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.
The human kidney is one of the most important organs in the human body; it performs many functions
and has a great impact on the work of the rest of the organs. Among the most important possible treatments is
dialysis, which works as an external artificial kidney, and several studies have worked to enhance the
mechanism of dialysate flow and improve the permeability of its membrane. This study introduces a new
numerical model based on previous research discussing the variations in the concentrations of sodium,
potassium, and urea in the extracellular area in the blood during hemodialysis. We simulated the differential
equations related to mass transfer diffusion and we developed the model in MATLAB Simu
This paper presents seven modified Adomian Decomposition Method (ADM) techniques for efficiently solving initial value problems, especially those involving non-homogeneous and nonlinear differential equations. While the classical ADM is effective for linear homogeneous cases, it has difficulties solving more complex problems. The proposed modifications—from MADM1 to MLADM—include Maclaurin and Taylor expansions, Laplace transforms, and single-step iterations.• These modifications enhance convergence, reduce complexity, and improve accuracy.• Each method offers specific advantages, such as accelerating convergence (MADM2, RADM4), simplifying computation (TSADM5), and achieving higher accuracy (MLADM).• Numerical examples confirm th
... Show More
In recent years, the positioning applications of Internet-of-Things (IoT) based systems have grown increasingly popular, and are found to be useful in tracking the daily activities of children, the elderly and vehicle tracking. It can be argued that the data obtained from GPS based systems may contain error, hence taking these factors into account, the proposed method for this study is based on the application of IoT-based positioning and the replacement of using IoT instead of GPS. This cannot, however, be a reason for not using the GPS, and in order to enhance the reliability, a parallel combination of the modern system and traditional methods simultaneously can be applied. Although GPS signals can only be accessed in open spaces, GP
... Show More
(4)
(3)
This book includes three main chapters: 1. Functions & Their Derivatives. 2. Minimum, Maximum and Inflection points. 3. Partial Derivative. In addition to many examples and exercises for the purpose of acquiring the student's ability to think correctly in solving mathematical questions.
Many of the signs that the global energy system indicate the start of a period of transition from total dependence on fossil energy sources, especially oil, into a new era in which alternative energy sources play an important role in meeting the growing needs of energy demand, so sought many of the developed countries through research the studies carried out to try to bring renewable energy sources and non-renewable (shale oil, oil sands, solar energy, wind energy .... etc) replace traditional fossil energy sources (oil, gas, coal) and despite the recent availability dramatically and spread throughout the the world, but they are going to dry up in the foreseeable future. So many countries, especially the developed sought to find
... Show More
In this paper, a compression system with high synthetic architect is introduced, it is based on wavelet transform, polynomial representation and quadtree coding. The bio-orthogonal (tap 9/7) wavelet transform is used to decompose the image signal, and 2D polynomial representation is utilized to prune the existing high scale variation of image signal. Quantization with quadtree coding are followed by shift coding are applied to compress the detail band and the residue part of approximation subband. The test results indicate that the introduced system is simple and fast and it leads to better compression gain in comparison with the case of using first order polynomial approximation.
(1)
(1)
Co-composting process can be acquired by combining organic fraction of municipal solid waste (OFMSW) with sewage sludge (SS) and mature compost (MC) as enhancement and bulking agent to overcome the problems of municipal solid waste and wastewater treatment plants besides the finally produced fertilizer usage for agriculture and horticulture. The effects of different mixture ratios of (OFMSW), (SS) and (MC) on the performance of composting process were investigated in this study. Piles of about 10 kg were prepared by mixing OFMSW, SS and MC in three different ratios (w/w) [OFMSW: SS: MC= 3:1:1, 3:2:1, and 3:3:1]. Results showed that the pile [3:1:1] was most beneficial to composting. The final compost products contained a
... Show MoreBackground: Health information systems in most countries are inadequate in providing the needed management support and the current health information systems are therefore widely seen as management obstacles rather than as tools,Objectives: the current study is an attempt to assess the behavioral and organizational determinants of health information system performance in Iraq.Methods: A cross-sectional study was conducted by interviewed a total of 189 respondents selected from six Iraqi governorates. The Organizational and Behavioral Assessment Tool was used to measure the behavioral and organizational determinants of health information system performance, it is one of the PRISM package tools that are used to assess the health informatio
... Show MoreThe aim of the research is to assess the quality of the university accounting education system in Iraq. The researcher relied on the opinions of a sample of academics specialized in this field by preparing a checklist focusing on a set of axes that would affect the quality of accounting education in the Iraqi environment.
The most prominent finding of the research is that the quality of accounting education in Iraqi universities is medium and differs from one university to another in some quality components. In addition, the prescribed curricula and study plans applied in the accounting departments do not live up to the required level, as the largest proportion of those curricula are theoretically d
... Show More
(1)
Thsst researcher problem of delays faced by researchers are all waiting to evaluate their standards by the experts who must take their views to extract the truth Virtual important step first step in building standards whatsoever, then the difference of opinion among experts about the paragraphs Whatever the scope of their functions, leading to confusion in maintaining these paragraphs or delete? Or ignore the views and opinion of the researcher to maintain the same? Or as agreed upon with the supervisor if he was a student? Especially if the concepts of a modern new building.
Therefore, the researcher sought to try to find a solution to her problem to conduct an experiment to test building steps