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.
Abstract
An experimental study was conducted for measuring the quality of surface finishing roughness using magnetic abrasive finishing technique (MAF) on brass plate which is very difficult to be polish by a conventional machining process where the cost is high and much more susceptible to surface damage as compared to other materials. Four operation parameters were studied, the gap between the work piece and the electromagnetic inductor, the current that generate the flux, the rotational Spindale speed and amount of abrasive powder size considering constant linear feed movement between machine head and workpiece. Adaptive Neuro fuzzy inference system (ANFIS) was implemented for evaluation of a serie
... Show MoreBackground: Anti-vascular endothelial growth factors commonly used intravitreally for treatment of variable retinal disease worldwide, which help to regulate the upregulation of vascular endothelial growth factors due to ischemia or/and other retinal insult.
Objective: To review all cases of intravitreal bevacizumab given in the retinal unit of the Eye Specialty Private Hospital in Iraq from December 2015 to June 2016, pointing out the common indications.
Methods: A retrospective study including all cases of intravitreal injections of bevacizumab recorded at the Eye Specialty Private Hospital from December 2015 to June 2016 were retrieved. Age, sex, laterality, diagnosis
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The analytical study of optical bistability is concerned in a fully
optimized laser Fabry-Perot system. The related phenomena of
switching dynamics and optimization procedure are also included.
From the steady state of optical bistability equation can plot the
incident intensity versus the round trip phase shift (φ) for different
values of dark mistuning
12
,
6
,
3
,
1.5
0 , o
or finesse (F= 1, 5, 20,
100). In order to obtain different optical bistable loops. The inputoutput
characteristic for a nonlinear Fabry-Perot etalon of a different
values of finesse (F) and using different initial detuning (φ0) are used
in this rese
The calibration of a low-speed wind tunnel (LSWT) test section had been made in the present work. The tunnel was designed and constructed at the Aerodynamics Lab. in the Mechanical Engineering Department/University of Baghdad. The test section design speed is 70 m/s. Frictional loses and uniformity of the flow inside the test section had been tested and calibrated based on the British standards for flow inside ducts and conduits. Pitot-static tube, boundary layer Pitot tube were the main instruments which were used in the present work to measure the flow characteristics with emphasize on the velocity uniformity and boundary layer growth along the walls of the test section. It is found that the maximum calibrated velocity for empty test sect
... Show MoreNaber and toning in the modern Arab poetry Mahmoud Darwish, a model
When we talk about the foresight in films, it is necessary to talk about dreams because foresight represents one of its distinct types. The Precognitive vision has become a possible material in dealing with as subjects in the film industry that adopt these ideas with their philosophical and scientific orientations, because they represent the imagination that predictors are specialized with. It can be invested through the introduction of a vision of another kind to achieve its goals and ambitions in the film industry and in particular the huge institutions of production as in Hollywood. The cinema works in the light of those concepts of production which found the prognostic dream (the foresight) as a distinctive genre in its films,
Th
HTH Ali Tarik Abdulwahid , Ahmed Dheyaa Al-Obaidi , Mustafa Najah Al-Obaidi, eNeurologicalSci, 2023
(3)
The main objective of the present work is to find a method increases the efficiency of the airfoil that is used for blade in wind turbine, wing in aircraft, propeller and helicopter (like NACA 4412). By overcoming the separation of flow at high angle of attacks, a slotted airfoil had been used and solved numerically through connecting the pressure side in the bottom surface with the suction side in the top surface of the airfoil to energize the separated flow. Slot exit, width and slope were considered as a parameters of slot configuration to determine the effective design of consideration. Reynolds number was taken as [1.6 x106 ] and the angle of attacks were ranged from (0o - 20o ). The numerical solution with Ansys Fluent commercial prog
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This work deals with a numerical investigation to evaluate the utilization of a water pipe buried inside a roof to reduce the heat gain and minimize the transmission of heat energy inside the conditioning space in summer season. The numerical results of this paper showed that the reduction in heat gain and energy saving could be occurred with specific values of parameters, like the number of pipes per square meter, the ratio of pipe diameter to the roof thickness, and the pipe inlet water temperature. Comparing with a normal roof (without pipes), the results indicated a significant reduction in energy heat gain which is about 37.8% when the number of pipes per m
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