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.
Solid waste generation and composition in Baghdad is typically affected by population growth, urbanization, improved economic conditions, changes in lifestyles and social and cultural habits.
A burning chamber was installed to burn cellulosic waste only. It was found that combustion reduced the original volume and weight of cellulosic waste by 97.4% and 85% respectively.
A batch composting study was performed to evaluate the feasibility of co-composting organic food waste with the cellulosic bottom ash in three different weight ratios (w/w) [95/5, 75/25, 50/50].
The composters were kept in controlled aerobic conditions for 7 days. Temperature, moisture, and pH were measured hourly as process succe
... Show MoreIn the present paper a low cost mechanical vibration shaker of rotating unbalanced type with uniaxial shaking table was designed and constructed in an attempt to provide opportunities for experimental testing and application of vibration in experimental modal analysis, stress relief of weldments, effect of vibration on heat transfer and seismic testing of civil engineering structures. Also, it provides unexpressive solution to enhance the knowledge and technical skills of students in mechanical vibration laboratory. The shaker consists of a five main parts shaker frame, shaker table, flexible support, drive motor, and eccentricity mechanism. The experimental results show that the amplitude of the shaker is increased with increasing the f
... Show MoreThe importance of evaluation depends on many institutions, whether governmental or private, including media institutions, rely on the list to evaluate the weight of things and appreciation, as well as judging things, achievements, and everything related to the institution is concerned. Because through evaluation, institutions can recognize weaknesses and strengths. It is also an effective tool for management review, through which the institution can review everything related to planning and decision-making, leadership, incentives and other administrative matters.
Therefore, this study attempts to shed light on the evaluation process, its basics and its importance in general and in the Kurdish media institutions as a model in part
... Show MoreThe using of the parametric models and the subsequent estimation methods require the presence of many of the primary conditions to be met by those models to represent the population under study adequately, these prompting researchers to search for more flexible models of parametric models and these models were nonparametric models.
In this manuscript were compared to the so-called Nadaraya-Watson estimator in two cases (use of fixed bandwidth and variable) through simulation with different models and samples sizes. Through simulation experiments and the results showed that for the first and second models preferred NW with fixed bandwidth fo
... Show MoreThe problem of frequency estimation of a single sinusoid observed in colored noise is addressed. Our estimator is based on the operation of the sinusoidal digital phase-locked loop (SDPLL) which carries the frequency information in its phase error after the noisy sinusoid has been acquired by the SDPLL. We show by computer simulations that this frequency estimator beats the Cramer-Rao bound (CRB) on the frequency error variance for moderate and high SNRs when the colored noise has a general low-pass filtered (LPF) characteristic, thereby outperforming, in terms of frequency error variance, several existing techniques some of which are, in addition, computationally demanding. Moreover, the present approach generalizes on existing work tha
... Show MoreThe purpose of this paper is to study the properties of the
partial level density ( ) l g and the total level density g ( ),
numerically obtained as a l sum of ( ) l g up to 34 max l , for
a Harmonic – Oscillator potential well. This method applied the
quantum – mechanical phase shift technique and concentrated
on the continuum region. Also a discussion of peculiarities of
quantal calculation for single particle level density of energy –
dependent potential