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.
Background: Because of wide use of Functional Endoscopic Sinus Surgery (FESS) technique in the recent years and basic role of coronal computed tomography (CT) scan in demonstrating the normal drainage route of para-nasal sinuses, identifying the major patterns of inflammatory sinonasal disease and accompanied anatomical variations is essential for appropriate preoperative surgical planning. In review of publisthed literature, there is no data on CT patterns of chronic inflammatory sinonasal disease and their accompained anatomical variations of nose and PNS in our local population.Objectives: was to determine the frequency of CT patterns and variations in patients with sinonasal symptoms.Methods: This was a cross sectional descriptive st
... Show MoreStuck pipe is a prevalent and costly issue in drilling operations, with the potential to cost the petroleum industry billions of dollars annually. To reduce the likelihood of this issue, efforts have been made to identify the causes of stuck pipes. The main mechanisms that cause stuck pipes include drill cutting of the formation, inappropriate hole-cleaning, wellbore instability, and differential sticking forces, particularly in highly deviated wellbores. The significant consequences of a stuck pipe include an increase in well costs and Non-Productive Time (NPT), and in the worst-case scenario, the loss of a wellbore section and down-hole equipment, or the need to sidetrack, plug, or abandon the well. This paper provides a comprehensive
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The increasing drinking water demand in many countries leads to an increase in the use of desalination plants, which are considered a great solution for water treatment processes. Reverse osmosis (RO) and electro-dialysis (ED) systems are the most popular membrane processes used to desalinate water at high salinity. Both systems work by separating the ionic contaminates and disposing of them as a brine solution, but ED uses electrical current as a driving force while RO uses osmotic pressure. A direct comparison of reverse osmosis and electro-dialysis systems is needed to highlight process development similarities and variances. This work aims to provide an overview of previous studies on reverse osmosis and electro-dial
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Speech enhancement aims to improve speech quality and intelligibility in noisy environments and is important in applications such as hearing aids, mobile communications and automatic speech recognition (ASR). This paper shows a structured review of speech enhancement techniques, classified depending on the channel configuration and signal processing framework. Both traditional and modern approaches are discussed, including classical signal processing methods, machine learning techniques, and recent deep learning-based models. Furthermore, common noise types, widely used speech datasets, and standard evaluation metrics for evaluating speech quality and intelligibility are reviewed. Key challenges such as non-stationary noise, data li
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Incorporating modern technology into education is becoming imperative. Numerous pharmacy institutions are incorporating virtual reality (VR) technology training into their curricula to enhance educational experience. This review examines the current state, historical evolution, and application of VR programs in pharmacy education and training. The review also provides details about the main challenges and limitations associated with the use of this technology. The VR technology, including virtual laboratories and simulations, significantly improves clinical training and educational outcomes. The utilization of VR in clinical teaching encounters numerous barriers, including ethical concerns and technological constraints, as well as other res
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The human stomach is home to the Gram-negative bacterium Helicobacter pylori, which has been connected to several gastrointestinal disorders. There may be a link between H. pylori infection and the start of autoimmune disorders, according to recent research. This review examines the intricate connections between persistent H. pylori infection, immune system dysregulation, and their possible role in initiating autoimmune disorders. The study begins with a summary of H. pylori infection and its prevalence worldwide, emphasizing the mounting data that connects this bacterium to autoimmune disorders. Then, using experimental data from animal models and epidemiological research as support, it undertakes a thorough review of autoimmune di
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The main objective of this study is to understand the work of the pile caps made of lightweight aerated foam concrete and study the many factors affecting the ability and the capacity of the shear. The study was done by analyzing previous practical and theoretical experiences on the reinforced concrete pile caps. The previous practical results indicated that all specimens failed by shear diagonal compression or tension modes except one specimen that failed flexural-shear mode. Based on test specimens' practical results and behavior, some theoretical methods for estimating the ultimate strength of reinforced concrete pile caps have been recommended, some of which evolved into the design documents available on the subject.
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Constitutional Review of 1992 and 1996 and the role of the Party of Progress and Socialism