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 need for quick airborne transportation is critical, especially in emergencies. Drones with suspended payloads might be used to accomplish quick airborne transportation. Due to the environment or the drone's motion, the slung load may oscillate and lead the drone to fall. The altitude and attitude controls are the backbones of the drone's stability, and they must be adequately designed. Because of their symmetrical and simple structure, quadrotor helicopters are one of the most popular drone classes. In this work, a genetic algorithm with two weighted terms fitness function is used to adjust a Proportional-Integral-Derivative (PID) controller to compensate for the altitude and attitude controllers in a quadrotor drone
... Show MoreEvery so often, a confluence of novel technologies emerges that radically transforms every aspect of the industry, the global economy, and finally, the way we live. These sharp leaps of human ingenuity are known as industrial revolutions, and we are currently in the midst of the fourth such revolution, coined Industry 4.0 by the World Economic Forum. Building on their guideline set of technologies that encompass Industry 4.0, we present a full set of pillar technologies on which Industry 4.0 project portfolio management rests as well as the foundation technologies that support these pillars. A complete model of an Industry 4.0 factory which relies on these pillar technologies is presented. The full set of pillars encompasses cyberph
... Show MoreSubstantial research has been performed on Building Information Modeling (BIM) in various topics, for instance, the use and benefit of BIM in design, construction, sustainable environment building, and Facility assets over the past several years. Although there are various studies on these topics, Building Information Modeling (BIM) awareness through facilities management is still relatively poor. The researcher's interest is increased in BIM study is based heavily upon the perception that it can facilitate the exchange and reuse of information during various project phases. This property and others can be used in the Iraqi Construction industry to motivate the government to eliminate the change resistance to use innovat
... Show MoreComputations of the relative permeability curves were made through their representation by two functions for wetting and nonwetting phases. Each function contains one parameter that controls the shape of the relative permeability curves. The values of these parameters are chosen to minimize an objective function, that is represented as a weighted sum of the squared differences between experimentally measured data and the corresponding data calculated by a mathematical model simulating the experiment. These data comprise the pressure drop across core samples and the recovery response of the displacing phase. Two mathematical models are constructed in this study to simulate incompressible, one-dimensional, two-phase flow. The first model d
... Show MoreReseach target the most important topic, is Activity and ProfitabilityIndictors Analysis for
Nationality and Iraqi Insurance Company, In order to stand on them ability to cover its risks
and explore the efficiency asset and its avialible resources using to determine them abilities to
profit generation from its insurance activity. The analysis was focus to examine their profit
and activity power, and test the significant differences aming them performance. Test 2
hypothese that is related and result it sign that the 2 company no has significant differences at
profitability and activity level. The research depend on coneclusion, recommended two
company to work at efficiency with cost element of insurance activity in or
Receipt date:10/27/2021 accepted date:12/15/2021 Publication date:31/12/2021
This work is licensed under a Creative Commons Attribution 4.0 International License.
The phenomenon of extremist extremism (terrorism) was one of the most prominent issues that took a large space in the twenty-first century, in which cognitive motives were mixed with strategic and ideological motives, leading to the emergence of terrorist extremi
... Show MoreNew complexes of Cu (ll), Ni (ll), Co (ll), and Zn (ll) wi th 2-amino-5-p-Fiouro Phenyl 1, 3, 4-Thiadiazole have been synthesized. The products were isolated, studied and characterized by physical measurements, ie,(Ff-IR), UV-Vis and the melting points were determined. The new Schiff base (L) has been used to prepare some complexes. The prepared complexes were identified and their structural geometry were suggested
Cognitive stylistics also well-known as cognitive poetics is a cognitive approach to language. This study aims at examining literary language by showing how Schema Theory and Text World Theory can be useful in the interpretation of literary texts. Further, the study attempts to uncover how readers can connect between the text world and the real world. Putting it differently, the study aims at showing how the interaction between ‘discourse world’ and ‘text world’. How readers can bring their own experience as well as their background knowledge to interact with the text and make interpretive connections.
Schema and text world theories are useful tools in cognitive stylistic stud
... Show MoreRare earth metal oxides (REMOs) have gained considerable attention in recent years owing to their distinctive properties and potential applications in electronic devices and catalysts. Particularly, cerium dioxide (CeO2), also known as ceria, has emerged as an interesting material in a wide variety of industrial, technological, and medical applications. Ceria can be synthesized with various morphologies, including rods, cubes, wires, tubes, and spheres. This comprehensive review offers valuable perceptions into the crystal structure, fundamental properties, and reaction mechanisms that govern the well-established surface-assisted reactions over ceria. The activity, selectivity, and stability of ceria, either as a stand-alone catalyst or as
... Show More