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.
Trajectory tracking and vibration suppression are essential objectives in a flexible joint manipulator control. The flexible joint manipulator is an under-actuated system, in which the number of control actions is less than the degree of freedom to be controlled. It is very challenging to control the underactuated nonlinear system with two degree of freedom. This paper presents a hierarchical sliding mode control (HSMC) for a rotary flexible joint manipulator (RFJM). Firstly, the rotary flexible joint manipulator is modeled by two subsystems. Secondly, the sliding surfaces for both subsystems are constructed. Finally, the control action is designed based on the Lyapunov function. Computer simulation results demonstrate the effectiveness of
... Show MoreWe studied, in this paper, the semiotics of the visual image of women in the discourse of empowerment, through three models of advertising images expressing the particularities of the Saudi Arabian environment.
We aim to know how the mark operates and how it is interpreted, as a semantic process in which the meaning ranges from description to interpretation, and we studied two hypotheses:
-The advertising image is a structure in which the mark corresponds to the reality and the discourse to the context.
-The significance is not found in the visual sign or in the textual sign of the advertising image, but in the creative event that opens up to the social, cultural, and psychological context, and creates a field of dia
... Show MoreA Survey Study Of A Sample Of The Public Of Baghdad Governorate
The current study aimed to identify the most prominent psychological and behavioral repercussions of the exposure of the elderly to the news of the Corona pandemic and to determine the mechanisms of their exposure. On an intended sample on both sides of (Al-Karkh and Al-Rasafa) and the simple random sample was adopted to choose the place of distribution of the questionnaire and the intentional sample.
The research concluded several results, most TV news is still a primary source of information and that most of the sample move between stations to see more information about the pandemic and that the presentation of views confuses the elderly ،There
... Show MoreStrives Total Productive Maintenance to increase the overall effectiveness of the equipment through the early involvement in the design and manufacture of equipment productivity. It also operates in an environment of simultaneous engineering work on the synchronization of activities to take advantage of early information by maintenance engineers, design, operation, and that helps to reduce the faults and facilitate future maintenance tasks.
Has adopted a search in the theoretical concept of the total maintenance productivity and concurrent engineering activities carried out during which the conjunction a
... Show MoreThe research involved a rapid, automated and highly accurate developed CFIA/MZ technique for estimation of phenylephrine hydrochloride (PHE) in pure, dosage forms and biological sample. This method is based on oxidative coupling reaction of 2,4-dinitrophenylhydrazine (DNPH) with PHE in existence of sodium periodate as oxidizing agent in alkaline medium to form a red colored product at ʎmax )520 nm (. A flow rate of 4.3 mL.min-1 using distilled water as a carrier, the method of FIA proved to be as a sensitive and economic analytical tool for estimation of PHE.
Within the concentration range of 5-300 μg.mL-1, a calibration curve was rectilinear, where the detection limit was 3.252 μg.mL
Abstract
Asthma is a complex disease defined by chronic airway inflammation and airflow limitation causing variable respiratory symptoms which include shortness of breath (SOB), wheezing, chest tightness and cough. Asthma guidelines advocate adding a second long acting bronchodilator to medium doses of inhaled corticosteroids (ICS) rather using high doses of ICS alone to control moderate to severe persistent asthma. The aim of this study was to evaluate the clinical outcomes of three medication regimens indicated for Iraqi patients suffering from persistent asthma.
This study was interventional randomized clinical study conducted on a sample of adult Iraqi asthm
... Show MoreDespite scholars’ attention on the typology of modality as a linguistic phenomenon, yet the use of modality across varieties of English is not well visible in communication-based researches that take semantics, pragmatics and discourse issues as the objects for their investigation. The paper generates its data from six M. A. dissertations from Nigerian University and equal number of the M. A. dissertations from Iraqi University to qualitatively and quantitatively investigate the contextual use of modality within the pragmatic perspective. The data analysis reveals that modality such as usuality, potentiality, necessity, probability and obligation in the dissertations encapsulates interpersonal and authorial voice in which the mean
... Show MoreAl-Dalmaj marsh and the near surrounding area is a very promising area for energy resources, tourism, agricultural and industrial activities. Over the past century, the Al-Dalmaje marsh and near surroundings area endrous from a number of changes. The current study highlights the spatial and temporal changes detection in land cover for Al-Dalmaj marsh and near surroundings area using different analyses methods the supervised maximum likelihood classification method, the Normalized Difference Vegetation Index (NDVI), Geographic Information Systems(GIS), and Remote Sensing (RS). Techniques spectral indices were used in this study to determine the change of wetlands and drylands area and of other land classes, th
... Show MoreThe aim of the present study is to examine the effectiveness of a proposed unite in voluntary work in enhancing critical thinking skills and the attitudes towards responsible citizenship among eighth grade female students in the Sultanate of Oman. In order to collect the study data, the researchers employed a quasi-experimental research design with twenty female students from Al-Sideeqah bint Al-Sideeq for basic education school. The research data were collected via a critical thinking test that consisted of twenty-five items and a scale of twenty items under three different dimensions, which aimed to measure students' attitudes towards responsible citizenship. The researchers implemented these two instruments as pre- and post the experi
... Show Moreدور التدقيق الاستراتيجي لإدارة الموارد البشرية في بلورة القدرات التنظيمية دراسة استطلاعية في رئاسة جامعة بغداد