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.
This paper presents a novel inverse kinematics solution for robotic arm based on artificial neural network (ANN) architecture. The motion of robotic arm is controlled by the kinematics of ANN. A new artificial neural network approach for inverse kinematics is proposed. The novelty of the proposed ANN is the inclusion of the feedback of current joint angles configuration of robotic arm as well as the desired position and orientation in the input pattern of neural network, while the traditional ANN has only the desired position and orientation of the end effector in the input pattern of neural network. In this paper, a six DOF Denso robotic arm with a gripper is controlled by ANN. The comprehensive experimental results proved the appl
... Show MoreIn this research, nanocomposites of poly(methyl methacrylate) (PMMA) and a mixture of nano silica (SiO2) and nano zirconia (ZrO2) were prepared in different weight percentages of the nano fillers to improve some of the properties of PMMA resin to be used as a denture base material. The nano filles were surface modified with a coupling agent and added to the PMMA in different amounts. Impact strength, transverse strength, hardness and roughness were tested for both control and experimental groups. The results indicate that PMMA/silica/zirconia nanocomposites, prepared with 5% by weight of both types of fillers, had a slight increase in impact s
Rainwater harvesting could be a possible solution to decrease the consequences of water scarcity and energy deficiency in Iraq and the Kurdistan Region of Iraq (KRI). This study aims to calculate the water and energy (electricity) saved by rainwater harvesting for rooftops and green areas in Sulaimani city, KR, Iraq. Various data were acquired from different formal entities in Sulaimani city. Moreover, Google Earth and ArcMap 10.4 software were used for digitizing and calculating the total rooftop and green areas. The results showed that for the used runoff coefficients (0.8 and 0.95), the harvested rainwater volumes were 2901563 and 12197131 m³ during the study period (2005 – 2006) and (2019-2020). Moreover, by compa
... Show MoreThis study investigates the Linguistic and Conceptual equivalence of Conner’s Revised Scales when applied on a Sudanese sample. Sudanese parents and teachers completed behavior-rating scales on a stratified sample of 200 children. These instruments were based on Conner’s parent -48 and teacher-28 questionnaires. Following a reliable translation into Sudanese Arabic the test-retest reliability of the items and the internal consistency of the original Conner’s' revised scales were explored. The associations between scale scores and between parents and teachers scores were also examined. Both instruments displayed good reliability and the original Conners scales had satisfactory internal consistency. The inter-correlation sugg
... Show MoreSewer system plays an indispensable task in urban cities by protecting public health and the environment. The operation, maintenance, and rehabilitation of this network have to be in a sustainable and scientific manner. For this purpose, it is important to support operators, decision makers and municipalities with performance evaluation procedure that is based on operational factors. In this paper, serviceability and performance indicator (PI) principles are employed to propose methodology comprising two enhanced PI curves that can be used to evaluate the individual sewers depending on operational factors such as flowing velocity and wastewater level in the sewers. In order to test this methodology; a case study of al-Ru
... Show MoreIt is widely accepted that early diagnosis of Alzheimer's disease (AD) makes it possible for patients to gain access to appropriate health care services and would facilitate the development of new therapies. AD starts many years before its clinical manifestations and a biomarker that provides a measure of changes in the brain in this period would be useful for early diagnosis of AD. Given the rapid increase in the number of older people suffering from AD, there is a need for an accurate, low-cost and easy to use biomarkers that could be used to detect AD in its early stages. Potentially, the electroencephalogram (EEG) can play a vital role in this but at present, no reliable EEG biomarker exists for early diagnosis of AD. The gradual s
... Show MoreThe earth-air heat exchanger (EHX) has a promising potential to passively save the energy consumption of traditional air conditioning systems while maintaining a high degree of indoor comfort. The use of EHX systems for air conditioning in commercial and industrial settings offers several environmental benefits and is capable of operating in both standalone and hybrid modes. This study tests the performance and effectiveness of an EHX design in a sandy soil area in Baghdad, Iraq. The area has a climate of the subtropical semi-humid type. Ambient air temperatures and soil temperatures were recorded throughout the months of 2021. During the months of January and June, the temperatures of the inlet and outflow air at varying air veloci
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