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 research, main types of optical coatings are presented which are used as covers for solar cells, these coatings are reflect the infrared (heat) from the solar cell to increase the efficiency of the cell (because the cell’s efficiency is inversely proportional to the heat), then the theoretical and mathematical description of these optical coatings are presented, and an optical design is designed to meet this objective, its optical transmittance was calculated using (MATLAB R2008a) and (Open Filters 1.0.2) programs
We propose an intraguild predation ecological system consisting of a tri-trophic food web with a fear response for the basal prey and a Lotka–Volterra functional response for predation by both a specialist predator (intraguild prey) and a generalist predator (intraguild predator), which we call the superpredator. We prove the positivity, existence, uniqueness, and boundedness of solutions, determine all equilibrium points, prove global stability, determine local bifurcations, and illustrate our results with numerical simulations. An unexpected outcome of the prey's fear of its specialist predator is the potential eradication of the superpredator.
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Mixed convection heat transfer in a vertical concentric annulus packed with a metallic porous media and heated at a constant heat flux is experimentally investigated with water as the working fluid. A series of experiments have been carried out with a Rayleigh number range from Ra=122418.92 to 372579.31 and Reynolds number that based on the particles diameter of Red=14.62, 19.48 and 24.36. Under steady state condition, the measured data were collected and analyzed. Results show that the wall surface temperatures are affected by the imposed heat flux variation and Reynolds number variation. The variation of the local heat transfer coefficient and the mean Nusselt number are presented and analyzed. An empirical
... Show MoreIn today’s competitive environment, organizational efficiency and sustained growth are crucial for survival. The performance of an organization is intricately connected to strategic planning, prompting firms to gather and leverage competitive information for a competitive advantage. Senior managers, recognizing this, initiate actions accordingly. This study aims to investigate the relationship between foresight, vision, strategic partnerships, motivation, system thinking, and organizational performance. Data, gathered through a self-administered questionnaire from various textile units, were analysed using structural equation modelling (SEM). The findings indicate that sub-constructs of strategic intelligence positively impact organizatio
... Show Morethin films of se:2.5% as were deposited on a glass substates by thermal coevaporation techniqi=ue under high vacuum at different thikness
The present work deals with five species of parasitic Hymenoptera belonging to Pteromalidae, Eupelmidae and Eurytornidae which have been reared from brachid beetles. A new species, Eurytoma irakensis is described and the species, Bruchocida orientalis Crawford is recorded for the first time from Iraq.
The objective of this research paper is two-fold. The first is a precise reading of the theoretical underpinnings of each of the strategic approaches: "Market approach" for (M. Porter), and the alternative resource-based approach (R B V), advocates for the idea that the two approaches are complementary. Secondly, we will discuss the possibility of combining the two competitive strategies: cost leadership and differentiation. Finally, we propose a consensual approach that we call "dual domination".
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Modeling forward kinematics with neural networks allows for efficient handling of nonlinear relationships and realistic error correction in time-critical applications by relying on accurate training data. This paper presents a Multi-Layer Feed-Forward Neural Network (MLFFNN) to solve the forward kinematics of a 3-DOF robot. The proposed MLFFNN consists of 50 hidden neurons and was trained using 628319 samples to find only the position (x, y, z) of the end-effector. Data were generated by MATLAB, assuming an incremental motion of joints. The joint variables ( , , and ) are the inputs of the NN, which outputs the positions of the end effector (x, y, z) calculated using the Denavit-Hartenberg (DH) method. The results demonstrate that t
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Background: The evaluation of the chronological age is a practical method in crime investigation field that assists in identifying individuals to treat them as underage or adult. This study aimed to assess the stages of third molars mineralization in relation to chronological age of Iraqi individuals, determine the gender differences and arches (maxillary/mandibular) differences.
Materials and Methods: A total of 300 orthopantomograms of orthodontic patients were collected according to specific criteria and evaluated visually. The developmental stages of maxillary and mandibular third molars were determined according to Demirjian method. T
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