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.
Electromyography (EMG) is being explored for evaluating muscle activity. For gait analysis, EMG needs to be small, lightweight, portable device, and with low power consumption. The proposed superficial EMG (sEMG) system is aimed to be used in rehabilitation centers and biomechanics laboratories for gait analysis in Iraq.
The system is built using MyoWare, which is controlled by using STM32F100 microcontroller. The sEMG signal is transferred via Bluetooth to the computer (about 30m range) for further processing. MATLAB is used for sEMG signal conditioning. The overall system cost (without computer) is about $80. The proposed system is validated using wired NORAXON EMG using the mean root mean squared metho
... Show MoreAround 65 million individuals suffer from epilepsy worldwide, and when it is not properly treated, it is linked to higher rates of physical harm and mortality. Due to the requirement for long‐term therapy and the side effects of many medications, medication compliance is a significant issue. The purpose of this review was to summarize the findings of previous studies examining the quality of life (QOL), adherence, patient education, and medication knowledge, as well as the impact of a pharmacist‐led educational intervention. Additionally, to find out if these studies benefit epileptic patients, to find the appropriate method used to help them in all aspects of their lives, and to use these in future studies. A systematic and comprehensi
... Show MoreA twisted-fin array as an innovative structure for intensifying the charging response of a phase-change material (PCM) within a shell-and-tube storage system is introduced in this work. A three-dimensional model describing the thermal management with charging phase change process in PCM was developed and numerically analyzed by the enthalpy-porosity method using commercial CFD software. Efficacy of the proposed structure of fins for performing better heat communication between the active heating surface and the adjacent layers of PCM was verified via comparing with conventional longitudinal fins within the same design limitations of fin material and volume usage. Optimization of the fin geometric parameters including the pitch, numb
... Show MoreIn this paper, third order non-polynomial spline function is used to solve 2nd kind Volterra integral equations. Numerical examples are presented to illustrate the applications of this method, and to compare the computed results with other known methods.
The study aimed to reveal the extent of the first intermediate grade science curriculum focus on the national values, health, environmental, economic values, in the light of the education policy in the Kingdom of Saudi Arabia, in addition to present a proposed vision to strengthen it in the science curriculum for the first intermediate grade. The study was applied to the two books student and the two books of activity on the first-second semesters for the academic year 1441 AH. To analyze the curriculum content, the study used a verified card prepared by the researchers and a criterion for interpreting percentages. The study reached the following results: environmental values ranked first with a concentration of (43%), i.e. with an avera
... Show MoreCompetitive advantage is a substantial strategic objective for organizations. It requires high levels in the quality of products and services provided to customers, continuous improvement of costing , care for creativity and innovative employees, and speed unique to the marketing and financial engineering, and business re-engineering processes. The situation in this area, requires actors to attract and develop human resources, including help in proper implementation of the strategic tasks that targeted by those institutions. According to the opinions and viewpoints of management scholars, the competitive advantage resource is the most important issue for organizations in the third millennium, which can be a
... Show MoreIdentity crisis is a dominant literary theme, especially in most Arab women writers’ works. However, it has not been given enough attention from a linguistic point of view. By so doing, the current study intends to fill this gap by analyzing the identity crisis from a pragma-stylistic perspective by examining the writer's style in three purposely selected extracts from Diana Abu-Jaber’s novel Origin (2007). The study aims to examine the identity crisis by using pragmatic and stylistic tools and to explore the effects of Abu-Jaber’s stylistic choices on the readers of her work. To conduct this study, an eclectic model comprising Searle’s speech acts (1979), Brown and Levinson's politeness theory (1987), Leech's model of figur
... Show MoreAtenolol was used with ammonium molybdate to prove the efficiency, reliability and repeatability of the long distance chasing photometer (NAG-ADF-300-2) using continuous flow injection analysis. The method is based on reaction between atenolol and ammonium molybdate in an aqueous medium to obtain a dark brown precipitate. Optimum parameters was studied to increase the sensitivity for developed method. A linear range for calibration graph was 0.1-3.5 mmol/L for cell A and 0.3-3.5 mmol/L for cell B, and LOD 133.1680 ng/100 µL and 532.6720 ng/100 µL for cell A and cell B respectively with correlation coefficient (r) 0.9910 for cell A and 0.9901 for cell B, RSD% was lower than 1%, (n=8) for the determination of ate
... Show MoreThe problem of job burnout has become one of the main problems for researchers in social welfare organizations (social protection bodies) - one of the formations of the Ministry of Labor and Social Affairs. Its negative effects increased in light of the COVID-19 pandemic, and in light of the Corona pandemic, the pressures and burdens of workers varied, which resulted in high rates of anxiety, tension, and intellectual and physical exhaustion, and then negatively affected their efficiency in performing work at the individual and organizational level, especially after the increasing tasks of these Bodies in carrying out their role in achieving the general goals and objectives as beingThe general goals are that they are responsible for providi
... Show MoreThe flexible joint robot manipulators provide various benefits, but also present many control challenges such as nonlinearities, strong coupling, vibration, etc. This paper proposes optimal second order integral sliding mode control (OSOISMC) for a single link flexible joint manipulator to achieve robust and smooth performance. Firstly, the integral sliding mode control is designed, which consists of a linear quadratic regulator (LQR) as a nominal control, and switching control. This control guarantees the system robustness for the entire process. Then, a nonsingularterminal sliding surface is added to give a second order integral sliding mode control (SOISMC), which reduces chartering effect and gives the finite time convergence as well. S
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