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.
We used to think of grammar as the bones of the language and vocabulary as the flesh to be added given that language consisted largely of life generated chunks of lexis. This “skeleton image” has been proverbially used to refer to that central feature of lexis named collocation- an idea that for the first 15 years of language study and analysis gave a moment‟s thought to English classroom material and methodology.
The work of John Sinclair, Dave Willis, Ron Carter, Michael McCarthy, Michael Lewis, and many others have all contributed to the way teachers today approach the area of lexis and what it means in the teaching/learning process of the language. This also seems to have incorporated lexical ideas into the teaching mechanis
. In recent years, Bitcoin has become the most widely used blockchain platform in business and finance. The goal of this work is to find a viable prediction model that incorporates and perhaps improves on a combination of available models. Among the techniques utilized in this paper are exponential smoothing, ARIMA, artificial neural networks (ANNs) models, and prediction combination models. The study's most obvious discovery is that artificial intelligence models improve the results of compound prediction models. The second key discovery was that a strong combination forecasting model that responds to the multiple fluctuations that occur in the bitcoin time series and Error improvement should be used. Based on the results, the prediction a
... Show More
(10)
The No Mobile Phone Phobia or Nomophobia notion is referred to the psychological condition once humans have a fear of being disconnected from mobile phone connectivity. Hence, it is considered as a recent age phobia that emerged nowadays as a consequence of high engagement between people, mobile data, and communication inventions, especially the smart phones. This review is based on earlier observations and current debate such as commonly used techniques that modeling and analyzing this phenomenon like statistical studies. All that in order to possess preferable comprehension concerning human reactions to the speedy technological ubiquitous. Accordingly, humans ought to restrict their utilization of mobile phones instead of prohibit
... Show More
(13)
(15)
(1)
Testing is a vital phase in software development, and having the right amount of test data is an important aspect in speeding up the process. As a result of the integrationist optimization challenge, extensive testing may not always be practicable. There is also a shortage of resources, expenses, and schedules that impede the testing process. One way to explain combinational testing (CT) is as a basic strategy for creating new test cases. CT has been discussed by several scholars while establishing alternative tactics depending on the interactions between parameters. Thus, an investigation into current CT methods was started in order to better understand their capabilities and limitations. In this study, 97 publications were evalua
... Show More
With the high usage of computers and networks in the current time, the amount of security threats is increased. The study of intrusion detection systems (IDS) has received much attention throughout the computer science field. The main objective of this study is to examine the existing literature on various approaches for Intrusion Detection. This paper presents an overview of different intrusion detection systems and a detailed analysis of multiple techniques for these systems, including their advantages and disadvantages. These techniques include artificial neural networks, bio-inspired computing, evolutionary techniques, machine learning, and pattern recognition.
(4)
(3)
A 20 year-old male was admitted with a history of recurrent palpitations from 5 years. Baseline ECG revealed premature ventricular contractions (PVCs) with delta waves. Stress ECG showed short non-sustained Ventricular tachycardia (VT). Echocardiography showed moderate dilation of the left ventricle with mild reduced systolic function and Ejection fraction was estimated to be 42%. Right ventricle was mildly dilated and hypokinetic. Both atria were mildly dilated. The patient referred to CVC for EP study with possible ablation. The ablation of the focus led to complete suppression of the ectopy. Post-procedure ECG and echocardiography showed normalized rhythm and systolic function.