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.
Polymeric hollow fiber membrane is produced by a physical process called wet or dry/wet phase inversion; a technique includes many steps and depends on different factors (starting from selecting materials, end with post-treatment of hollow fiber membrane locally manufactured). This review highlights the most significant factors that affect and control the characterization and structure of ultrafiltration hollow fiber membranes used in different applications.
Three different types of polymers (polysulfone PSF, polyethersulfone PES or polyvinyl chloride PVC) were considered to study morphology change and structure of hollow fiber membranes in this review. These hollow fiber membranes were manufactured with different pro
... Show MoreIn recent years, the field of research around the congestion problem of 4G and 5G networks has grown, especially those based on artificial intelligence (AI). Although 4G with LTE is seen as a mature technology, there is a continuous improvement in the infrastructure that led to the emergence of 5G networks. As a result of the large services provided in industries, Internet of Things (IoT) applications and smart cities, which have a large amount of exchanged data, a large number of connected devices per area, and high data rates, have brought their own problems and challenges, especially the problem of congestion. In this context, artificial intelligence (AI) models can be considered as one of the main techniques that can be used to solve ne
... Show MorePrimary hypogonadism combined with Müllerian hypoplasia and partial alopecia are common features of this syndrome, which was reported only in four earlier families from areas where consanguineous marriage is prevalent. An autosomal recessive pattern of inheritance was suggested earlier and is supported by this report.
Fibroepithelioma of Pinkus (FEP) is a slowly growing, low-grade malignant tumor with very low metastatic potential that is considered a distinct variant of basal cell carcinoma (BCC). It usually manifests as sessile or polypoidal lesions on the trunk of middle-aged patients. However, it may present in younger age groups, even in children. In this case, we present a rare case of FEP atypically presenting as a scaly plaque on the lower back for several years in an elderly female who was eventually diagnosed by excisional biopsy and histopathology.
We present a case of congenital of flexor pollicis longus agenesis without thenar hypoplasia in a 12-year-old girl with no history of trauma. Two-staged corrective surgery was planned. In the first stage, the flexor pulley was reconstructed using silicone followed by the second stage 3 months later when flexor pollicis longus reconstruction was performed using tendon transfer of the flexor digitorum superficialis. The patient completed post-operative physiotherapy and the result of the surgical treatment in both functional and cosmetic aspects was, in the authors’ opinion, excellent.
Orthodontic wires facilitate the required dental adjustments in the context of orthodontic therapy. The archwire has played a crucial role in orthodontic treatment, and the increasing emphasis on aesthetic preferences from patients, as well as the development of composite and ceramic brackets, have prompted investigations into aesthetic archwires that complement these brackets. Orthodontic wires are produced using a diverse range of materials. The utilisation of all available wire types can improve patient comfort, decrease chairside time, and shorten the overall duration of treatment. The individual clinician must possess comprehensive knowledge and comprehension of the various requirements and alternatives throughout the therapeut
... Show MoreEnhancing fatigue resistance in asphalt binders and mixtures is crucial for prolonging pavement lifespan and improving road performance. Recent advancements in nanotechnology have introduced various nanomaterials such as alumina (NA), carbon nanotubes (CNTs), and silica (NS) as potential asphalt modifiers. These materials possess unique properties that address challenges related to asphalt fatigue. However, their effectiveness depends on proper dispersion and mixing techniques. This review examines the mixing methods used for each nanomaterial to ensure uniform distribution within the asphalt matrix and maximize performance benefits. Recent research findings are synthesized to elucidate how these nanomaterials and their mixing proce
... Show MoreFace recognition and identity verification are now critical components of current security and verification technology. The main objective of this review is to identify the most important deep learning techniques that have contributed to the improvement in the accuracy and reliability of facial recognition systems, as well as highlighting existing problems and potential future research areas. An extensive literature review was conducted with the assistance of leading scientific databases such as IEEE Xplore, ScienceDirect, and SpringerLink and covered studies from the period 2015 to 2024. The studies of interest were related to the application of deep neural networks, i.e., CNN, Siamese, and Transformer-based models, in face recogni
... Show MoreRecent growth in transport and wireless communication technologies has aided the evolution of Intelligent Transportation Systems (ITS). The ITS is based on different types of transportation modes like road, rail, ocean and aviation. Vehicular ad hoc network (VANET) is a technology that considers moving vehicles as nodes in a network to create a wireless communication network. VANET has emerged as a resourceful approach to enhance the road safety. Road safety has become a critical issue in recent years. Emergency incidents such as accidents, heavy traffic and road damages are the main causes of the inefficiency of the traffic flow. These occurrences do not only create the congestion on the road but also increase the fuel consumption and p
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