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.
The current research aims to determine the requirements of Trends of International Mathematics and Science Study (TIMSS 2019) and to find out the extent to which the content of science textbooks for grades (1-4) in the Sultanate of Oman includes the requirements of (TIMSS 2019). Only the content dimension has been taken into account when conducting the content analysis. The study population includes all science books from the first to the fourth grade for the academic year 2021-2022. The study identified and organized the requirements in the study tool, which is a list of requirements of (TIMSS 2019). The results showed a general deficiency in all grades (1-4) in the content dimension including many main topics, subtopics, and objectives
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Experimental work from Magnetic Abrasive Finishing (MAF) tests was carried out design parameters (amplitude, and number of cycle which are formed the shape of electromagnetic pole), and technological parameters (current, cutting speed, working gap, and finishing time) all have an influence on the mechanical properties of the surface layer in MAF process. This research has made to study the effect of design and technological parameters on the surface roughness (Ra), micro hardness (Hv) and material removal (MR) in working zone. A set of experimental tests has been planned using response surface methodology according to Taguchi matrix (36) with three levels and six factors
... Show MoreThe process of evaluating business processes, complex, repetition of procurement processes, need for raw materials and frequency of demand, which makes dealing with suppliers in the evaluation process, making the need for a process intervention in the process. Lighter on the other hand.
Many Iraqi companies suffer from problems related to suppliers, and cases of administrative and financial corruption are often raised regarding this type of contract and from this reality the necessity of researching this problem and trying to develop some solutions to reduce its impact on the companies' work, by using a method that works according to the standards adopted in Evaluation and selection of the supplier in the
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The study objective was to conduct Pharmacoeconomics study (cost-effective analysis) between infliximab reference (Remicade) and its biosimilar (Remsima) in patients with rheumatoid arthritis (RA) in Iraqi hospitals.
This is a retrospective multicenter pharmacoeconomic analysis conducted at two large teaching governmental hospitals in Baghdad, Iraq which provided infliximab to patients with RA. Data were collected from patient’s medical records and face-to-face interviews with the patients from December 2021 to April 2022.
The study included 57 patients with rheumatoid arthritis (RA). The patients were categorized into two groups according to the type of infliximab they received over 30 weeks: 27 patients received
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The calculation. of the nuclear. charge. density. distributions. ρ(r) and root. mean. square. radius.( RMS ) by elastic. electron. scattering. of medium. mass. nuclei. such. as (90Zr, 92Mo) based. on the model. of the modified. shell. and the use of the probability. of occupation. on the surface. orbits. of level 2p, 2s eroding. shells. and 1g gaining. shells. The occupation probabilities of these states differ noticeably from the predictions of the SSM. We have found. an improvement. in the determination. of ground. charge. density. and this improvement. allow. more precise. identification. of (CDD) between. (92Mo- 90Zr) to illustrate the influence of the extra
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Results of charge, neutron and matter densities and related form factors for one- proton halo nucleus 8B are presented using a two- frequency shell model approach. We choose a model space for the core of 7Be different from that of the extra one valence proton. One configuration is assumed for the outer proton to be in 1p1/2 - shell. The results of the matter density distributions are compared with those fitted to the experimental data. The calculated proton and matter density distributions of this exotic nucleus exhibit a long tail behavior, which is considered as a distinctive feature of halo nuclei. Elastic electron scattering form factors of this exotic nucleus are also studied. The effects of
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The aim of this study is to achieve the best distinguishing function of the variables which have common characteristics to distinguish between the groups in order to identify the situation of the governorates that suffer from the problem of deprivation. This allows the parties concerned and the regulatory authorities to intervene to take corrective measures. The main indicators of the deprivation index included (education, health, infrastructure, housing, protection) were based on 2010 data available in the Central Bureau of Statistics
الملخص ان حق الملكية هو الحق الاوسع نطاقا يمنح صاحبه صلاحية ممارسة السلطات كافة ويكون محل هذه السلطات كل ما يملك الشخص سواء كان شقه او طبقة اسوة بالعقارات الاخرى كدار للسكن او ارض ، ومن اهم هذه السلطات واوسعها نطاقا ( هو سلطة التصرف ). تعد هذه السلطة جوهر حق الملكية وأخطر السلطات الممنوحة للمالك كونه بواسطتها يمكنه الاستغناء عن ملكه بأي تصرف ناقل له كالبيع أو الهبة او الوصية مثلا ، ولأهمية هذه السلط
... Show MoreBackground: Schneiderian first rank symptoms are
considered highly valuable in the diagnosis of
schneideria.
They are more evident in the acute phase of the
disorder and fading gradually with time. Many studies
have shown that the rate of these symptoms are
variable in different countries and are colored by
cultural beliefs and values.
Objectives: To find out the rate of Schneiderian first
rank symptoms among newly diagnosed schizophrenic
patients, to assess which symptom(s) might
predominate in those patients, and to find out if there
is/are any correlation(s) between the occurrence of
these symptoms and the sex of the patients.
Methods: Out of twenty-four patients with no past
psychiatric hi