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.
The goal of this paper is to design a robust controller for controlling a pendulum
system. The control of nonlinear systems is a common problem that is facing the researchers in control systems design. The Sliding Mode Controller (SMC) is the best solution for controlling a nonlinear system. The classical SMC consists from two phases. The first phase is the reaching phase and the second is the sliding phase. The SMC suffers from the chattering phenomenon which is considered as a severe problem and undesirable property. It is a zigzag motion along the switching surface. In this paper, the chattering is reduced by using a saturation function instead of sign function. In spite of SMC is a good method for controlling a nonlinear system b
The aim of the present study is to research two morphological processes: acronym and compounding (phrasal compounds/ circumlocution) and one syntactic category which are 'existential sentences' in science fiction short stories. The present paper identifies different types and rates of existential sentences. In this respect , 'bare existential and locative’ read the high percentages and may be contrasted with other classifications of English existential sentences which have a verb other than 'be' and a definite expression. 'Phrasal compounds' vary in rates as they constitute notable percentage for those that involve 'lexical means and lexical relations' followed by 'prepositional compounds' , 'conjunctional compounds' , and those invo
... Show MoreMedium Access Control (MAC) spoofing attacks relate to an attacker altering the manufacturer assigned MAC address to any other value. MAC spoofing attacks in Wireless Fidelity (WiFi) network are simple because of the ease of access to the tools of the MAC fraud on the Internet like MAC Makeup, and in addition to that the MAC address can be changed manually without software. MAC spoofing attacks are considered one of the most intensive attacks in the WiFi network; as result for that, many MAC spoofing detection systems were built, each of which comes with its strength and weak points. This paper logically identifies and recognizes the weak points
and masquerading paths that penetrate the up-to-date existing detection systems. Then the
The internet, unlike other traditional means of communication, has a flexibility to stimulate the user and allows him to develop it. Perhaps, the reason for the superiority of the internet over other traditional means of communication is the possibility of change and transmission from one stage to another in a short period. This means that the internet is able to move from the use to the development of the use and then the development of means and innovation as the innovation of the internet is a logical product of the interaction of the user with the network. The internet invests all the proposals and ideas and does not ignore any even if it is simple. This is represented in social networking sites which in fact reflects personal emotio
... Show MoreBACKGROUND: Three-dimensional (3D) printing is an evolving technology that has been used recently in a wide spectrum of applications. AIM: The objective is to evaluate the application of 3D printing in various neurosurgical practice. PATIENTS AND METHODS: This pilot study was conducted in the neurosurgical hospital in Baghdad/Iraq between July 2018 and July 2019. An X, Y, and Z printer was used. The working team included neurosurgeons, biomedical engineers, and bio-technicians. The procedure starts with obtaining Magnetic resonance imaging (MRI) or computed tomography (CT) scan in particular protocols. The MRI, and CT or angiography images were imported into a 3D programmer for DICOM images called 3D slice where these files con
... Show MoreAmeloblastic fibroma is a rare benign tumor usually affects the first two decades of life. The neoplasm is more predominant in mandibular molar-premolar region and rarely affects the maxilla. In this report, we present a couple of Ameloblastic fibroma cases, affecting boys at their 1st decade. The lesions were presented as swellings of their maxilla, which is atypical location. Radiographic images showed well-defined radiolucency containing areas of radio-opacities and impacted teeth. Differential diagnosis was established as cystic/neoplastic conditions. The lesions were incised and histopathologically diagnosed as Ameloblastic fibroma, since they were composed of immature odontogenic mesenchymal and epithelial cells showing different c
... Show MoreImproving speaking skills of Iraqi EFL students was the main purpose of the current research. Thirty EFL students were selected as the research participants for achieving this aim. All students completed the pretest and then spent the next 25 weeks meeting for 90 minutes each to present their nine lectures, answer difficult questions, and get feedback on their use of language in context. Progressive-tests, posttests and delayed post-tests followed every three courses. The researcher utilized SPSS 22 to anal Analyze the data descriptively and inferentially after doing an ANOVA on repeated measurements. It has been shown that using the ideas of sociocultural theory in the classroom has an important and positive impact on students of
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