<30). Fasting-insulin-levels and Lipid-profile, Homeostatic-model assessment-of-insulin-resistance (HOMA-IR), follicle-stimulating-hormone (FSH), luteinizing-hormone (LH), testosterone and
... Show MoreThe subject of the evolution of fire insurance of the hottest topics accidents, because it falls within the commercial insurance, as its importance is reflected for being a security source and contentment of the insured person and so it is worth pointing out the importance of fire insurance in enterprises and organizations of all kinds, because of the guarantee of its assets from meridian as well as protection from the effects of the fire therefore ensure continuity in the performance of their activities
Optical burst switching (OBS) network is a new generation optical communication technology. In an OBS network, an edge node first sends a control packet, called burst header packet (BHP) which reserves the necessary resources for the upcoming data burst (DB). Once the reservation is complete, the DB starts travelling to its destination through the reserved path. A notable attack on OBS network is BHP flooding attack where an edge node sends BHPs to reserve resources, but never actually sends the associated DB. As a result the reserved resources are wasted and when this happen in sufficiently large scale, a denial of service (DoS) may take place. In this study, we propose a semi-supervised machine learning approach using k-means algorithm
... Show MoreAbstract:
The internal audit is considered the safety valve for senior management in all institutions. It aims to protect property, and raise the efficiency and effectiveness of the administrative performance, by following up on compliance with laws and instructions and the application of regulations in a way that increases the administrative performance of the department. The internal audit is possible to determine Weaknesses or imbalances in the administrative performance. To achieve this goal, an analytical descriptive methodology was adopted. The Baghdad Health Department / Al-Rosana was considered as society for this s
... Show MoreObjectives: This study aims to assess and compare the micro-shear bond strength (μSBS) of a novel resin-modified glass-ionomer luting cement functionalized with a methacrylate co-monomer containing a phosphoric acid group, 30 wt% 2-(methacryloxy) ethyl phosphate (2-MEP), with different substrates (dentin, enamel, zirconia, and base metal alloy). This assessment is conducted in comparison with conventional resin-modified glass ionomer cement and self-adhesive resin cement. Materials and methods: In this in vitro study, ninety-six specimens were prepared and categorized into four groups: enamel (A), dentin (B), zirconia (C), and base metal alloys (D). Enamel (E) and dentin (D) specimens were obtained from 30 human maxillary first premolars e
... Show MoreBACKGROUND: Hospital training courses for pharmacy students were required to prepare students to meet the challenges of real-world hospital work. AIM: Because there have been few studies on the efficacy of such courses, we aimed to recognize recent graduates’ perceptions, benefits, and factors influencing the quality of hospital training courses for pharmacy students. METHODS: A qualitative study using a phenomenology approach was conducted in 2022 and included several hospitals in Baghdad, Iraq, using in-depth face-to-face individual-based semi-structured interviews. Until saturation, a convenient sample of recently graduated pharmacists was included. The obtained data were analyzed using a thematic content analysis approach
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