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.
In this research an Artificial Neural Network (ANN) technique was applied for the prediction of Ryznar Index (RI) of the flowing water from WTPs in Al-Karakh side (left side) in Baghdad city for year 2013. Three models (ANN1, ANN2 and ANN3) have been developed and tested using data from Baghdad Mayoralty (Amanat Baghdad) including drinking water quality for the period 2004 to 2013. The results indicate that it is quite possible to use an artificial neural networks in predicting the stability index (RI) with a good degree of accuracy. Where ANN 2 model could be used to predict RI for the effluents from Al-Karakh, Al-Qadisiya and Al-Karama WTPs as the highest correlation coefficient were obtained 92.4, 82.9 and 79.1% respectively. For
... Show MoreIn this research an Artificial Neural Network (ANN) technique was applied for the prediction of Ryznar Index (RI) of the flowing water from WTPs in Al-Karakh side (left side) in Baghdad city for year 2013. Three models (ANN1, ANN2 and ANN3) have been developed and tested using data from Baghdad Mayoralty (Amanat Baghdad) including drinking water quality for the period 2004 to 2013. The results indicate that it is quite possible to use an artificial neural networks in predicting the stability index (RI) with a good degree of accuracy. Where ANN 2 model could be used to predict RI for the effluents from Al-Karakh, Al-Qadisiya and Al-Karama WTPs as the highest correlation coefficient were obtained 92.4, 82.9 and 79.1% respe
... Show MoreThis study aims to fabricate and assess the β-tricalcium phosphate (β-TCP) bioactive ceramic coat layer on bioinert ceramic zirconia implants through the direct laser melting technique by applying a long-pulsed Nd:YAG laser of 1064 nm. Surface morphologies, adherence, and structural change in the coatings were evaluated by optical microscopy, field emission scanning electron microscope, hardness, and x-ray diffractometer. The elastic modulus (EM) of the coating was also determined using the nanoindentation test. The quality of the coating was improved when the laser power was 90 W with a decrease in the scan speed to 4 mm s−1. The chemical composition of the coat was maintained after laser processing; also, the Energy Dispersive
... Show MoreAfter the information revolution that occurred in the Western world, and the developments in all fields, especially in the field of education and e-learning, from an integrated system based on the effective employment of information and communication technology in the teaching and learning processes through an environment rich in computer and Internet applications, the community and the learner were able to access information sources and learning at any time and place, in a way that achieves mutual interaction between the elements of the system and the surrounding environment. After the occurrence of the phenomenon of Covid 19, it led to a major interruption in all educational systems that had never happened before, and the disrupt
... Show MoreAbstract
One of the major components in an automobile engine is the throttle valve part. It is used to keep up with emissions and fuel efficiency low. Design a control system to the throttle valve is newly common requirement trend in automotive technology. The non-smoothness nonlinearity in throttle valve model are due to the friction model and the nonlinear spring, the uncertainty in system parameters and non-satisfying the matching condition are the main obstacles when designing a throttle plate controller.
In this work, the theory of the Integral Sliding Mode Control (ISMC) is utilized to design a robust controller for the Electronic Throttle Valve (ETV) system. From the first in
... Show MoreThe present study focused mainly on the buckling behavior of composite laminated plates subjected to mechanical loads. Mechanical loads are analyzed by experimental analysis, analytical analysis (for laminates without cutouts) and numerical analysis by finite element method (for laminates with and without cutouts) for different type of loads which could be uniform or non-uniform, uniaxial or biaxial. In addition to many design parameters of the laminates such as aspect ratio, thickness ratio, and lamination angle or the parameters of the cutout such as shape, size, position, direction, and radii rounding) which are changed to studytheir effects on the buckling characteristics with various boundary conditions. Levy method of classical lam
... Show MoreThis paper delves into some significant performance measures (PMs) of a bulk arrival queueing system with constant batch size b, according to arrival rates and service rates being fuzzy parameters. The bulk arrival queuing system deals with observation arrival into the queuing system as a constant group size before allowing individual customers entering to the service. This leads to obtaining a new tool with the aid of generating function methods. The corresponding traditional bulk queueing system model is more convenient under an uncertain environment. The α-cut approach is applied with the conventional Zadeh's extension principle (ZEP) to transform the triangular membership functions (Mem. Fs) fuzzy queues into a family of conventional b
... Show MoreDiamond-like carbon (DLC) homogeneous thin films were deposited from cyclohexane (Ccyclohexane (Ccyclohexane (Ccyclohexane (C cyclohexane (Ccyclohexane (Ccyclohexane (C cyclohexane (Ccyclohexane (C 6H12 ) liquid by using a plasma jet system which operates with alternating high voltage 7.5 which operates with alternating high voltage 7.5which operates with alternating high voltage 7.5which operates with alternating high voltage 7.5 which operates with alternating high voltage 7.5which operates with alternating high voltage 7.5which operates with alternating high voltage 7.5 which operates with alternating high voltage 7.5which operates with alternating high voltage 7.5 which operates with alternating high voltage 7.5which operates with al
... Show MoreIn all process industries, the process variables like flow, pressure, level, concentration
and temperature are the main parameters that need to be controlled in both set point
and load changes.
A control system of propylene glycol production in a non isothermal (CSTR) was
developed in this work where the dynamic and control system based on basic mass
and energy balance were carried out.
Inlet concentration and temperature are the two disturbances, while the inlet
volumetric flow rate and the coolant temperature are the two manipulations. The
objective is to maintain constant temperature and concentration within the CSTR.
A dynamic model for non isothermal CSTR is described by a first order plus dead
time (FO