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.
Given the importance of ecology and its entry into various fields in general and the urban environment particularly; ecological cities take wide ranges of application at multiple regional and global levels. However, it repeatedly noted that there was a state of cognitive confusion and overlapping in the term ecology comes from the diversity of implementation within several disciplines. Architects, designers, and planners have instilled biological development directly into the formal principles as well as the social structures of the ecological cities. Therefore, the research presents a rapid review of the most relevant areas that dealt with the ecological cities by research and analysis at various levels, from the concept and definition of
... Show MoreLanguage mirrors understanding of the same or other culture. Meaning is hardly encoded in the world community. Some linguists cannot solve language problems because of its abstractedness. Language communicators learn the second or foreign language at schools for three reasons. First, English is not their first language. Second, they have little or no educational background in experiencing what they know in another language. Third, they have not improved their communication skills in English. Analyzing the language as a mean of communication would not be learned enough without its practice. This paper gives an exclusive preview of applied linguistics. It defines the conversion of different areas of the study of language with second o
... Show MoreThis paper aims to give an overview of acculturation in the literature by means of its explicit definitions, main characteristics, and categorical process. It also foreshadows the significance of acquiring novice culture with particular connection to second language acquisition. Schumann and John Berry underscored acculturation each with its own model of acculturation. In the case of this review, you will realize that Schumann's two main aspects are firmly rooted in berry's model of acculturation as an exclusive description in relation to second language acquisition. Steven Krashen outlined acquiring language from the intellectual and linguistic view of learning, whereas Micheal Long demanded for communication in social perspective. It has
... Show MorePreserving and saving energy have never been more important, thus the requirement for more effective and efficient heat exchangers has never been more important. However, in order to pave the way for the proposal of a truly efficient technique, there is a need to understand the shortcomings and strengths of various aspects of heat transfer techniques. This review aims to systematically identify these characteristics two of the most popular passive heat transfer techniques: nanofluids and helically coiled tubes. The review indicated that nanoparticles improve thermal conductivity of base fluid and that the nanoparticle size, as well as the concentrations of the nanoparticles plays a major role in the effectiveness of the nanofluids.
... Show MoreGiven the importance of ecology and its entry into various fields in general and the urban environment particularly; ecological cities take wide ranges of application at multiple regional and global levels. However, it repeatedly noted that there was a state of cognitive confusion and overlapping in the term ecology comes from the diversity of implementation within several disciplines. Architects, designers, and planners have instilled biological development directly into the formal principles as well as the social structures of the ecological cities. Therefore, the research presents a rapid review of the most relevant areas that dealt with the ecological cities by research and analys
الخلاصة
تتناول هذه الورقة مخططات وسياسات الاستيطان في الضفة الغربية والقدس الشرقية منذ العام 1967، عبر سياسات قادها حزب العمل وأكملها حزب الليكود وكاديما وبقية الأحزاب الإسرائيلية، تلك السياسات التي استهدفت فرض السيطرة السياسية الكاملة على الأرض، وما نتج عن ذلك من سيطرة حصرية على الأرضوتقييد استخداماتها، ومحاصرة الوجود الفلسطيني والتضييق عليه، وتحويل مراكز ال
... Show MoreThe article describes the basic principles of modeling a dictionary article in the “Dictionary of the Language of Russian Folklore Lexicon epics” (M. A. Bobunova, A. T. Khrolenko). Among such principles are the principle of linguocentrism (representation of universal cognitions in strict observance of the traditions of lexicographic science), the principle of anthropocentrism (language learning as a means of human consciousness / subconsciousness), the principle of expansionism (attracting material from various knowledge bases), the principle of explanatory ("explanatory moment"), and fractal principle (synergistic potential of the presented material: nonlinearity and self-similarity; hierarchical organizati
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