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.
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Subcutaneous vascularization has become a new solution for identification management over the past few years. Systems based on dorsal hand veins are particularly promising for high-security settings. The dorsal hand vein recognition system comprises the following steps: acquiring images from the database and preprocessing them, locating the region of interest, and extracting and recognizing information from the dorsal hand vein pattern. This paper reviewed several techniques for obtaining the dorsal hand vein area and identifying a person. Therefore, this study just provides a comprehensive review of existing previous theories. This model aims to offer the improvement in the accuracy rate of the system that was shown in previous studies and
... Show MoreThe current study aimed to review previous scholarly efforts to understand the concept of sustainable development, its practices, and its significance for public institutions. The study focuses on the dimensions of sustainable development—environmental, social, and economic—within public institutions. Sustainable development allows these institutions to balance environmental protection, economic growth, and social justice, ensuring the prosperity of both current and future generations. Furthermore, sustainable development is crucial for maintaining organizational performance. The review bridges knowledge gaps related to sustainable development and utilizes an analytical approach, surveying previous studies on the topic. The sele
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Одной из активно развивающихся отраслей лексикологии является неология, объект её изучения - новое слово или неологизм. В задачу неологии входит выявление новых слов и новых значений у уже существующих в языке слов, анализ причин и способов их появления, описание факторов, влияющих на появление нового в лексической системе языка, разработка языковой политики в отношении новых номинаций. Лексикограф
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The traditional centralized network management approach presents severe efficiency and scalability limitations in large scale networks. The process of data collection and analysis typically involves huge transfers of management data to the manager which cause considerable network throughput and bottlenecks at the manager side. All these problems processed using the Agent technology as a solution to distribute the management functionality over the network elements. The proposed system consists of the server agent that is working together with clients agents to monitor the logging (off, on) of the clients computers and which user is working on it. file system watcher mechanism is used to indicate any change in files. The results were presente
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It is axiomatic that languages mirror the world view of their users. Manipulating honorific forms among people inevitably reflects this truth . Honorifics are conventionalized forms or expressions manifested in all the world's languages and are used to express the social status of the participants in the verbal interaction and to convey indications like politeness and respect . English is no exception. However the question is what exactly creates these forms and their meanings. Although honorifics have been extensively researched from a grammatical and semantic angle , yet they haven’t received that significant attention i
... Show MoreFor the graph , the behavior associated with to the majority of the graphical properties of this graph is covered in this article. The reflection of the capabilities of on the Ly constructions is one of the key ideas addressed throughout this paper. For instance, by this technique we can comprehend the mechanism via which groups of relatively tiny structure are exist within Ly.
