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.
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The earth-air heat exchanger (EHX) has a promising potential to passively save the energy consumption of traditional air conditioning systems while maintaining a high degree of indoor comfort. The use of EHX systems for air conditioning in commercial and industrial settings offers several environmental benefits and is capable of operating in both standalone and hybrid modes. This study tests the performance and effectiveness of an EHX design in a sandy soil area in Baghdad, Iraq. The area has a climate of the subtropical semi-humid type. Ambient air temperatures and soil temperatures were recorded throughout the months of 2021. During the months of January and June, the temperatures of the inlet and outflow air at varying air veloci
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Millions of pilgrims and visitors from numerous parts of the world flock to Karbala (one of the most prominent ideological and religious places in central Iraq) each year to visit the holy shrines in Karbala due to their sanctity. Many improvements have been made to the Two Holy Shrines (THS), the Shrines of Imam Husayn and Imam Abbas, and the area between them (ATHS), due to the high temperatures in this region and to improve pedestrian thermal comfort. Studies on improving outdoor thermal comfort in Karbala are scarce. Hence, this research aims to look into historical and current architectural changes and how they affect thermal comfort. On the hottest summer day, the ENVI-met software program was used to simulate the building des
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In this paper, a single link flexible joint robot is used to evaluate a tracking trajectory control and vibration reduction by a super-twisting integral sliding mode (ST-ISMC). Normally, the system with joint flexibility has inevitably some uncertainties and external disturbances. In conventional sliding mode control, the robustness property is not guaranteed during the reaching phase. This disadvantage is addressed by applying ISMC that eliminates a reaching phase to ensure the robustness from the beginning of a process. To design this controller, the linear quadratic regulator (LQR) controller is first designed as the nominal control to decide a desired performance for both tracking and vibration responses. Subsequently, discontinuous con
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Air pollution is one of the important problems facing Iraq. Air pollution is the result of uncontrolled emissions from factories, car exhaust electric generators, and oil refineries and often reaches unacceptable limits by international standards. These pollutants can greatly affect human health and regular population activities. For this reason, there is an urgent need for effective devices to monitor the molecular concentration of air pollutants in cities and urban areas. In this research, an optical system has been built consisting of aHelium-Neonlaser,5mWand at 632.8 nm, a glass cell with a defined size, and a power meter(Gentec-E-model: uno) where a scattering of the laser beam occurs due to air pollution. Two pollutants were examin
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