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.
Joseph Curtis wrote in his book (Introduction to Semiotics narrative and rhetoric) on the development of a semiotic project in exploring the meaning of communion. The book is rich in theoretical and analytical benefits both in the approach of texts and in the pursuit of letters in search of mechanisms of scriptural and scriptural generation and mechanics in narrative production, especially as the book offers exercises that help to assess the distance separating the narrative spread from the sin of the text, for the semiotics, Refers to the theoretical developments of the science of relations, through the combination of conventional definitions and the representative and comparative limitations, to provide an approach to the application o
... Show MoreThis paper explores a fuzzy-logic based speed controller of an interior permanent magnet synchronous motor (IPMSM) drive based on vector control. PI controllers were mostly used in a speed control loop based field oriented control of an IPMSM. The fundamentals of fuzzy logic algorithms as related to drive control applications are illustrated. A complete comparison between two tuning algorithms of the classical PI controller and the fuzzy PI controller is explained. A simplified fuzzy logic controller (FLC) for the IPMSM drive has been found to maintain high performance standards with a much simpler and less computation implementation. The Matlab simulink results have been given for different mechanical operating conditions. The simulated
... Show MoreApplications of nonlinear, time variant, and variable parameters represent a big challenge in a conventional control systems, the control strategy of the fuzzy systems may be represents a simple, a robust and an intelligent solution for such applications.
This paper presents a design of fuzzy control system that consists of three sub controllers; a fuzzy temperature controller (FC_T), a fuzzy humidity controller (FC_H) and a ventilation control system; to control the complicate environment of the greenhouse (GH) using a proposed multi-choice control system approach. However, to reduce the cost of the crop production in the GH, the first choice is using the ventilation system to control the temperature and humidit
... Show MoreObjectives: Recently, there have been important advances in the clinical application of targeted hybrid near-infrared (NIR) fluorescent-radioactive tracers. ICG-99mTc-nanocolloid, for example, is already being used by some centres for sentinel lymph node biopsy in head and neck cancer. The radioactive component allows imaging at depths which would not be possible with NIR alone and, once exposed, the NIR fluorescence reporter can be imaged at very high resolution. Gamma detection is currently carried out with a separate hand-held gamma camera or with a non-imaging probe. Visualisation of NIR fluorescence during surgery requires a dedicated NIR camera, several of which are available commercially. We describe a novel hand-held hybrid NIR-gamm
... Show MoreBlock cipher technique is one of cryptography techniques to encrypt data block by block. The Serpent is one of AES candidates. It encrypts a 128-bit block by using 32 rounds of a similar calculation utilizing permutations and substitutions. Since the permutations and substitutions of it are static. Then this paper proposes dynamic methods for permutation, substitution and key generation based on chaotic maps to get more security. The proposed methods are analyzed and the results showed that they were able to exceed the weakness resulting from the use of static permutations and substitutions boxes in the original algorithm and also can reduce number of rounds and time usage compared with a classical Serpent block
... Show MoreAddressed the problem of the research is marked (experimentation in caves fee) concept and its role in experimentation deviate Display Num formal charges caves. The search came in four sections: general framework for research and identified the research problem and the need for him. With an indication of the importance of his presence. Then specify the search for the goals of (revealed the nature and role of experimentation in determining the nature of Manifesting fee documented on the walls of caves), followed by the establishment of the three search limits (objectivity, the temporal and spatial) were then determine the terms related to the title. Then provide the theoretical framework and indicators that resulted from academic theorizi
... Show MoreThis research focuses on the contemporary geostrategic transformations that afflicted the countries of the Middle East, with a focus on the countries of the Arab East, after the collapse of the system of international relations, and the emergence of the unipolar system led by the United States of America. After the events of September 11 and the events that followed, especially the occupation of Iraq in 2003, the study area witnessed a group of geopolitical variables and the emergence of dangerous phenomena that threatened the state structure in the countries of the Middle East; the most notably are the phenomenon of terrorism, cross-border armed groups, sectarian polarization, the phenomenon of migration and the internal and the externa
... Show MoreThe photoconductivity and its dependence on light intensity have been investigated in a-Ge20Se80 thin films as a function of temperature between (293–323)K. The result showed that the photoconductivity and photosensitivity increase with increase of annealing temperature. This behavior is interpreted in terms of the dispersive diffusion –controlled recombination of localized electrons and holes.
The current research aims through its chapters to verify the relationship and impact of strategic leadership as an independent variable in the marketing performance as a respondent variable, in a leap cement plant, and try to come up with a set of recommendations that contribute to enhancing the practice and adoption of the two variables in the organization under discussion. And based on the importance of the research topic to the community, and to the researched organization and its members, the analytical and analytical approach was adopted in the completion of this research, and the research community included a leap cement plant in Anbar Governorate, while the research sample was represented by (department heads, and people o
... Show MoreThe Environmental Data Acquisition Telemetry System is a versatile, flexible and economical means to accumulate data from multiple sensors at remote locations over an extended period of time; the data is normally transferred to the final destination and saved for further analysis.
This paper introduces the design and implementation of a simplified, economical and practical telemetry system to collect and transfer the environmental parameters (humidity, temperature, pressure etc.) from a remote location (Rural Area) to the processing and displaying unit.
To get a flexible and practical system, three data transfer methods (three systems) were proposed (including the design and implementation) for rural area services, the fi
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