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.
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Addressed the problem of the research is marked (experimentation in caves fee) concept and its role in experimentation deviate Display Num formal charges caves. The search came in four sections: general framework for research and identified the research problem and the need for him. With an indication of the importance of his presence. Then specify the search for the goals of (revealed the nature and role of experimentation in determining the nature of Manifesting fee documented on the walls of caves), followed by the establishment of the three search limits (objectivity, the temporal and spatial) were then determine the terms related to the title. Then provide the theoretical framework and indicators that resulted from academic theorizi
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Every cultural achievement is a creative text, and every text is a group of signs. The Winged Bull sculpture is a sort of text that is not confined to some signs; indeed, its cultural signs go far beyond as they are open-ended, everlasting and it lends itself to various horizons of interpretation. The recipient has to combine the signs of this sculpture, which belong to different patterns, in the pursuit for perfection so that he can decode its media message.
I have tackled this sculpture by adopting a semiotic approach. The semiotic approach is a modern critical approach which is as wide as culture and as rich as knowledge. It has been linked to modernism, which in turn has been linked to modern critical approaches, because it can
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DBN Rashid, International Journal of Innovation, Creativity and Change, 2020
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As technology advances and develops, the need for strong and simple authentication mechanisms that can help protect data intensifies. The contemporary approach to giving access control is through graphical passwords comprising images, patterns, or graphical items. The objective of this review was to determine the documented security risks that are related to the use of graphical passwords, together with the measures that have been taken to prevent them. The review was intended to present an extensive literature review of the subject matter on graphical password protection and to point toward potential future research directions. Many attacks, such as shoulder surfing attacks, SQL injection attacks, and spyware attacks, can easily ex
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Modern agriculture is challenged by soil degradation, nutrient depletion, plant diseases, and excessive dependence on chemical fertilizers and pesticides. By examining different strains of Pantoea, the study highlights their role in promoting plant growth, improving their tolerance to stress, reducing reliance on synthetic agricultural inputs, and contributing to more sustainable and environmentally friendly agricultural practices. Using a combination of practical qualitative methods and reliable quantitative data, the research gathers extensive information on how these microbes impact various crops and key soil health indicators. The improvements in plant growth statistics and nutrient levels are often quite astonishing. The result
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