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.
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 MoreRheumatoid arthritis is a chronic, progressive, inflammatory autoimmune disease of unidentified etiology, associated with articular, extra-articular and systemic manifestation that require long-standing treatment. Taking patient’s beliefs about the prescribed medication in consideration had been shown to be an essential factor that affects adherence of the patient in whom having positive beliefs is an essential for better adherence. The purpose of the current study was to measure beliefs about medicines among a sample of Iraqi patients with Rheumatoid arthritis and to determine possible association between this belief and some patient-certain factors. This study is a cross-sectional study carried out on 250 already diagnosed rheumatoid
... Show MoreThe complexity and variety of language included in policy and academic documents make the automatic classification of research papers based on the United Nations Sustainable Development Goals (SDGs) somewhat difficult. Using both pre-trained and contextual word embeddings to increase semantic understanding, this study presents a complete deep learning pipeline combining Bidirectional Long Short-Term Memory (BiLSTM) and Convolutional Neural Network (CNN) architectures which aims primarily to improve the comprehensibility and accuracy of SDG text classification, thereby enabling more effective policy monitoring and research evaluation. Successful document representation via Global Vector (GloVe), Bidirectional Encoder Representations from Tra
... Show MoreThe sustainable development according to the United Nation, listed firms throughout globally now routinely provide sustainability data. However, there is not enough information on Sustainability Performance Quality (SPQ) in the majority of emerging economies, including Malaysia. This study looks at how the SPQ of the top 100 Malaysian-listed businesses is affected by factors as connected with corporate governance (e.g., board meeting, board size, and board ethnic diversity). Utilizing 500 firm-year data, a longitudinal sample of 500 nonfinancial firms on the Bursa Malaysia for 2015-2019 is employed in this study. The findings from the analysis using the panel regression demonstrated that: ethnic diversity and board siz
... Show MoreTrajectory tracking and vibration suppression are essential objectives in a flexible joint manipulator control. The flexible joint manipulator is an under-actuated system, in which the number of control actions is less than the degree of freedom to be controlled. It is very challenging to control the underactuated nonlinear system with two degree of freedom. This paper presents a hierarchical sliding mode control (HSMC) for a rotary flexible joint manipulator (RFJM). Firstly, the rotary flexible joint manipulator is modeled by two subsystems. Secondly, the sliding surfaces for both subsystems are constructed. Finally, the control action is designed based on the Lyapunov function. Computer simulation results demonstrate the effectiveness of
... Show MoreThe introduction of concrete damage plasticity material models has significantly improved the accuracy with which the concrete structural elements can be predicted in terms of their structural response. Research into this method's accuracy in analyzing complex concrete forms has been limited. A damage model combined with a plasticity model, based on continuum damage mechanics, is recommended for effectively predicting and simulating concrete behaviour. The damage parameters, such as compressive and tensile damages, can be defined to simulate concrete behavior in a damaged-plasticity model accurately. This research aims to propose an analytical model for assessing concrete compressive damage based on stiffness deterioration. The prop
... Show MoreShatt Al-Arab River in Al Basrah, Iraq, has recently recorded massive levels of TDS values (Total Dissolved Solids) in the water as a result of reduced fresh water discharge from sources, causing the river to become salinized due to salt wedge intrusion. Therefore, a block dam in the south reach is required to salt intrusion prevention. The main objective of this research is to simulate the hydraulic impact of a suggested barrage in Ras Al Besha on the Shatt Al-Arab River. The HEC-RAS (5.0.7) model was used to develop a one-dimensional unsteady model to gaining an understanding of the proposed barrage's influence on river behaviour. The daily discharges of the Tigris River provided as the upstream boundary conditions, wh
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