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.
In this paper, a new equivalent lumped parameter model is proposed for describing the vibration of beams under the moving load effect. Also, an analytical formula for calculating such vibration for low-speed loads is presented. Furthermore, a MATLAB/Simulink model is introduced to give a simple and accurate solution that can be used to design beams subjected to any moving loads, i.e., loads of any magnitude and speed. In general, the proposed Simulink model can be used much easier than the alternative FEM software, which is usually used in designing such beams. The obtained results from the analytical formula and the proposed Simulink model were compared with those obtained from Ansys R19.0, and very good agreement has been shown. I
... Show MoreBackground: It was stated in scientific literatures that the entire craniofacial complex is influenced by the growth of the cranial base structures. Nevertheless, many times this is not the case, and this point is subject to great controversy so the aim of this study is to evaluate the possible differences in cranial base shape and flexure between different skeletal classes for both genders and to investigate any possible correlation between cranial base variables and other skeletal base variables. Materials and Methods: The sample include 75 lateral cephalometric radiographs of Iraqi adults aged between 18-25 years (39 males, 36 females), collected from patients and undergraduate students in the orthodontic department of College of Dentist
... Show MoreBecause the Coronavirus epidemic spread in Iraq, the COVID-19 epidemic of people quarantined due to infection is our application in this work. The numerical simulation methods used in this research are more suitable than other analytical and numerical methods because they solve random systems. Since the Covid-19 epidemic system has random variables coefficients, these methods are used. Suitable numerical simulation methods have been applied to solve the COVID-19 epidemic model in Iraq. The analytical results of the Variation iteration method (VIM) are executed to compare the results. One numerical method which is the Finite difference method (FD) has been used to solve the Coronavirus model and for comparison purposes. The numerical simulat
... Show MoreA simple and novel membraneless paper-based microfluidic fuel cell was presented in this study. The occurrence of laminar flow was employed to ensure no mixing of the fuel and oxidant fluids along the bath of reaction. The acidic wastewater was used as a fuel. It was an air-breathing cell, so air and tab water were used as oxidants. Both the fuel and tab water flowed continuously under gravity. Whatman filter paper was used for preparation of the fuel cell channel and two carbon fibre electrodes were used and firmed on the edges of the cell. The performance of the cell was examined over three consecutive days. The results indicated that the present cell has the potential to generate electric power, but an extensive study is required to harv
... Show MoreThe increasing demand for energy has encouraged the development of renewable resources and environmentally benign fuel such as biodiesel. In this study, ethyl fatty esters (EFEs), a major component of biodiesel fuel, were synthesized from soybean oil using sodium ethoxide as a catalyst. By-products were glycerol and difatty acyl urea (DFAU), which has biological characteristics, as antibiotics and antifungal medications. Both EFEs and DFAU have been characterized using Fourier transform infrared (FTIR) spectroscopy, and 1H nuclear magnetic resonance (NMR) technique. The optimum conditions were studied as a function of reaction time, reactant molar ratios, catalyst percentage and the effect of organic solvents. The conversion ratio of soybea
... Show MoreMobile ad hoc network security is a new area for research that it has been faced many difficulties to implement. These difficulties are due to the absence of central authentication server, the dynamically movement of the nodes (mobility), limited capacity of the wireless medium and the various types of vulnerability attacks. All these factor combine to make mobile ad hoc a great challenge to the researcher. Mobile ad hoc has been used in different applications networks range from military operations and emergency disaster relief to community networking and interaction among meeting attendees or students during a lecture. In these and other ad hoc networking applications, security in the routing protocol is necessary to protect against malic
... Show MoreMicrofinance Institutions (MFIs) offers small loans with easy repayment system and till now these institutions have served millions of needy people around the globe. This study highlights the hurdles influence the smooth working and growth of Microfinance institution in Egypt. The structured interviews were conducted from the top and mid-level managers of MFI's. This study revealed that interest rate, political and economic conditions, corruption, customer outreach, competition and technology are the important elements for MFI's success. It is evident that lack of use of technology and less importance drawn on customer outreach programs are the main challenges of MFI's in Egypt. This study provides a roadmap for practitioners and strategic
... Show MoreThe research aims to indicate the relationship between lean production tools included seven {constant improvement , and Just in time (JIT), and the production smoothing , and quality at the source, and standardized work, Visual management, and activities 5S } and Mass Customization strategy for the model (Pine & Gilomer, 1997) {collaborative, adaptive, cosmetic, transparent}, as well as providing a conceptual framework and applied for variables search to clarify how they will choose a Mass Customization strategy through the lean production tools, , and recognize the reality of the practices of Iraqi industries in such a field. Moreover, aims to highlight the positive aspects that accrue to companies a
... Show MoreLocking of the knee is a one of the commonest orthopedic outpatient presentation. This patient usually need magnetic resonance imaging (MRI) when there is suspected lesion in the soft tissue clinically. Meniscal tears is the first differential diagnosis when accompany with painful knee. (1, 2)Giant cell tumor (GCT) is benign a localized nodular tenosynovitis often occur in the tendon sheath , Mostly involve the hand tendons in middle age group between 30 and 50 years old , female affect more than male.(3,4) The WHO defines two well-known kinds of giant cell tumor: (1) pigmented villonodular synovitis ( generalized type), which mainly involve the joints of the lower limb and (2) giant cell tumor of the tendon sheath ( localized type)
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