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.
The present study identifies the linguistic means used to realize hyperbole in poetry as a rhetorical device that makes readers experience the beauty of poetic language. To achieve the aim of the study, a model of analysis in accordance with Spitzbardt (1963), Norrick (1982), and McCarthy & Carter (2004) is used. The analysis of data under investigation reveals that hyperbole is a crucial aid used by poets to portrait the real world as imaginative. In conclusion, poets prefer using lexico-grammatical repertoires than lexico-grammatical configurations. Keywords
Fe, Co and Sb nanopowders were fruitfully prepared by electrical wire explosion method in Double distilled and de-ionized water (DDDW) media. The formation of iron, cobalt and antimony (FeCoSb) alloy nanopowder was monitored by X-ray diffraction. The x-ray diffraction pattern indicates that there are iron, cobalt and antimony peaks. Optical properties of this alloy nanoparticles were characterized by UV-Visible absorption spectra. The absorption peak position is shifted to the lower wavelengths when the current increases. That means the mean size of the nanoparticles controlled by changing the magnitude of the current. The surface morphological analysis is carried out by employing Scanning Electron Microscope (SEM). Particles with varies
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Systole merazvensis sp. n. from Iraq, is described, figuri4 and differentiated from ,other species of the genus Systok.
Worldwide, enormous amounts of waste cause major environmental issues, including scrap tires and plastic, and large waste, a consequence of the demolition of buildings, including crushed concrete, crushed clay bricks, and crushed thermo-stone. From that point, it’s possible to consider that the recycling processes for these materials and using them in the manufacturing field will reduce the adverse effects on the environment of these wastes and the consumption of natural resources. Sustainable concrete blocks can be considered as one of the products produced by using these materials as partial volume replacement of the coarse, fine aggregate, or cement content, considering their dry density, workability, absorption, compressive st
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Worldwide, enormous amounts of waste cause major environmental issues, including scrap tires and plastic, and large waste, a consequence of the demolition of buildings, including crushed concrete, crushed clay bricks, and crushed thermo-stone. From that point, it’s possible to consider that the recycling processes for these materials and using them in the manufacturing field will reduce the adverse effects on the environment of these wastes and the consumption of natural resources. Sustainable concrete blocks can be considered as one of the products produced by using these materials as partial volume replacement of the coarse, fine aggregate, or cement content, considering their dry density, workability, absorption, co
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The loss of dental hard tissue as a result of odontoclastic activity is known as root resorption. It is unwanted and pathological in permanent teeth. Root resorption may happen within the root canal called internal root resorption or on the outer surface of the root called external root resorption. Regardless of where it occurs, root resorption is irreparable, can cause pain for the patient, necessitates treatment, and in some circumstances, resulting in the early loss of the affected tooth. It might be challenging to precisely diagnose and treat root resorption. There is limited information within literatures on root resorption therefore this review aims to understand the radiological and clinical characteristics of r
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A session is a period of time linked to a user, which is initiated when he/she arrives at a web application and it ends when his/her browser is closed or after a certain time of inactivity. Attackers can hijack a user's session by exploiting session management vulnerabilities by means of session fixation and cross-site request forgery attacks.
Very often, session IDs are not only identification tokens, but also authenticators. This means that upon login, users are authenticated based on their credentials (e.g., usernames/passwords or digital certificates) and issued session IDs that will effectively serve as temporary static passwords for accessing their sessions. This makes session IDs a very appealing target for attackers. In many c