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 Coronavirus Disease 2019 (COVID-19) pandemic has caused an unprecedented disruption in medical education and healthcare systems worldwide. The disease can cause life-threatening conditions and it presents challenges for medical education, as instructors must deliver lectures safely, while ensuring the integrity and continuity of the medical education process. It is therefore important to assess the usability of online learning methods, and to determine their feasibility and adequacy for medical students. We aimed to provide an overview of the situation experienced by medical students during the COVID-19 pandemic, and to determine the knowledge, attitudes, and practices of medical students regarding electronic medical education.
... Show MoreAfter completion of the artistic production, the artist plays the echo of this production upon the recipient. Whether this recipient is from the public, art connoisseurs, or private artists, critics and academics. In the past, the boundaries of Time and place had a great effect in limiting this echo or its quality, as the views of the recipients were largely influenced by the prevailing thought or the artistic trends that dominate the artistic scene in the surrounding environment in which the artist created. In order for the artist to show works for the widest segment of the recipient, he bears the burden of the costs of transporting the work, a keeper of damage on the move, and the material amounts that may hinder the publication of the
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Idiomatic expressions in Russian journalism make one important borrowed means for making a dialogue with the receiver's intellect in so far as it has the distinct feature of having clarity and exactness of meaning. The meaning is seen as a shortcut for covering a series of concepts and details so as to arrive at the intended meaning. This is done by stimulating the reader by the use of certain clear idioms. The use of such idioms in a journalistic text is not for a linguistic purpose only, but it is a cultural and social phenomenon reflecting the type of current changes in the society and it aims at discoursing with the reader's mind. This paper is a practi
... Show MorePraise be to Allah, Lord of the Worlds, teach the pen, taught the human what he didn't know, Ihmad - Almighty - and thank him, and repent to him and ask forgiveness, which is the most forgiving, and bear witness that there is no god but Allah alone has no partner, gives and prevents, And I bear witness that Muhammad is a slave to Allah and his Messenger, who called for guidance and good speech and spoke, peace be upon him and his family and companions, and those who followed them until the Day of Judgment.
This study is marked by: The ignorant poem and body language
Its main objective is to reveal the manifestations of this language in the text mentioned, and accordingly, the sieve poem has been read semantic (semantic) and hermeneutic, revealing the poet's ability to employ symbols and signals (body language) in the poem chosen for this purpose; The existence of such language in pre-Islamic poetry. After a long reflection and reading, the signs and symbols of the physical movement of the body, and its feminine and aesthetic manifestations were identified, and this was achieved through the use of modern critical methodologies that directly affect this language. The study consisted of an introduction and three topics, followed by t
Thin films of In2O3-CdO at various CdO contents (0.01, 0.02, 0.03, 0.04 and 0.05) were deposited on transparent substrate which is glass using chemical spray pyrolysis deposition method at substrate temperature 150oC. The structural properties was studied to characterize the prepared materials by XRD analysis. Surface morphology has been illustrated using scanning electron microscopy which proved the nanosize of prepared materials. This materials have been used as gas sensor for toxic gas which is hydrogen sulfide H2S. The sensitivity and response speed have been investigated with addition of CdO nanoparticles. © 2021, S.C. Virtual Company of Phisics S.R.L. All rights reserved.
The roots of international relations: peace or war: A critical review A great debate has taken place about international relations between scholars concerning peace and War .The concept of root is matched with that of exception. And the importance of the research lies in the ensuing results in the report about the legitimacy of war and the space it holds, so if the origin of international relation is war .the obstacles against it are going to decrease .and if the origin lies in peace then the dimension of its legitimacy will narrow. key words: international relation –peace-war. Résumé : L’Origine des relations internationales : guerre ou paix : révisions critiques L’origine des relations internationales entre guerre et paix, a s
... Show MoreThe main challenge is to protect the environment from future deterioration due to pollution and the lack of natural resources. Therefore, one of the most important things to pay attention to and get rid of its negative impact is solid waste. Solid waste is a double-edged sword according to the way it is dealt with, as neglecting it causes a serious environmental risk from water, air and soil pollution, while dealing with it in the right way makes it an important resource in preserving the environment. Accordingly, the proper management of solid waste and its reuse or recycling is the most important factor. Therefore, attention has been drawn to the use of solid waste in different ways, and the most common way is to use it as an alternative
... Show MoreThe recent advancements in security approaches have significantly increased the ability to identify and mitigate any type of threat or attack in any network infrastructure, such as a software-defined network (SDN), and protect the internet security architecture against a variety of threats or attacks. Machine learning (ML) and deep learning (DL) are among the most popular techniques for preventing distributed denial-of-service (DDoS) attacks on any kind of network. The objective of this systematic review is to identify, evaluate, and discuss new efforts on ML/DL-based DDoS attack detection strategies in SDN networks. To reach our objective, we conducted a systematic review in which we looked for publications that used ML/DL approach
... Show MoreThis article comprehensively examines the history, diagnosis, genetics, diversity, and treatment of SARS-CoV-2. It details the emergence of coronaviruses over the past 50 years, including the coronavirus from 2019 and its subsequent mutations, along with updated information about this virus. This review explains the development and nomenclature of coronaviruses, their cellular invasion through glycoprotein spikes binding to ACE-2 receptors, and the mechanism of cell entry via endocytosis. Diagnosis methods for COVID-19, including nucleic acid amplification, serology, and imaging techniques like chest X-ray and CT scan tests, are discussed. Treatment approaches for COVID-19 are outlined, emphasizing healthcare, antiviral medications like Rem
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