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.
This work is concerned with designing two types of controllers, a PID and a Fuzzy PID, to be used
for flying and stabilizing a quadcopter. The designed controllers have been tuned, tested, and
compared using two performance indices which are the Integral Square Error (ISE) and the Integral
Absolute Error (IAE), and also some response characteristics like the rise time, overshoot, settling
time, and the steady state error. To try and test the controllers, a quadcopter mathematical model has
been developed. The model concentrated on the rotational dynamics of the quadcopter, i.e. the roll,
pitch, and yaw variables. The work has been simulated with “MATLAB”. To make testing the
simulated model and the controllers m
This study aims to design unified electronic information system to manage students attendance in Lebanese French university/Erbil, as a system that simplifies the process of entering and counting the students absence, and generate absence reports to expel students who passed the acceptable limit of being absent, and by that we can replace the traditional way of using papers to count absence, with a complete electronically system for managing students attendance, in a way that makes the results accurate and unchangeable by the students.
In order to achieve the study's objectives, we designed an information syst
... Show MoreAbstract [email protected] Background: Acute Traumatic Stress Disorder (ATSD) might be complicated by Post Traumatic Stress Disorder (PTSD). Psychological First Aid (PFA) said to be helpful to reduce the possibility of reduction of ASD and PTSD symptoms. PFA is simple procedure to deliver help & support to victims, may be by some one close to him, quietly and professionally. Iraq has and is still experiencing, continuous traumatic stresses. ATSD is especially seen in war such as during the Gulf War, Embargo and nowadays under the current American occupation. With the extreme shortage of recourses and the given late priority to psychological problems and intervention have disastrous consequences on the psycho-social wellbeing of peop
... Show MoreIn this work chemical vapor deposition method (CVD) for the production of carbon nanotubes (CNTs) have been improved by the addition of S. Steel mesh container (SSMC) inside which the catalyst (Fe/Al2O3) was placed. Scanning electron microscopy (SEM) investigation method used to study nanotubes produced, showed that high yield of two types of (CNTs) obtained, single wall carbon nanotube (SWCNTs) with diameter and length of less than 50nm and several micrometers respectively and nanocoil tubes with a diameter and length of less than 100nm and several micrometers respectively. The chemical analysis of (CNTs) reveals that the main component is carbon (94%) and a little amount of Al (0.32%), Fe (2.22%) the reminder is oxygen. It was also fou
... Show MorePricing has an important position among the elements of marketing mixture (4ps) as it represents revenues that in turn represent one of the important pillars' for resources affecting on organizations sustainability and development , and the failure in determining prices and their strategies has a dangerous effect on the organizations reality and future as a whole . from this point, this is what from the focus of the research problem,which centered on how to get companies to critical price that satisfies customers and achieve corporate objectives.
... Show MoreKetoprofen has recently been proven to offer therapeutic potential in preventing cancers such as colorectal and lung tumors, as well as in treating neurological illnesses. The goal of this review is to show the methods that have been used for determining ketoprofen in pharmaceutical formulations. Precision product quality control is crucial to confirm the composition of the drugs in pharmaceutical use. Several analytical techniques, including chromatographic and spectroscopic methods, have been used for determining ketoprofen in different sample forms such as a tablet, capsule, ampoule, gel, and human plasma. The limit of detection of ketoprofen was 0.1 ng/ ml using liquid chromatography with tandem mass spectrometry, while it was 0
... Show MoreNonmissile penetrating spine injury (NMPSI) represents a small percent of spinal cord injuries (SCIs), estimated at 0.8% in Western countries. Regarding the causes, an NMPSI injury caused by a screwdriver is rare. This study reports a case of a retained double-headed screwdriver in a 37-year-old man who sustained a stab injury to the back of the neck, leaving the patient with a C4 Brown-Sequard syndrome (BSS). We discuss the intricacies of the surgical management of such cases with a literature review.
PubMed database was searched by the following combined formula of medical subjects headings,
Dell Hymesin 1964coined The Ethnography of Communication in an attempt to explain the ways in which people use the language to interact. It hypothesizes that ethnography is less applicable among participants who have the same sociocultural background. It was proven that all the basic speech components occur whenever there is an interactional situation. The elements of (SPEAKING) schema are closely connected. However, the findings establish the fact that these elements take place effectively among participants who have the same sociocultural background.One of the most outstanding conclusions is the capability of the (SPEAKING) model to analyze not only an interaction between two or more participants, but also any event which consists of a mo
... Show MoreThe tourism industry has become, currently, an art, an industry and a science. It is also one of the components that make up touristic regions. Tourist attractions are no longer the exclusive visits of museums and archeological sites, but also involve other service facilities. It is, therefore, imperative that the authorities should become aware of the degradation of tourist resorts and prevent them from getting worse. Moreover, the authorities should take a set of decisions concerning the protection of the urban aspect with its historical, social, and environmental dimensions, as well as, adapting it to the modern requirements that can bring comfort to the citizens and tourists at physical and psychological levels.