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 paper, a modified derivation has been introduced to analyze the construction of C-space. The profit from using C-space is to make the process of path planning more safety and easer. After getting the C-space construction and map for two-link planar robot arm, which include all the possible situations of collision between robot parts and obstacle(s), the A* algorithm, which is usually used to find a heuristic path on Cartesian W-space, has been used to find a heuristic path on C-space map. Several modifications are needed to apply the methodology for a manipulator with degrees of freedom more than two. The results of C-space map, which are derived by the modified analysis, prove the accuracy of the overall C-space mapping and cons
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Background: Tubal ligation, recognized as a surgical intervention that ensures permanent contraception, has established itself as an option for women seeking a definitive solution for family planning. Objective: To assess the psychosexual implications of tubal ligation in a sample of women in Baghdad, Iraq. Methods: A prospective cohort study was conducted in a teaching hospital for 2 years, from the first of January 2022 to the end of December 2023, in which 203 women who underwent tubal ligation were included. Results: In the present study, we found that 158 (77.8%) had no depression, mild depression presented in 27 (13.3%), and moderate depression in only 15 (7.4%). While 163 (80.3%) of women did not suffer from anxiety, 32 (15.8
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The study of the dynamic behavior of packed distillation column was studied by frequency response analysis using Matlab program. A packed distillation column (80 mm diameter) (2000 mm height) filled with glass packing (Raschig Rings 10mm), packing height (1500 mm) has been modified for separation of methanol-water mixture (60 vol%). The column dynamic behavior was studied experimentally under different step changes in, feed rate (±30%), reflux rate (±22%), and reboiler heat duty (±150%), the top and bottom concentration of methanol were measured. A frequency response analysis for the above step response was carried out using Bode diagram, the log modulus and the phase angle were used to analyze the process model. A Matlab progra
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The Wang-Ball polynomials operational matrices of the derivatives are used in this study to solve singular perturbed second-order differential equations (SPSODEs) with boundary conditions. Using the matrix of Wang-Ball polynomials, the main singular perturbation problem is converted into linear algebraic equation systems. The coefficients of the required approximate solution are obtained from the solution of this system. The residual correction approach was also used to improve an error, and the results were compared to other reported numerical methods. Several examples are used to illustrate both the reliability and usefulness of the Wang-Ball operational matrices. The Wang Ball approach has the ability to improve the outcomes by minimi
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Vascular patterns were seen to be a probable identification characteristic of the biometric system. Since then, many studies have investigated and proposed different techniques which exploited this feature and used it for the identification and verification purposes. The conventional biometric features like the iris, fingerprints and face recognition have been thoroughly investigated, however, during the past few years, finger vein patterns have been recognized as a reliable biometric feature. This study discusses the application of the vein biometric system. Though the vein pattern can be a very appealing topic of research, there are many challenges in this field and some improvements need to be carried out. Here, the researchers reviewed
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This paper presents a stylistic analysis of two poems of well-known poets of the English literature, namely; E.E. Cummings and the Irish noble laureate Seamus Heaney. The researcher's attempt here is to approach Cummings’s poem “maggie and milly and molly and may” and Heaney’s “A Kite for Aibhín” from the stylistics’ point of view. The paper also analyzes the poems using the tools of linguistics with a view to make their meaning explicit.
It is worth noting that stylistics as a scientific discipline is really beneficial to those who are teaching and studyi
... Show MoreGroundwater modelling is particularly challenging in arid regions where limited water recharge is available. A fault zone will add a significant challenge to the modelling process. The Western Desert in Iraq has been chosen to implement the modelling concept and calculate the model sensitivity to the changes in aquifer hydraulic properties and calibration by researching 102 observations and irrigation wells. MODFLOW-NWT, which is a Newtonian formulation for MODFLOW-2005 approaches, have been used in this study. Further, the simulation run has been implemented using the Upstream-Weighting package (UPW) to treat the dry cells. The results show sensitivity to the change of the Kx value for the major groundwater discharge flow. Only abo
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Ibn al-Haytham is the pioneer of optics, which is a science that had described optics circumstances. Optics or landscape science as it was known by the Arab and Muslim scientists at the time when is a science known as the conditions of sighters in their quantity and quality as the proximity and distance from the beholder , the different forms , conditions and what mediate between the beholder and the microscopes , to explain useful knowledge of what obscures the sight of the conditions of sighters and is used to measure the space Distant criminality and mirrors.
Ibn al-Haitham wrote his famous book The Book of Mirrors and studied mistakes adopted the m
... Show MoreA QR code is a type of barcode that can hold more information than the familiar kind scanned at checkouts around the world. The “QR” stands for “Quick Response”, a reference to the speed at which the large amounts of information they contain can be decoded by scanners. They are being widely used for advertising campaigns, linking to company websites, contest sign-up pages and online menus. In this paper, we propose an efficient module to extract QR code from background and solve problem of rotation in case of inaccurate image taken from mobile camera.