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.
Background: It is important to achieve good glycemic control to avoid long-term diabetic complications. It has been largely debated about the role of correct way of insulin administration to get the desired glycemic control.
Objective: To evaluate the effect of teaching diabetic patients who are on insulin therapy the correct way of injecting insulin and its effect on glycemic control.
Methods: A non randomized clinical trial with 820 diabetic patients on insulin therapy on whom A1 c estimation was performed before and after three months of teaching them the right injection technique.
Results : Sixty seven patients (8.17%) had A1 c 6.5% before they were enrolled in the study while the majority (753 patents, 91.82%) had A1 c 6.5%
The study area comprises Injana Formation (Late Miocene), exposed on the hills nearby of Tharthar Lake and about 120 km north of Baghdad city. This study depends on sedimentologic and facies analysis to recognize paleoenvironment and recognize the kinds of vertebrate bone fossils during Late Miocene. Sedimentologic and facies analysis showed many sedimentary facies: facies (Se) of scoured erosional surface, facies of (Sp) cross- bedded sandstones, facies (Fs) of fine sandstone facies, facies of (Fc) claystone, and facies of (C) calcareous clay. Facies analysis referred to the sub environments which are: point bar, over bank and floodplain in addition to fining upward cycles of deposition, which refers to meandering flu
... Show MoreThe researcher tackles the most outstanding conditions of experimentation, the importance of the study lies in being helpful to the workers in the field of theatre in general and directors in particular which the conditions of experimentation that should be taken.The study aims at knowing the experimental basis which the director (Sami Abdulhamid) followed in the realization of this.The researcher tackles in the First inquiry the concept of experimentation and the second tackles the conditions of experimentation.In the methodology of study the researcher analyzed the show of the "Othello in the Kitchen" and comes up to the following: 1. the dhows has cone with the nature of the previous shows experienced the methods that were not familia
... Show MoreThe Reasons behind the decadence of the studies concerning the evening school in Salah al Deen A field study
Objective: To compare distal tibia nonunion plating and grafting with and without platelet-rich plasma (PRP) regarding union rate, union time and complications Conclusion: Combining PRP with autologous bone graft results in a higher union rate, less healing duration, less post-operative pain, and more callus formation. (Rawal Med J 202;45:629- 632). Methodology: In this prospective comparative study, 32 patients with nonunion tibia from July 2017 January 2019 were divided into two groups: group A (16 cases) were treated by plating and grafting with PRP and group B (16 cases) were treated by plating and grafting only. Keywords: Tibial nonunion, bone graft, plateletrich plasma. Results: There was higher union rate in group A related to group
... Show MoreBipedal robotic mechanisms are unstable due to the unilateral contact passive joint between the sole and the ground. Hierarchical control layers are crucial for creating walking patterns, stabilizing locomotion, and ensuring correct angular trajectories for bipedal joints due to the system’s various degrees of freedom. This work provides a hierarchical control scheme for a bipedal robot that focuses on balance (stabilization) and low-level tracking control while considering flexible joints. The stabilization control method uses the Newton–Euler formulation to establish a mathematical relationship between the zero-moment point (ZMP) and the center of mass (COM), resulting in highly nonlinear and coupled dynamic equations. Adaptiv
... Show MoreBackground: The primary stability of the dental implant is a crucial factor determining the ability to initiate temporary implant-supported prosthesis and for subsequent successful osseointegration, especially in the maxillary non-molar sites. This study assessed the reliability of the insertion torque of dental implants by relating it to the implant stability quotient values measured by the Osstell device. Material and methods: This study included healthy, non-smoker patients with no history of diabetes or other metabolic, or debilitating diseases that may affect bone healing, having non-restorable fractured teeth and retained roots in the maxillary non-molar sites. Primary dental implant stability was evaluated using a torque ratc
... Show MoreTo create a highly efficient photovoltaic-thermal (PV-T) system and maximise the energy and exergy efficiency, this study aims to propose an innovative configuration of a PV-T system comprising wavy tubes with twisted-tape inserts. Following the validation of a numerical model, a parametric study has been conducted to assess the geometrical effects of twisted tape and wavy tubes, as well as the coolant fluid type and velocity, on the overall performance of a PV-T system, located in Shiraz, Iran. It is found that employing twisted tape improves the energy and exergy efficiency by approx. 6.3%. The best configuration yields 12.4% and 16.8% increase in energy and exergy efficiency compared to conventional PV systems. This is achieved at 15% vo
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