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.
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The purpose of this paper is to develop a hybrid conceptual model for building information modelling (BIM) adoption in facilities management (FM) through the integration of the technology task fit (TTF) and the unified theory of acceptance and use of technology (UTAUT) theories. The study also aims to identify the influence factors of BIM adoption and usage in FM and identify gaps in the existing literature and to provide a holistic picture of recent research in technology acceptance and adoption in the construction industry and FM sector.
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The maximization of the net present value of the investment in oil field improvements is greatly aided by the optimization of well location, which plays a significant role in the production of oil. However, using of optimization methods in well placement developments is exceedingly difficult since the well placement optimization scenario involves a large number of choice variables, objective functions, and restrictions. In addition, a wide variety of computational approaches, both traditional and unconventional, have been applied in order to maximize the efficiency of well installation operations. This research demonstrates how optimization approaches used in well placement have progressed since the last time they were examined. Fol
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The flexible joint robot manipulators provide various benefits, but also present many control challenges such as nonlinearities, strong coupling, vibration, etc. This paper proposes optimal second order integral sliding mode control (OSOISMC) for a single link flexible joint manipulator to achieve robust and smooth performance. Firstly, the integral sliding mode control is designed, which consists of a linear quadratic regulator (LQR) as a nominal control, and switching control. This control guarantees the system robustness for the entire process. Then, a nonsingularterminal sliding surface is added to give a second order integral sliding mode control (SOISMC), which reduces chartering effect and gives the finite time convergence as well. S
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The problem of job burnout has become one of the main problems for researchers in social welfare organizations (social protection bodies) - one of the formations of the Ministry of Labor and Social Affairs. Its negative effects increased in light of the COVID-19 pandemic, and in light of the Corona pandemic, the pressures and burdens of workers varied, which resulted in high rates of anxiety, tension, and intellectual and physical exhaustion, and then negatively affected their efficiency in performing work at the individual and organizational level, especially after the increasing tasks of these Bodies in carrying out their role in achieving the general goals and objectives as beingThe general goals are that they are responsible for providi
... Show MoreThe current research aims to recognize the exploratory and confirmatory factorial structure of the test-wiseness scale on a sample of Hama University students, using the descriptive method. Thus, the sample consists of (472) male and female students from the faculties of the University of Hama. Besides, Abu Hashem’s 50 item test-wiseness scale (2008) has been used. The validity and reliability of the items of the scale have also been verified, and six items have been deleted accordingly. The results of the exploratory factor analysis of the first degree have shown the presence of the following five acceptable factors: (exam preparation, test time management, question paper handling, answer sheet handling, and revision). Moreover,
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The objective of the present study is to determine the effect of Kaolin as a fuel oil additive to minimize the fireside corrosion of superheater boiler tubes of ASTM designation (A213-T22) by increasing the melting point of the formed slag on the outside tubes surface, through the formation of new compounds with protective properties to the metal surface. The study included measuring corrosion rates at different temperatures with and without additive use with various periods of time, through crucible test method and weight loss technique.
A mathematical model represents the relation between corrosion rate and the studied variables, is obtained using statistical regression analysis. Using this model,
... Show MoreThe erythrocyte aggregation is an important physiological phenomenon in the circulation of blood. It is a basic characteristic of normal blood that plays a major role in the cardiovascular system, especially in the microcirculation. This study explained the kinetics of single cells rouleaux formation one- dimensional aggregate and three- dimensional aggregate, during simultaneous, and the effect of hematocrit on the process of aggregation and sedimentation. The present study was done on forty one healthy subjects. Laser light is passed through a well mixed sample of blood and the forward scattered light intensities recorded continuously. The samples were prepared with different hematocrit, (10%, 15%, 20%, and 25%). Increasing
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