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.
Circular thin walled structures have wide range of applications. This type of structure is generally exposed to different types of loads, but one of the most important types is a buckling. In this work, the phenomena of buckling was studied by using finite element analysis. The circular thin walled structure in this study is constructed from; cylindrical thin shell strengthen by longitudinal stringers, subjected to pure bending in one plane. In addition, Taguchi method was used to identify the optimum combination set of parameters for enhancement of the critical buckling load value, as well as to investigate the most effective parameter. The parameters that have been analyzed were; cylinder shell thickness, shape of stiffeners section an
... Show MoreThe Khor Mor gas-condensate processing plant in Iraq is currently facing operational challenges due to foaming issues in the sweetening tower caused by high-soluble hydrocarbon liquids entering the tower. The root cause of the problem could be liquid carry-over as the separation vessels within the plant fail to remove liquid droplets from the gas phase. This study employs Aspen HYSYS v.11 software to investigate the performance of the industrial three-phase horizontal separator, Bravo #2, located upstream of the Khor Mor sweetening tower, under both current and future operational conditions. The simulation results, regarding the size distribution of liquid droplets in the gas product and the efficiency gas/liquid separation, r
... Show MoreA problem of solid waste became in the present day common global problem among all countries, whether developing or developed countries, and can say that no country in the world today is immuning from this dilemma which must find appropriate solutions. The problem has reached a stage that can not ignore or delay, but has became a daily problem occupies the minds of ecologists, economists and politicians took occupies center front in the lists of priorities for the countries in terms of finding solutions to the rapid scientific and radical them. and that transport costs constitute an important component of total costs borne by the municipal districts in the process of disposal of solid waste, so any improvement in the
... Show MoreGA Al Omran, AA Noaimi, Z Al Madfai, H Al Hamamy, Journal of the Faculty of Medicine Baghdad, 2012
The Banking Supervision of the most important functions of the Central Bank of Iraq, which he intended to have a strong banking system and a sound and competitive, and exercised control over the banks by inspection bodies to ensure their compliance with the laws, regulations and orders and instructions and the safety of their financial positions.
The research was aimed to release the concept of banking inspection, compliance and problems and obstacles faced by the inspectors, and monitors compliance and down to make recommendations.
Has been reached on a set of theoretical and practical conclusions, including: -
1-confirmed the statistical analysis of the answers to the research sample the importance of the role o
... Show MoreThis paper concerns is the preparation and characterization of a bidentate ligand [4-(5,5- dimethyl-3-oxocyclohex-1-enylamino)-N-(5-methylisoxazol-3-yl) benzene sulfonamide]. The ligand was prepared from fusing of sulfamethoxazole and dimedone at (140) ºC for half hour. The complex was prepared by refluxing the ligand with a bivalent cobalt ion using ethanol as a solvent. The prepared ligand and complex were identified using Spectroscopic methods. The proposed tetrahedral geometry around the metal ions studied were concluded from these measurements. Both molar ratio and continuous variation method were studied to determine metal to ligand ratio (M:L). The M to L ratio was found to be (1:1). The adsorption of cobalt complex was carried out
... Show MoreGas-lift technique plays an important role in sustaining oil production, especially from a mature field when the reservoirs’ natural energy becomes insufficient. However, optimally allocation of the gas injection rate in a large field through its gas-lift network system towards maximization of oil production rate is a challenging task. The conventional gas-lift optimization problems may become inefficient and incapable of modelling the gas-lift optimization in a large network system with problems associated with multi-objective, multi-constrained, and limited gas injection rate. The key objective of this study is to assess the feasibility of utilizing the Genetic Algorithm (GA) technique to optimize t
Surface water samples from different locations within Tigris River's boundaries in Baghdad city have been analyzed for drinking purposes. Correlation coefficients among different parameters were determined. An attempt has been made to develop linear regression equations to predict the concentration of water quality constituents having significant correlation coefficients with electrical conductivity (EC). This study aims to find five regression models produced and validated using electrical conductivity as a predictor to predict total hardness (TH), calcium (Ca), chloride (Cl), sulfate (SO4), and total dissolved solids (TDS). The five models showed good/excellent prediction ability of the parameters mentioned above, which is a very
... Show MoreBackground : Shoulder pain is a common problem that can pose difficult diagnostic and therapeutic challenges for the family physician It is the third most common musculoskeletal complaint in the general population, and account for 5% of all general practitioners musculoskeletal consults Objective: To determine the diagnostic performance of ultrasonography compared with the physical examination for detection of rotator cuff tears in painful shoulder syndrome. Method: Prospective study was done on seventy patients (48 male, 22 female), age ranged between 30-70 years (mean age 50 years), From February 2007 to July 2011, were subjected to comparative study in Al-Kindy teaching hospital with rotator cuff tears, including physical and ultrasonogr
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