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.
Rudimentary non-communicating functional uterine horn with unicornuate uterus, originating from anomalous embryological development of one Mullerian duct, is prone to different complications either at the gynecological or obstetrical level such as chronic pelvic pain, hematometra, subfertility and decreased quality of life. This unique case report presents a 14-year-old female with a history of severe chronic pelvic pain. She was diagnosed with Familial Mediterranean Fever (FMF) and had an appendectomy for suspected appendicitis within the symptoms’ interval. Ultrasound showed a right 5*6 cm right complex cystic mass assuming ovarian in place. She underwent a suspected endometrioma cystectomy operation and was diagnosed with left unico
... Show MoreSeeking pharmacist advice about minor ailments is a common practice among Iraqi patients because such advice is free and quick. Unfortunately, the assessment and management of minor ailments by Iraqi pharmacists were inappropriate. Therefore, this study aimed to develop a model for a mobile application that can assist community pharmacists in the diagnosis and management of minor ailments.
The scientific content of the application was based on the information in the symptoms in the pharmacy and British Nati
This paper presents a cognition path planning with control algorithm design for a nonholonomic wheeled mobile robot based on Particle Swarm Optimization (PSO) algorithm. The aim of this work is to propose the circular roadmap (CRM) method to plan and generate optimal path with free navigation as well as to propose a nonlinear MIMO-PID-MENN controller in order to track the wheeled mobile robot on the reference path. The PSO is used to find an online tune the control parameters of the proposed controller to get the best torques actions for the wheeled mobile robot. The numerical simulation results based on the Matlab package show that the proposed structure has a precise and highly accurate distance of the generated refere
... Show MoreThe aim of this study is to investigate the kinetics of copper removal from aqueous solutions using an electromembrane extraction (EME) system. To achieve this, a unique electrochemical cell design was adopted comprising two glass chambers, a supported liquid membrane (SLM), a graphite anode, and a stainless-steel cathode. The SLM consisted of a polypropylene flat membrane infused with 1-octanol as a solvent and bis(2-ethylhexyl) phosphate (DEHP) as a carrier. The impact of various factors on the kinetics constant rate was outlined, including the applied voltage, initial pH of the donor phase solution, and initial copper concentration. The results demonstrated a significant influence of the applied voltage on enhancing the rate of c
... Show More: The Aluminium (Al) material emerged as a plasmonic material in the wavelength ranges from the ultraviolet to the visible bands in different on-chip plasmonic applications. In this paper, we demonstrate the effect of using Al on the electromagnetic (EM) field distribution of a compact hybrid plasmonic waveguide (HPW) acting as a polarization rotator. We compare the performance of Al with other familiar metals that are widely used as plasmonic materials, which are Silver (Ag) and Gold (Au). Furthermore, we study the effect of reducing the geometrical dimensions of the used materials on the EM field distributions inside the HPW and, consequently, on the efficiency of the polarization rotation. We perform the study based o
... Show MoreThe purpose of this research is to find the estimator of the average proportion of defectives based on attribute samples. That have been curtailed either with rejection of a lot finding the kth defective or with acceptance on finding the kth non defective.
The MLE (Maximum likelihood estimator) is derived. And also the ASN in Single Curtailed Sampling has been derived and we obtain a simplified Formula All the Notations needed are explained.
Constructing a fine 3D geomodel for complex giant reservoir is a crucial task for hydrocarbon volume assessment and guiding for optimal development. The case under study is Mishrif reservoir of Halfaya oil field, which is an Iraqi giant carbonate reservoir. Mishrif mainly consists of limestone rocks which belong to Late Cenomanian age. The average gross thickness of formation is about 400m. In this paper, a high-resolution 3D geological model has been built using Petrel software that can be utilized as input for dynamic simulation. The model is constructed based on geological, geophysical, pertophysical and engineering data from about 60 available wells to characterize the structural, stratigraphic, and properties distri
... Show MoreBackground: Uncontrolled hyperphosphatemia is the main difficulty facing staff treating patients with end-stage renal disease on hemodialysis. Sevelamer and calcium-containing phosphate binders have been associated with cost burden and tissue calcification, respectively. Therefore, the current trial was targeted to investigate the efficacy of a new phosphate binder, ferric citrate, in a sample of Iraqi patients with end-stage renal disease on hemodialysis. Keywords: Ferric citrate, Hemodialysis Phosphate binder