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.
Student performance may influence by several factors in all his study levels such as primary school, intermediate school and even in his college; some of these factors are psychological factors, social factors, and the factors which correlate with student environment.
In this paper we study some of these factors to discover their influence by using canonical correlation analysis to analyze the data. Many conclusions are discovered to help who focuses student performance or to make it pest in future.
The research study and analysis of the integration of marketing communications and their impact on the marketing performance of a number of telecom companies, as included in the research problem to know the role of marketing communications community in achieving sales and market share, profitability and customer satisfaction. The importance of research begins to be the right choice for the elements of marketing communications, lead to savings in time, effort and money and create a more idea about the effectiveness of the application of the concept of integration. The research to determine the role of marketing communications in promoting the integration of the marketing performance of companies in the field of sales and marke
... Show MoreConcrete columns with hollow-core sections find widespread application owing to their excellent structural efficiency and efficient material utilization. However, corrosion poses a challenge in concrete buildings with steel reinforcement. This paper explores the possibility of using glass fiber-reinforced polymer (GFRP) reinforcement as a non-corrosive and economically viable substitute for steel reinforcement in short square hollow concrete columns. Twelve hollow short columns were meticulously prepared in the laboratory experiments and subjected to pure axial compressive loads until failure. All columns featured a hollow square section with exterior dimensions of (180 × 180) mm and 900 mm height. The columns were categorized into
... Show MoreLow-temperature stratification, high-volumetric storage capacity, and less-complicated material processing make phase-changing materials (PCMs) very suitable candidates for solar energy storage applications. However, their poor heat diffusivities and suboptimal containment designs severely limit their decent storage capabilities. In these systems, the arrangement of tubes conveying the heat transport fluid (HTF) plays a crucial role in heat communication between the PCM and HTF during phase transition. This study investigates a helical coil tube-and-shell thermal storage system integrated with a novel central return tube to enhance heat transfer effectiveness. Three-dimensional computational fluid dynamics simulations compare the proposed d
... Show MoreA recent study compared experimentally the hydraulic and thermal activity of twisted tape inserts for two types, metal foam twisted tape (MFTT) and traditional twisted tape (TTT), in a double pipe heat exchanger. The investigation goal of the innovatively designed MFTT is to enhance the heat transfer process, which provides a higher thermal enhancement factor over those of TTT under the same conditions. Heat transfer activity in terms of Nusselt number (
Codes of red, green, and blue data (RGB) extracted from a lab-fabricated colorimeter device were used to build a proposed classifier with the objective of classifying colors of objects based on defined categories of fundamental colors. Primary, secondary, and tertiary colors namely red, green, orange, yellow, pink, purple, blue, brown, grey, white, and black, were employed in machine learning (ML) by applying an artificial neural network (ANN) algorithm using Python. The classifier, which was based on the ANN algorithm, required a definition of the mentioned eleven colors in the form of RGB codes in order to acquire the capability of classification. The software's capacity to forecast the color of the code that belongs to an object under de
... Show MoreThis study aims to assess the effect of adding twisted fins in a triple-tube heat exchanger used for latent heat storage compared with using straight fins and no fins. In the proposed heat exchanger, phase change material (PCM) is placed between the middle annulus while hot water is passed in the inner tube and outer annulus in a counter-current direction, as a superior method to melt the PCM and store the thermal energy. The behavior of the system was assessed regarding the liquid fraction and temperature distributions as well as charging time and energy storage rate. The results indicate the advantages of adding twisted fins compared with those of using straight fins. The effect of several twisted fins was also studied to discover
... Show MoreBreast cancer is among the primary causes of death among Iraqi women and is a serious worldwide health concern. ALK or anaplastic lymphoma kinase, is connected to several cancers, including breast cancer.. The goal of this research was to assess the prevalence of anaplastic lymphoma kinase (ALK) with Alkaline phosphatise (ALP) and Lactate dehydrogenase (LDH) together as diagnostic markers. The study comprised 60 patients with metastatic breast cancer and 60 healthy volunteers. The blood levels of the enzymes (ALP), (LDH), and ALK in Iraqi breast cancer patients are compared to those of healthy controls. It was shown that compared to healthy people, patients had breast cancer noticeably greater levels of ALK, ALP, and NDH .These biomarkers m
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