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 paper is intended to focus on the existing relation between 'logic' and 'meaning', and how 'meaning' is looked at through logical perspective. Besides, this paper adopts simple logical symbols to represent some aspects of meaning.
Since meaning is still regarded as a thorny area that needs further study to determine its nature and borderline, this paper proposes to resort to logic and logical rules. This paper points out how logical rules are used and how they clarify some oblique sentences. The paper also sheds light on how meaningful sentences are logically symbolized and how logic can define the borderline of meaning in an adequate manner. This paper hypothesizes that logic, l
... Show MoreObjectives: Although the Frankfort Horizontal (FH) and sella-nasion were routinely used as craniofacial reference planes, the inter-individual orientations were changeable when related to true horizontal (HOR). Natural head position (NHP) is a reproducible, standardized position, with the head in an upright posture and eyes focused on a point in the distance at eye level so that the visual axis is horizontal. The natural head position has importance in anthropological as well as in orthodontic fields, as this position has a relatively fixed relationship to the true horizontal and vertical planes. However, NHP is clinically not simple and it takes long time to be recorded, in addition to a deficiency in the tools utilized in the NHP and l
... Show MoreDuring the course of fixed orthodontic therapy, patients should be instructed to eat specific food stuffs and beverages in order to maintain good health for the dentition and supporting structures and prevent frequent attachment debonding that prolong the treatment duration. After searching and collecting articles from 1930 till July 2021, the current review was prepared to emphasize various types of foods that should be taken during the course of fixed orthodontic therapy and to explain the effect of various food stuffs and beverages on the growth and development of craniofacial structures, tooth surfaces, root resorption, tooth movement, retention and stability after orthodontic treatment and the effect on the components of fixed ortho
... Show MoreOptimization of well placement plays a considerable role in the production and maximizing the net present value of the investment of oil field developments. However, the application of the optimization techniques in well placement developments is so complicated because many decision variables, objective functions, and constraints are involved in the well placement optimization case. Furthermore, many computational techniques; conventional and non-conventional, have been utilized to optimize well placement operations. This study displays the advancement of the optimization methods applied in the well placement. Subsequently, the study assorted the applied optimization methods, and it demonstrates the restriction and the range of implementati
... Show MoreThis research aimed to diagnose the perception based on Telecommunications of Iraq to the importance of activating knowledge management marketing in possession, as well as Indication of impediments to activate the management of marketing knowledge in the researched companies, also aimed to show the extent of the existence of significant differences in perception based on Telecommunications Iraqi importance of activating the management marketing knowledge in possession. To achieve the objectives of this research, the questionnaire was developed and distributed to a sample of telecommunications companies in the city of Sulaimaniya, was selected on the criterion according to the company's life in terms of seniority in the telecommunication
... Show MoreIn this paper, a robust adaptive sliding mode controller is designed for a mobile platform trajectory tracking. The mobile platform is an example of a nonholonomic mechanical system. The presence of holonomic constraints reduces the number of degree of freedom that represents the system model, while the nonholonomic constraints reduce the differentiable degree of freedom. The mathematical model was derived here for the mobile platform, considering the existence of one holonomic and two nonholonomic constraints imposed on system dynamics. The partial feedback linearization method was used to get the input-output relation, where the output is the error functions between the position of a certain point on the platform
... Show MoreThe aim of this paper is to translate the basic properties of the classical complete normed algebra to the complete fuzzy normed algebra at this end a proof of multiplication fuzzy continuous is given. Also a proof of every fuzzy normed algebra without identity can be embedded into fuzzy normed algebra with identity and is an ideal in is given. Moreover the proof of the resolvent set of a non zero element in complete fuzzy normed space is equal to the set of complex numbers is given. Finally basic properties of the resolvent space of a complete fuzzy normed algebra is given.
A general velocity profile for a laminar flow over a flat plate with zero incidence is obtained by employing a new boundary condition to the other available boundary conditions. The general velocity profile is mathematically simple and nearest to the exact solution. Also other related values, boundary layer thickness, displacement thickness, momentum thickness and coefficient of friction are nearest to the exact solution compared with other corresponding values for other researchers.
This paper is concerned with introducing and studying the new approximation operators based on a finite family of d. g. 'swhich are the core concept in this paper. In addition, we study generalization of some Pawlak's concepts and we offer generalize the definition of accuracy measure of approximations by using a finite family of d. g. 's.
Experimental investigation of the influence of inserting the metal foam to the solar chimney to induce natural ventilation are described and analyzed in this work. To carry out the experimental test, two identical solar chimneys (without insertion of metal foam and with insertion of metal foam) are designed and placed facing south with dimensions of length× width× air gap (2 m× 1 m× 0.2 m). Four incline angles are tested (20o,30o,45o,60o) for each chimney in Baghdad climate condition (33.3o latitude, 44.4o longitude) on October, November, December 2018. The solar chimney performance is investigated by experimentally recording absorber pl
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