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.
Artificial roughness on the absorber plate of a Solar Air Heater (SAH) is a popular technique for increasing its effective efficiency. The study investigated the effect of geometrical parameters of discrete multi-arc ribs (DMAR) installed below the SAH absorber plate on the effective efficiency. The effects of major roughness factors, such as number of gaps (Ng = 1-4), rib pitch (p/e = 4-16), rib height (e/D = 0.018-0.045), gab width (wg/e = 0.5-2), angle of attack ( = 30-75), and Reynolds number (Re= 2000-20000) on the performance of a SAH are studied. The performance of the SAH is evaluated using a top-down iterative technique. The results show that as Re rises, SAH-effective DMAR's efficiency first ascends to a specified value o
... Show MoreMultiple linear regressions are concerned with studying and analyzing the relationship between the dependent variable and a set of explanatory variables. From this relationship the values of variables are predicted. In this paper the multiple linear regression model and three covariates were studied in the presence of the problem of auto-correlation of errors when the random error distributed the distribution of exponential. Three methods were compared (general least squares, M robust, and Laplace robust method). We have employed the simulation studies and calculated the statistical standard mean squares error with sample sizes (15, 30, 60, 100). Further we applied the best method on the real experiment data representing the varieties of
... Show MoreModerately, advanced national election technologies have improved political systems. As electronic voting (e-voting) systems advance, security threats like impersonation, ballot tampering, and result manipulation increase. These challenges are addressed through a review covering biometric authentication, watermarking, and blockchain technologies, each of which plays a crucial role in improving the security of e-voting systems. More precisely, the biometric authentication is being examined due to its ability in identify the voters and reducing the risks of impersonation. The study also explores the blockchain technology to decentralize the elections, enhance the transparency and ensure the prevention of any unauthorized alteration or
... Show MoreSummed up the idea of this research in an attempt to find the establishment of the knowledge convergence to show the features of verbal acts that occurred a prime location in the lesson deliberative theory book unique contract ( IbnAbdRabbaAndalusian ) to prove that Arabic was the old literary studies included many of the features of this theory in both theoretical and practical
Background: Community pharmacists endure significantly elevated levels of work-related stress and depression, posing a threat to their overall well-being and possibly affecting the quality of patient care. Objectives: To explore workplace-associated stress and depression in Iraqi community pharmacists. Methods: This observational study was conducted using a cross-sectional design. Information was gathered through the utilization of an internet-based survey. The study involved a community pharmacist with a minimum of one year of experience working at community pharmacies. The survey utilized pre-validated questionnaires. The level of stress experienced was assessed using the Perceived Stress Scale (PSS)-10, while the level of depression was
... Show MoreThe Gullfaks field was discovered in 1978 in the Tampen area of the North Sea and it is one of the largest Norwegian oil fields located in Block 34/10 along the western flank of the Viking Graben in the northern North Sea. The Gullfaks field came on stream in 1986 and reached a peak of production in 2001. After some years, a decrease in production was noticed due to the decrease in pressure in the well. The goal of this paper is to improve the production of a well located in Gullfaks field by injecting CO2 through coiled tubing. The use of the CO2 injection method is due to the fact that it is a greenhouse gas, and its production in the atmosphere contributes to global warming. It is important to reduce its emission
... Show MoreWe study the physics of flow due to the interaction between a viscous dipole and boundaries that permit slip. This includes partial and free slip, and interactions near corners. The problem is investigated by using a two relaxation time lattice Boltzmann equation with moment-based boundary conditions. Navier-slip conditions, which involve gradients of the velocity, are formulated and applied locally. The implementation of free-slip conditions with the moment-based approach is discussed. Collision angles of 0°, 30°, and 45° are investigated. Stable simulations are shown for Reynolds numbers between 625 and 10 000 and various slip lengths. Vorticity generation on the wall is shown to be affected by slip length, angle of incidence,
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