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.
Media studies have focused mostly on the issue of the mental image because the image that is formed in the mind has become not only a photo of a human being and having kept for himself. This image has an outside influence which may sometimes up to the formation of the fate of others and it sometimes includes individuals and groups together.
This study comes in the context of identifying the image of Iraqi political parties among Iraqi university students and the nature of the view that students have in their minds about these parties.
Chapter one includes the problem of the research, the importance of the study, the goals and method used. Chapter two is divided into two sections: section one deals with the concept of the mental i
This research aimed to diagnose the perception based on Telecommunications of Iraq to the importance of activating knowledge management marketing in possession, as well as Indication of impediments to activate the management of marketing knowledge in the researched companies, also aimed to show the extent of the existence of significant differences in perception based on Telecommunications Iraqi importance of activating the management marketing knowledge in possession. To achieve the objectives of this research, the questionnaire was developed and distributed to a sample of telecommunications companies in the city of Sulaimaniya, was selected on the criterion according to the company's life in terms of seniority in the telecommunication
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In this paper, a robust adaptive sliding mode controller is designed for a mobile platform trajectory tracking. The mobile platform is an example of a nonholonomic mechanical system. The presence of holonomic constraints reduces the number of degree of freedom that represents the system model, while the nonholonomic constraints reduce the differentiable degree of freedom. The mathematical model was derived here for the mobile platform, considering the existence of one holonomic and two nonholonomic constraints imposed on system dynamics. The partial feedback linearization method was used to get the input-output relation, where the output is the error functions between the position of a certain point on the platform
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The aim of this paper is to translate the basic properties of the classical complete normed algebra to the complete fuzzy normed algebra at this end a proof of multiplication fuzzy continuous is given. Also a proof of every fuzzy normed algebra without identity can be embedded into fuzzy normed algebra with identity and is an ideal in is given. Moreover the proof of the resolvent set of a non zero element in complete fuzzy normed space is equal to the set of complex numbers is given. Finally basic properties of the resolvent space of a complete fuzzy normed algebra is given.
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This work presents an experimental study of heat transfer and flow of distilled water and metal oxide nanofluid Fe3O4-distilled water at concentrations of (φ = 0.3, 0.6, 0.9 %) by volume in a horizontal pipe with constant magnetic field. All the tests are carried out with Reynolds number range (2900-9820) and uniform heat flux (11262-19562 W/m2). The results show that, the nanofluid concentration and magnetic intensity increase, the Nusselt number increases. The maximum enhancement in Nusselt number with magnetic nanofluid is (5.4 %, 26.4 %, 42.7 %) for volume concentration (0.3, 0.6, 0.9 %) respectively. The enhancement is maximized with magnetic intensity (0.1, 0.2, 0.3 tesla) respectively to (43.9, 44
... Show MoreThe dynamics of a single condensing two-phase bubble of two different dispersed-continuous systems were studied. The systems were, CCl4 - water and CCl4 - 100% glycerol. Cinephotography was used to determine the change in height, diameter and time. These results were used to determine the experimental rise velocity of the bubble, which was compared with a theoretical one based on some equations used. It was found that the velocity of the first system remained almost constant, while it decreased gradually for the second system.
In this review paper, several research studies were surveyed to assist future researchers to identify available techniques in the field of infectious disease modeling across complex networks. Infectious disease modelling is becoming increasingly important because of the microbes and viruses that threaten people’s lives and societies in all respects. It has long been a focus of research in many domains, including mathematical biology, physics, computer science, engineering, economics, and the social sciences, to properly represent and analyze spreading processes. This survey first presents a brief overview of previous literature and some graphs and equations to clarify the modeling in complex networks, the detection of soc
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Onchocerciasis is an infection with cutaneous, ocular and systemic manifestations caused by the filarial nematode Onchocerca volvulus, which is transmitted by the bite of various species of the anthropophilic blood-sucking Simulium vectors (black flies). Onchocerciasis is endemic to the savannahs and rainforests of subequatorial Africa and in some countries of the Arabian Peninsula, notably Yemen and Oman, and in Central America, and the Amazon basin of South America. Onchocercomas, which can be defined as subcutaneous fibrous nodules containing adult worms, are among the variable clinical manifestations of this infestation; they are either superficial or deep and usually located over bony prominences. In this paper we report a case of an o
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The most influential theory of ‘Politeness’ was formulated in 1978 and revised in 1987 by Brown and Levinson. ‘Politeness’, which represents the interlocutors’ desire to be pleasant to each other through a positive manner of addressing, was claimed to be a universal phenomenon. The gist of the theory is the intention to mitigate ‘Face’ threats carried by certain ‘Face’ threatening acts towards others.
‘Politeness Theory’ is based on the concept that interlocutors have ‘Face’ (i.e., self and public – image) which they consciously project, try to protect and to preserve. The theory holds that various politeness strategies are used to prot
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