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.
Trajectory tracking and vibration suppression are essential objectives in a flexible joint manipulator control. The flexible joint manipulator is an under-actuated system, in which the number of control actions is less than the degree of freedom to be controlled. It is very challenging to control the underactuated nonlinear system with two degree of freedom. This paper presents a hierarchical sliding mode control (HSMC) for a rotary flexible joint manipulator (RFJM). Firstly, the rotary flexible joint manipulator is modeled by two subsystems. Secondly, the sliding surfaces for both subsystems are constructed. Finally, the control action is designed based on the Lyapunov function. Computer simulation results demonstrate the effectiveness of
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The introduction of concrete damage plasticity material models has significantly improved the accuracy with which the concrete structural elements can be predicted in terms of their structural response. Research into this method's accuracy in analyzing complex concrete forms has been limited. A damage model combined with a plasticity model, based on continuum damage mechanics, is recommended for effectively predicting and simulating concrete behaviour. The damage parameters, such as compressive and tensile damages, can be defined to simulate concrete behavior in a damaged-plasticity model accurately. This research aims to propose an analytical model for assessing concrete compressive damage based on stiffness deterioration. The prop
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Shatt Al-Arab River in Al Basrah, Iraq, has recently recorded massive levels of TDS values (Total Dissolved Solids) in the water as a result of reduced fresh water discharge from sources, causing the river to become salinized due to salt wedge intrusion. Therefore, a block dam in the south reach is required to salt intrusion prevention. The main objective of this research is to simulate the hydraulic impact of a suggested barrage in Ras Al Besha on the Shatt Al-Arab River. The HEC-RAS (5.0.7) model was used to develop a one-dimensional unsteady model to gaining an understanding of the proposed barrage's influence on river behaviour. The daily discharges of the Tigris River provided as the upstream boundary conditions, wh
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A substantial portion of today’s multimedia data exists in the form of unstructured text. However, the unstructured nature of text poses a significant task in meeting users’ information requirements. Text classification (TC) has been extensively employed in text mining to facilitate multimedia data processing. However, accurately categorizing texts becomes challenging due to the increasing presence of non-informative features within the corpus. Several reviews on TC, encompassing various feature selection (FS) approaches to eliminate non-informative features, have been previously published. However, these reviews do not adequately cover the recently explored approaches to TC problem-solving utilizing FS, such as optimization techniques.
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In this study, the thermal buckling behavior of composite laminate plates cross-ply and angle-ply all edged simply supported subjected to a uniform temperature field is investigated, using a simple trigonometric shear deformation theory. Four unknown variables are involved in the theory, and satisfied the zero traction boundary condition on the surface without using shear correction factors, Hamilton's principle is used to derive equations of motion depending on a Simple Four Variable Plate Theory for cross-ply and angle-ply, and then solved through Navier's double trigonometric sequence, to obtain critical buckling temperature for laminated composite plates. Effect of changing some design parameters such as, ortho
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