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.
Heat pipes and two‐phase thermosyphon systems are passive heat transfer systems that employ a two‐phase cycle of a working fluid within a completely sealed system. Consequently, heat exchangers based on heat pipes have low thermal resistance and high effective thermal conductivity, which can reach up to the order of (105 W/(m K)). In energy recovery systems where the two streams should be unmixed, such as airconditioning systems of biological laboratories and operating rooms in hospitals, heat pipe heat exchangers (HPHEs) are recommended. In this study, an experimental and theoretical study was carried out on the thermal performance of an air‐to‐air HPHE filled with two refrigerants as working fluids, R22 and R407c. The heat pipe he
... Show MoreSickle cell disease (SCD) is a hereditary ailment that can cause severe pain and suffering to people who are affected. However, with continued investment in research and treatment options, we can make progress towards improving the lives of those with SCD. Over 40% of patients experience painful vaso-occlusive crises (VOCs), so we must work towards finding solutions and providing support for those living with this condition, These episodes, a hallmark of SCD, significantly contribute to morbidity, mortality, and a diminished quality of life, while also incurring substantial healthcare costs. Chronic pain particularly affects older adolescents and adults with SCD, with over half reporting daily discomfort. Opioid-based analgesics, though sti
... Show MoreCryptography algorithms play a critical role in information technology against various attacks witnessed in the digital era. Many studies and algorithms are done to achieve security issues for information systems. The high complexity of computational operations characterizes the traditional cryptography algorithms. On the other hand, lightweight algorithms are the way to solve most of the security issues that encounter applying traditional cryptography in constrained devices. However, a symmetric cipher is widely applied for ensuring the security of data communication in constraint devices. In this study, we proposed a hybrid algorithm based on two cryptography algorithms PRESENT and Salsa20. Also, a 2D logistic map of a chaotic system is a
... Show MoreIn petroleum reservoir engineering, history matching refers to the calibration process in which a reservoir simulation model is validated through matching simulation outputs with the measurement of observed data. A traditional history matching technique is performed manually by engineering in which the most uncertain observed parameters are changed until a satisfactory match is obtained between the generated model and historical information. This study focuses on step by step and trial and error history matching of the Mishrif reservoir to constrain the appropriate simulated model. Up to 1 January 2021, Buzurgan Oilfield, which has eighty-five producers and sixteen injectors and has been under production for 45 years when it started
... Show MoreThis research addresses a problem manifested in a main question: what is the role of the digital media in marketing the artistic products? in order to determine the role played by the digital media in the disclosure and promotion of the artistic product, its price and places of distribution, as the basic elements of the marketing mixture.
This is a descriptive research in which the researcher used the survey method to check the opinions of a sample chosen according to the (proportion) method from the research community represented by instructors and students of the college of Fine Arts- University of Dayala.
... Show MoreRecently, there has been an increasing advancement in the communications technology, and due to the increment in using the cellphone applications in the diverse aspects of life, it became possible to automate home appliances, which is the desired goal from residences worldwide, since that provides lots of comfort by knowing that their appliances are working in their highest effi ciency whenever it is required without their knowledge, and it also allows them to control the devices when they are away from home, including turning them on or off whenever required. The design and implementation of this system is carried out by using the Global System of Mobile communications (GSM) technique to control the home appliances – In this work, an ele
... Show MoreThe basic objective of the research is to study the quality of the water flow service in the Directorate of Karbala sewage and how to improve it after identifying the deviations of the processes and the final product and then providing the possible solutions in addressing the causes of the deviations and the associated quality gaps. A number of quality tools were used and applied to all data Stations with areas and activities related to the drainage of rainwater, as the research community determines the stations of lifting rainwater in the Directorate of the streams of Karbala holy, and the station was chosen Western station to apply the non-random sampling method intended after meeting a number of. It is one of the largest and m
... Show MoreThis study deals with the intellectual representations whose intellectual systems are incarnated in the Jewish personality, which is considered one of the complex intellectual systems that has caused controversy throughout the ages because of the ambiguity due to the religious and psychological factors that were reflected directly and strongly on the intellectual structure of the Jewish community in general and the Jewish - Zionist personality in particular, in an attempt (to create new dimensions embodied by intellectual representations of a human nature embodied by what that - peaceful - religiously oppressed - psychologically and socially isolated character presents, because of the curse of the peoples of the world that was a cause fo
... Show More