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 surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
The paper is highlighting the athletics and heroic sports which encouraged and played at Greek and Islamic period. The paper is identifying the Islamic athletics and heroic sport and compare them with Greek sports, as it is the model of sports while the sport during the Islamic period was not undertaken by scientific researches or articles even in Wikipedia. Although, this period was encouraged and practice many sports such as archery, sword grappling and wrestling, equestrianism, jogging and running whereas there are many Arabic references revealed during the Islamic 610 A.D. while the Greek and Olympic was known at 732 A.D. The paper is followed the literature review and historical to shied a light scientifically about traditional sports
... Show MoreCurrently, there is an intensive development of bipedal walking robots. The most known solutions are based on the use of the principles of human gait created in nature during evolution. Modernbipedal robots are also based on the locomotion manners of birds. This review presents the current state of the art of bipedal walking robots based on natural bipedal movements (human and bird) as well as on innovative synthetic solutions. Firstly, an overview of the scientific analysis of human gait is provided as a basis for the design of bipedal robots. The full human gait cycle that consists of two main phases is analysed and the attention is paid to the problem of balance and stability, especially in the single support phase when the biped
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Citric acid is an essential ingredient for the manufacture of (12) key industrial chemicals. Citric acid use is increasing steadily with a high annual growth rate as a result of the development of ever more sophisticated applications. Citric acid is widely utilized in the food and pharmaceutical industries due to its low toxicity when compared to other acidulous. Other uses for citric acid can be found in cleaning supplies and detergents. Based on information from a review of the literature, Citric acid production substrates and methods for surface fermentation, submerged fermentation, solid-state fermentation, and international market expansion are all covered in the current review study. Finally, there is still much to learn about the
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The paper is highlighting the athletics and heroic sports which encouraged and played at Greek and Islamic period. The paper is identifying the Islamic athletics and heroic sport and compare them with Greek sports, as it is the model of sports while the sport during the Islamic period was not undertaken by scientific researches or articles even in Wikipedia. Although, this period was encouraged and practice many sports such as archery, sword grappling and wrestling, equestrianism, jogging and running whereas there are many Arabic references revealed during the Islamic 610 A.D. while the Greek and Olympic was known at 732 A.D. The paper is followed the literature review and historical to shied a light scientifically about tradition
... Show MoreSecondary trigeminal neuralgia (STN) results from an identifiable underlying pathology, including tumor compression, multiple sclerosis, arteriovenous malformations, hypertension, structural lesions, inflammation, trauma, or familial genetic conditions. This study, through a comprehensive review of the literature in PubMed, Google Scholar, Web of Science, and the Cochrane Library, explores the multifaceted aspects of STN. This study delves into the diverse etiological factors, focusing on the pathophysiological mechanisms that lead to trigeminal nerve dysfunction. The clinical manifestations of STN often overlap with those of primary trigeminal neuralgia, creating diagnostic challenges and necessitating a thorough evaluation that in
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Over the years, the issue of inclusion of students with special educational needs (SEN) in mainstream schools is controversial worldwide. Evidence from research argues that without a positive teachers’ attitude towards the inclusion of students with SEN in mainstream schools, the successful implementation of inclusion is most likely doubtable. The aim of this paper is to understand teachers’ attitudes towards the inclusion of students with SEN in mainstream schools from different perspectives and from different contexts. The conclusion drawn in this review can be that teachers’ attitude is the most important key towards the appropriate inclusion implementation in mainstream schools. The disparity of teachers’ attitudes towards th
... Show MoreRepresent choices Behaviorism available to the Managerial leaders one of the prerequisites to run any beginnings of a psychological or dilemmas Managerial barriers to working in the field of work has been varied these options until it had taken several kinds of which contributed to the left different impacts on the alleviation of these problems, which prompted the researcher to raising the problem of study within the framework of questionable content how to contribute to that shown by Choices Behaviorism accredited to the Managerial leaders in the management of frustration
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Background: Because of wide use of Functional Endoscopic Sinus Surgery (FESS) technique in the recent years and basic role of coronal computed tomography (CT) scan in demonstrating the normal drainage route of para-nasal sinuses, identifying the major patterns of inflammatory sinonasal disease and accompanied anatomical variations is essential for appropriate preoperative surgical planning. In review of publisthed literature, there is no data on CT patterns of chronic inflammatory sinonasal disease and their accompained anatomical variations of nose and PNS in our local population.Objectives: was to determine the frequency of CT patterns and variations in patients with sinonasal symptoms.Methods: This was a cross sectional descriptive st
... Show MoreThe water supply network inside the building is of high importance due to direct contact with the user that must be optimally designed to meet the water needs of users. This work aims to review previous research and scientific theories that deal with the design of water networks inside buildings, from calculating the amount of consumption and the optimal distribution of the network, as well as ways to rationalize the use of water by the consumer. The process of pumping domestic water starts from water treatment plants to be fed to the public distribution networks, then reaching a distribution network inside the building till it is provided to the user. The design of the water supply network inside the building is
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