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.
This research aims to invest qur›anic words referring to lie in media language. The researcher has chosen a set of qur›anic words functioning as «lie».
It is an attempt to review the media language which is used to make use of repetition of terms and templated which make it weak and ineffective language. The use of qur›anic texts and terms according to the semantic field for each topic will give this media language an opportunity for growth, development and stability.
This researcher identifies a number of words to study them in the light of their lexical meaning using the Dictionary of Language Standards by Ibn Fares as it focuses on the general meaning of the root language. He also uses the Dictionary of the Basis of Rhe
The finite element approach is used to solve a variety of difficulties, including well bore stability, fluid flow production and injection wells, mechanical issues and others. Geomechanics is a term that includes a number of important aspects in the petroleum industry, such as studying the changes that can be occur in oil reservoirs and geological structures, and providing a picture of oil well stability during drilling. The current review study concerned about the advancements in the application of the finite element method (FEM) in the geomechanical field over a course of century.
Firstly, the study presented the early advancements of this method by development the structural framework of stress, make numerical computer solution
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Contemporary life is racing against time in its temptations and variables, and it has become shaped and changed in an amazing way in its various aspects and fields. This was facilitated by intellectual and scientific communication between civilizations, and the rapid progression in successive inventions and discoveries in the fields of science and arts of knowledge. This contributed to a great economic and commercial renaissance. Then, these economic developments entered the world into a very strong competition, which forced producers to calculate all production costs, to reach the highest profits by reducing the price of the produced commodity on the one hand, and achieving quality in appearance (especially) on the other hand. Since the ma
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1 - To explain the financial impact of the activities and areas of human resources management and the adoption of the methodology for estimating costs on the basis of conduct and statement of how to assess costs and benefits of human resource activities.
2 - Measuring human capital, and its impact on the financial statements.
Design/methodology/approach:
Concentrated dimensions of the research paper's lack of financial statements prepared by the organizations for information mandated human resource its components of the three (attraction - development
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