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.
The role of teacher of kindergarten plays an important role in the educational institution for kindergarten role in the educational institution for kindergarten and the failure of its role in the development of the mental processes of children kindergarten means failing in this institution .and hence the importance and effectiveness of the role of the student applied section kindergarten application period it is there fore necessary to be aware of the importance of learning. in preschool and good professional setting and enjoy a significant level of psychological and social systems and mental qualities and study is the urgent need to find generations hare systematic thinker's mind so stay away from memorization and trad
... Show MoreThe meniscus has a crucial function in human anatomy, and Magnetic Resonance Imaging (M.R.I.) plays an essential role in meniscus assessment. It is difficult to identify cartilage lesions using typical image processing approaches because the M.R.I. data is so diverse. An M.R.I. data sequence comprises numerous images, and the attributes area we are searching for may differ from each image in the series. Therefore, feature extraction gets more complicated, hence specifically, traditional image processing becomes very complex. In traditional image processing, a human tells a computer what should be there, but a deep learning (D.L.) algorithm extracts the features of what is already there automatically. The surface changes become valuable when
... Show MoreMaterials recycling has a significant economic and environmental impact; as a result, steel, aluminium, plastic, and other recyclable materials have been pushed for use in construction materials. One of these recyclable materials is the crumb rubber, has been considered as a pavement component. The general behaviour of the composite rubber-hot mix asphalt system would be varied from that of the conventional rubber free mix. In this review, desirable characteristics of hot mix asphalt are highlighted first. Also, effect of gradation and the main types of rubber are specified. Afterward, many studies that considered the crumb rubber as a waste product and its associated mixture and modifiers are reviewed. The factors affect the crumb
... Show MoreIonic liquids (ILs) have been recognized for their potential as environmentally friendly solvents when compared to traditional organic solvents. Additionally, their function goes beyond that of solvents, and cocatalysts, as they frequently act as stabilizing agents and ligands for the metal-active species and intermediates in catalytic systems. This comprehensive review primarily focuses on the application of Pd-incorporated ILs in catalyzing cross-coupling Suzuki reactions. The responses play a vital role in creating a wide range of structurally diverse and highly functionalized organic compounds, focusing specifically on nucleopalladation Suzuki coupling reactions. The review provides a detailed summary of the reaction conditions, stereos
... Show MoreNowadays, cloud computing has attracted the attention of large companies due to its high potential, flexibility, and profitability in providing multi-sources of hardware and software to serve the connected users. Given the scale of modern data centers and the dynamic nature of their resource provisioning, we need effective scheduling techniques to manage these resources while satisfying both the cloud providers and cloud users goals. Task scheduling in cloud computing is considered as NP-hard problem which cannot be easily solved by classical optimization methods. Thus, both heuristic and meta-heuristic techniques have been utilized to provide optimal or near-optimal solutions within an acceptable time frame for such problems. In th
... Show More"1998 onwards, a span reporting 1000s of studies depicts the ever-increasing Schiff bases and their complexes applicability; this study genetically tests the research of the last 20 years. The variety of these molecules structural has made them obtainable for a so broad ambit for implementations of biological. They are eminent and because of this unique feature they find their position in the quantitative and qualitative calculation of metals in the aqueous medium. It demonstrated to be prominent catalysts and showed an enjoyable effect of fluorescence. Definitively, Schiff base fissures gotten situation of a unique during bio-experiments and in vitro to develop drugs with a large number of biological structures containing parasites
... Show MoreAI in teaching English is reshaping language learning. While interest in AI-supported education is growing worldwide, research in this area is still emerging in Iraq. This review synthesizes empirical AI-based intervention studies to enhance English language learning in Iraqi higher education, and the perceptions of stakeholders regarding AI tools in language instruction. The reviewed intervention studies, comprising studies employed different AI platforms to support grammar instruction, speaking fluency, writing feedback, and pragmatic competence. These interventions yielded improvements in learners’ performance, motivation, and communicative confidence. In parallel, perception-focused studies revealed positive attitudes toward A
... Show MorePortland cement concrete is the most commonly used construction material in the world for decades. However, the searches in concrete technology are remaining growing to meet particular properties related to its strength, durability, and sustainability issue. Thus, several types of concrete have been developed to enhance concrete performance. Most of the modern concrete types have to contain supplementary cementitious materials (SCMs) as a partial replacement of cement. These materials are either by-products of waste such as fly ash, slag, rice husk ash, and silica fume or from a geological resource like natural pozzolans and metakaolin (MK). Ideally, the utilization of SCMs will enhance the concrete performance, minimize
... Show MoreTranslating news between Arabic and English is more complex than it may initially appear. The process is far more than the process of finding the same words, as it usually touches upon the structural differences, cultural allusions, and in most situations, the ideological pressure. This critical literature review is based on a narrative synthesis of 18 peer-reviewed studies published from 2023 to 2026 and explores the interaction of these factors in real journalistic practice. An even closer examination of the literature indicates that there are three common points of challenge. Firstly, structural and lexical differences between Arabic and English can be observed that have to be constantly adjusted to. Second, cultural and religious allusi
... Show MoreA cumulative review with a systematic approach aimed to provide a comparison of studies’ investigating the possible impact of the active form of vitamin D3, calcitriol (CTL), on the tooth movement caused by orthodontic forces (OTM) by evaluating the quality of evidence, based on collating current data from animal model studies, in vivo cell culture studies, and human clinical trials. Methods: A strict systematic review protocol was applied following the application of the International Prospective Register of Systematic Reviews (PROSPERO). A structured search strategy, including main keywords, was defined during detailed search with the application of electronic database systems: Medline/Pubmed, EMBASE, Scopus, Web of Science, and
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