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.
Wastewater recycling for non-potable uses has gained significant attention to mitigate the high pressure on freshwater resources. This requires using a sustainable technique to treat natural municipal wastewater as an alternative to conventional methods, especially in arid and semi-arid rural areas. One of the promising techniques applied to satisfy the objective of wastewater reuse is the constructed wetlands (CWs) which have been used extensively in most countries worldwide through the last decades. The present study introduces a significant review of the definition, classification, and components of CWs, identifying the mechanisms controlling the removal process within such units. Vertical, horizontal, and hybrid CWs
... Show MoreThe research aims to identify the level of awareness of student teachers in the behavioral disorders and autism specialization about the diagnosing Autism Spectrum Disorder and Social (Pragmatic) Communication Disorder according to some variables. The study was conducted on a sample of (113) student teachers. The researcher employed the awareness scale of a teacher-screening questionnaire for autism spectrum disorder and social pragmatic communication disorder. The results showed that the average of teachers in the total degree of awareness of autism spectrum disorder and social communication have recorded a moderate degree. As for the awareness of autism spectrum disorder was high. Then, the awareness of social communication disorder wa
... Show MoreIsatin is a heterocyclic molecule that belongs to one of the most important classes of organic compounds known as indolines. Isatin, isatin analogs, and their Schiff bases have recently attracted a lot of attention in medicinal chemistry. Isatin, itself, shows various biological activities such as antiviral, anticancer, antimicrobial, anti-inflammatory, analgesic, antioxidant, and anticonvulsant. Bis- Schiff bases containing isatin moiety have been known to possess a wide spectrum of pharmacological activities. This review offers up-to-date information on the most active isatin bis-Schiff bases, which would include anticancer, antimicrobial, antiviral, anticonvulsant, anti-inflammatory, and analgesic activities. These observations c
... Show MoreMobile ad hoc network security is a new area for research that it has been faced many difficulties to implement. These difficulties are due to the absence of central authentication server, the dynamically movement of the nodes (mobility), limited capacity of the wireless medium and the various types of vulnerability attacks. All these factor combine to make mobile ad hoc a great challenge to the researcher. Mobile ad hoc has been used in different applications networks range from military operations and emergency disaster relief to community networking and interaction among meeting attendees or students during a lecture. In these and other ad hoc networking applications, security in the routing protocol is necessary to protect against malic
... Show MoreDistributed Denial of Service (DDoS) attacks on Web-based services have grown in both number and sophistication with the rise of advanced wireless technology and modern computing paradigms. Detecting these attacks in the sea of communication packets is very important. There were a lot of DDoS attacks that were directed at the network and transport layers at first. During the past few years, attackers have changed their strategies to try to get into the application layer. The application layer attacks could be more harmful and stealthier because the attack traffic and the normal traffic flows cannot be told apart. Distributed attacks are hard to fight because they can affect real computing resources as well as network bandwidth. DDoS attacks
... Show MoreThe clinical response to natalizumab in patients with multiple sclerosis (MS) may be significantly influenced by genetic variation. Mutations in genes related to the drug’s mechanism of action or the pathological milieu of MS can contribute substantially to interindividual differences in treatment outcomes. This review aims to provide an overview of previous studies that have examined genetic polymorphisms associated with the clinical efficacy of natalizumab. A systematic literature search was conducted across the PubMed, Google Scholar, and ResearchGate databases using targeted keywords relevant to the subject matter. Several genetic loci were found to be linked to natalizumab responsiveness, including the integrin subunit alpha 4 (ITGA4
... Show MorePrevious studies on the synthesis and characterization of metal chelates with uracil by elemental analysis, conductivity, IR, UV-Vis, NMR spectroscopy, and thermal analysis were covered in this review article. Reviewing these studies, we found that uracil can be coordinated through the electron pair on the N1, N3, O2, or O4 atoms. If the uracil was a mono-dentate ligand, it will be coordinated by one of the following atoms: N1, N3 or O2. But if the uracil was bi-dentate ligand, it will be coordinated by atoms N1 and O2, N3 and O2 or N3 and O4. However, when uracil forms complexes in the form of polymers, coordination occurs through the following atoms: N1 and N3 or N1 and O4.
The electrical activity of the heart and the electrocardiogram (ECG) signal are fundamentally related. In the study that has been published, the ECG signal has been examined and used for a number of applications. The monitoring of heart rate and the analysis of heart rhythm patterns, the detection and diagnosis of cardiac diseases, the identification of emotional states, and the use of biometric identification methods are a few examples of applications in the field. Several various phases may be involved in the analysis of electrocardiogram (ECG) data, depending on the type of study being done. Preprocessing, feature extraction, feature selection, feature modification, and classification are frequently included in these stages. Ever
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