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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Several stress-strain models were used to predict the strengths of steel fiber reinforced concrete, which are distinctive of the material. However, insufficient research has been done on the influence of hybrid fiber combinations (comprising two or more distinct fibers) on the characteristics of concrete. For this reason, the researchers conducted an experimental program to determine the stress-strain relationship of 30 concrete samples reinforced with two distinct fibers (a hybrid of polyvinyl alcohol and steel fibers), with compressive strengths ranging from 40 to 120 MPa. A total of 80% of the experimental results were used to develop a new empirical stress-strain model, which was accomplished through the application of the parti
... Show Moreتعد الملابس وسيلة هامة لكل مايقوم به الانسان في حياته العامة ، فهي الانطباع والكلمة الخارجية عن ذاته الداخلية فهي تعكس فكرة الفرد عن ذاته وعن شخصيته , كما تعد وسيلة تعبير جمالية وفنية , فهي تساعد على اخفاء عيوب الجسد وابراز محاسنه . ويتوقف اختيار الفرد لملابسه على مجموعة عوامل منها احتياجه , قدراته المالية , سنه , مركزه الاجتماعي , طبيعة عمله ,الظروف الجوية التي يعيش فيها وعلى مايُؤمن به من قيم و
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Objective : the aim of the study is to evaluate the effectiveness of nurse’s practices and knowledge program toward care of patient with cardiopulmonary bypass .Methodology: A pre-experimental design (one group pretest- posttest design) was used to carry out this study in three governmental hospitals in Baghdad ( Iraqi Centre for Heart Diseases , Ibn – Albitar Centre for Cardiac Surgery and Ibn – Alnafees Centre for Cardiothoracic and Vascular Surgery ) for the period from 15th of May 2022 into 20th of April 2023.The construction and development of the program and instruments had carry out by the researcher to measured the purposes of the study , twenty two nurses was purposively assigned for the study group . The
... Show MoreBackground: Human semen contains high concentrations of fructose, zinc (Zn) and copper (Cu) in bound and ionic forms for Zn and Cu. The presence of abnormal levels of fructose and those trace elements may affect spermatogenesis with regard to production, maturation, motility and fertilizing capacity of the spermatozoa.Objective: To evaluate the levels of fructose, Zn and Cu in seminal plasma in different groups of male infertility and to correlate their concentrations with various sperm parameters.Methods: The concentrations of fructose, Zn and Cu were measured in 114 semen samples from normozoospermic, oligozoospermic, astheno-zoospermic, and azoospermic men using the electrothermal-atomic absorption spectrometry for Zn and Cu determinatio
... Show MoreAccording to the importance of the conveyor systems in various industrial and service lines, it is very desirable to make these systems as efficient as possible in their work. In this paper, the speed of a conveyor belt (which is in our study a part of an integrated training robotic system) is controlled using one of the artificial intelligence methods, which is the Artificial Neural Network (ANN). A visions sensor will be responsible for gathering information about the status of the conveyor belt and parts over it, where, according to this information, an intelligent decision about the belt speed will be taken by the ANN controller. ANN will control the alteration in speed in a way that gives the optimized energy efficiency through
... Show MoreMany waste materials can be repurposed effectively within asphalt concrete to enhance the performance and sustainability of pavement. One of these waste materials is sawdust ash (SDA). This study explores the beneficial use of SDA as a substitute for limestone dust (LD) mineral filler in asphalt concrete. The replacement rate was 0%, 15%, 30%, 45%, and 60% by weight of total mineral filler. Scanning electron microscopy (SEM) was employed to assess the surface morphology of Sawdust (SD), SDA, and LD. In addition, a series of tests, including Marshall stability and flow, indirect tensile strength,moisture susceptibility, and repeated uniaxial loading tests, were conducted to examine the performance characteristics of asphalt mixtures of diffe
... Show MoreSignature verification involves vague situations in which a signature could resemble many reference samples or might differ because of handwriting variances. By presenting the features and similarity score of signatures from the matching algorithm as fuzzy sets and capturing the degrees of membership, non-membership, and indeterminacy, a neutrosophic engine can significantly contribute to signature verification by addressing the inherent uncertainties and ambiguities present in signatures. But type-1 neutrosophic logic gives these membership functions fixed values, which could not adequately capture the various degrees of uncertainty in the characteristics of signatures. Type-1 neutrosophic representation is also unable to adjust to various
... Show MoreWe demonstrate a behavior of laser pulse grows through fiber laser inside and output cavity with a soliton fiber laser based on the multi-wall carbon nanotube saturable absorber (SA), we investigate the effects of a saturable absorber parameter on the mode-locking of a realistic Erbium fiber ring laser. Generalized nonlinear Schrodinger equation including the nonlinear effects as gain dispersion, second anomalous group velocity dispersion (GVD), self phase modulation (SPM), and two photon absorption used to describe pulse evolution. An analytical method has been used to understand and to quantify the role of the SA parameter on the propagation dynamics of pulse laser. We compute the chirp, power, width and phase of the soliton for range
... Show MoreThe research discusses the need to find the innovative structures and methodologies for developing Human Capital (HC) in Iraqi Universities. One of the most important of these structures is Communities of Practice (CoPs) which contributes to develop HC by using learning, teaching and training through the conversion speed of knowledge and creativity into practice. This research has been used the comparative approach through employing the methodology of Data Envelopment Analysis (DEA) by using (Excel 2010 - Solver) as a field evidence to prove the role of CoPs in developing HC. In light of the given information, a researcher adopted on an archived preliminary data about (23) colleges at Mosul University as a deliberate sample for t
... Show MoreThis present study demonstrated that liver was involved in 14 %of typhoid patients manifesting with hepatomegaly. Elevation of serum enzymes in typhoid fever was presumably of a muscular origin, while elevation of liver enzyme was relatively less common. This study was performed on 30 female patients diagnosed by ultrasound (US) of abdomen, with paratyphoid A, ranged between (20-40) years compared with 30 healthy control .Patients volunteers were treated with appropriate antibiotics for 14 days and investigations were repeated 2-3 week after completion of treatment. Patients had clinical and biochemical evidence of hepatic dysfunction. The spectrum of hepatic involvement included hepatomegaly , jaundice, derangement of various hepatic func
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