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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
In this paper, the Active Suspension System (ASS) of road vehicles was investigated. In addition to the conventional stiffness and damper, the proposed ASS includes a fuzzy controller, a hydraulic actuator, and an LVDT position sensor. Furthermore, this paper presents a nonlinear model describing the operation of the hydraulic actuator as a part of the suspension system. Additionally, the detailed steps of the fuzzy controller design for such a system are introduced. A MATLAB/Simulink model was constructed to study the proposed ASS at different profiles of road irregularities. The results have shown that the proposed ASS has superior performance compared to the conventional Passive Suspension System (PSS), where the body displacemen
... Show MoreAlumina thin films have significant applications in the areas of optoelectronics, optics, electrical insulators, sensors and tribology. The novel aspect of this work is that the homogeneous alumina thin films were prepared in several stages to generate a plasma jet. In this paper, aluminium nanoparticles suspended in vinyl alcohol were prepared using exploding wire plasma. TEM analysis was used to determine the size and shape of particles in aluminium and vinyl alcohol suspensions; the TEM images showed that the particle size is 17.2 nm. Aluminium/poly vinyl alcohol (Al/PVA) thin films were prepared using this suspension on quartz substrate by plasma jet technique at room temperature with an argon gas flow rate of 1 L/min. The Al/PV
... Show MoreThe growing use of tele
This paper presents a new secret diffusion scheme called Round Key Permutation (RKP) based on the nonlinear, dynamic and pseudorandom permutation for encrypting images by block, since images are considered particular data because of their size and their information, which are two-dimensional nature and characterized by high redundancy and strong correlation. Firstly, the permutation table is calculated according to the master key and sub-keys. Secondly, scrambling pixels for each block to be encrypted will be done according the permutation table. Thereafter the AES encryption algorithm is used in the proposed cryptosystem by replacing the linear permutation of ShiftRows step with the nonlinear and secret pe
... Show MoreBackground: Patients requiring renal biopsies have various glomerular diseases according to their demographic characteristics.
Objective: To study types of glomerular disease among adult Iraqi patients in a single center in Baghdad/Iraq
Material and Methods: A total of 120 native kidney biopsies were studied. All biopsies were adequate and were processed for Light Microscopy.
The age range of the study patients was 17-67 years, with a mean of 38.5 years. The mean follow up period was 28 weeks (4-52 weeks)
Indication for biopsy included: Nephrotic syndrome (N=72; 60%), Asymptomatic proteinuria (N=21; 17.5%), acute nephritic presentation (N=17; 14.16%), asymptomatic haematuria (N=10; 8.33%).
Results: Primary glomerulonephrit
Enhancement of the performance for hybrid solar air conditioning system was presented in this paper. The refrigerant temperature leaving the condenser was controlled using three-way valve, this valve was installed after the compressor to regulate refrigerant flow rate towards the solar system. A control system using data logger, sensors and computer was proposed to set the opening valve ratio. The function of control program using LabVIEW software is to obtain a minimum refrigerant temperature from the condenser outlet to enhance the overall COP of the unit by increasing the degree of subcooled refrigerant. A variable load electrical heater with coiled pipe was used instead of the solar collector and the storage tank to simulate the sola
... Show MoreAbstract:
The research aims to clarify the impact of adopting the IFRS16 financial reporting standard on lease contracts in insurance companies on audit procedures. The change in the classification of lease contracts in the case of adopting the IFRS16 financial reporting standard necessarily requires audit procedures that are compatible with this change. A proposed audit program was prepared, guided by international auditing standards, based on the study of the client's environment and analysis of external and internal risks in the light of financial and non-financial indicators. The researchers reached a set of concl
... Show MoreThis paper features the modeling and design of a pole placement and output Feedback control technique for the Active Vibration Control (AVC) of a smart flexible cantilever beam for a Single Input Single Output (SISO) case. Measurements and actuation actions done by using patches of piezoelectric layer, it is bonded to the master structure as sensor/actuator at a certain position of the cantilever beam.
The smart structure is modeled based on the concept of piezoelectric theory, Bernoulli -Euler beam theory, using Finite Element Method (FEM) and the state space techniques. The number of modes is reduced using the controllability and observability grammians retaining the first three
dominant vibratory modes, and for the reduced syste
The mucilage from the seeds of Lallemantia royleana family Labiatae was extracted and subjected to preformulation study for evaluation of its suitability for use as suspending agent. Furosemide suspensions were prepared using (1.5% w/v) of the extracted Lallemantia royleana mucilage, (1.5% w/v) chitosan and (0.35% w/v) xanthan gum. The mucilage was white in color and the average yield of dried mucilage obtained from L.royleana nutlets was 14 % w/w of the seeds used. It is sparingly soluble in water but swells in contact with it, giving a highly viscous solution. It is slightly acidic to neutral. It was found that the extracted natural mucilage of Lallemantia royleana exhibited a higher viscosity profil
... Show MoreFilm and literature exchanges it’s influences since the early beginning of the motion pictures appearance .it was a phenomenon in other genres such as theatre ,short stories and novels .the film used out of this interaction with literature the content , themes and subjects whish were more attached to the society. based on that , the film gains it’s successes and wide spread of influences on it’s audiences who became more familiar with the motion picture style.Astrok , the French film critic wrote about “Camera the pain “ and called it as the a way of writing in the future .he was talking about the future’s role of the film .It is the importance of the film in the creation and documenting the life and its various fields.Becaus
... Show MoreBackground: Congenital club foot is a complex deformity of foot .It is a collection of different abnormalities, with different etiologies. Consequently, Severity varies with difficulties in evaluating treatment strategies with outcome results. The treatment of congenital club foot remains controversial. Usually, the orthopedist's goal is to obtain anatomically and functionally normal feet in all patients. Objective: To asses short term follow up result of conservatively treated club feet in relation to the age
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