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.
Piperine, a crystalline alkaloid compound isolated from Piper nigrum, piper longum, and other types of piper, has had many fabulous pharmacological advantages for preventing and treating some specific diseases, such as analgesic, anti-inflammatory, hepatoprotective, antimetastatic, antithyroid, immunomodulatory, antitumor, rheumatoid arthritis, osteoarthritis, Alzheimer's, and improving the bioavailability of other drugs. However, its potential for clinical use through oral usage is hindered by water solubility and poor bioavailability. The low level of oral bioavailability is caused by low solubility in water and is photosensitive, susceptible to isomerization by UV light, which causes piperine concentration to decrease. Many different
... Show MoreThere are serious environmental problems in all countries of the world, due to the waste material such as crushed clay bricks (CCB) and in huge quantities resulting from the demolition of buildings. In order to reduce the effects of this problem as well as to preserve natural resources, it is possible to work on recycling (CCB) and to use it in the manufacture of environmentally friendly loaded building units by replacing percentages in coarse aggregate by volume. It can be used as a powder and replacing of percentages in cement by weight and study the effect on the physical and mechanical properties of the concrete and the masonry unit. Evaluation of its performance through workability, dry density, compressive strength, thermal conduct
... Show MoreLarge language models (LLMs) are a rapidly evolving class of artificial intelligence with significant potential in clinical healthcare. Despite accelerating adoption, rigorous systematic evidence on clinical utility, patient safety, and implementation feasibility remains fragmented. To systematically review LLM applications across clinical domains, evaluate performance with appropriate contextual caveats, characterize implementation barriers, and identify ethical and regulatory considerations. Scientific databases were searched from January 2020 to January 2025. Studies evaluating transformer-based LLMs (≥10M parameters) in clinical settings were eligible. Data were independently double-extracted; quality was assessed using QUADAS-2, RE-A
... Show MoreIncorporating the LiDAR sensor in the most recent Apple devices represents a substantial development in 3D mapping technology. Meanwhile, Apple's Lidar is still a new sensor. Therefore, this article reviews the potential uses of the Apple Lidar sensor in various fields, including engineering and construction, focusing on indoor and outdoor as-built 3D mapping and cultural heritage conservation. The affordable cost and shorter observation times compared to traditional surveying and other remote sensing techniques make the Apple Lidar an attractive choice among scholars and professionals. This article highlights the need for continued research on the Apple LiDAR sensor technology while discussing its specifications and limitations. A
... Show MoreConventional cooling systems are major energy consumers in hot climates, directly contributing to increased carbon emissions and placing a significant strain on Iraq's national electricity grid. This study aims to explore and evaluate clean and sustainable alternatives to conventional systems. The methodology is based on a comparative analysis of various cooling technologies, including mechanical, absorption, adsorption, drying, and hybrid systems, using key performance indicators such as the coefficient of performance (COP), energy consumption, carbon emissions, and system cooling capacity. The results show that innovative solar cooling technologies offer superior operational effi
Several million tons of solid waste are produced each year as a result of construction and demolition activities around the world, and brick waste is one of the most widely wastes. Recently, there has been growing number in studies that conducted on using of recycling brick waste (RBW) to produce environmentally friendly concrete. The use of brick waste (BW) as potential partial cement or aggregate replacement materials is summarized in this review where the performance is discussed in the form of the mechanical strength and properties that related to durability of concrete. It was found that, because the pozzolanic activity of clay brick powder, it can be utilized as substitute for cement in replacement level up t
... Show MoreSeveral million tons of solid waste are produced each year as a result of construction and demolition activities around the world, and brick waste is one of the most widely wastes. Recently, there has been growing number in studies that conducted on using of recycling brick waste (RBW) to produce environmentally friendly concrete. The use of brick waste (BW) as potential partial cement or aggregate replacement materials is summarized in this review where the performance is discussed in the form of the mechanical strength and properties that related to durability of concrete. It was found that, because the pozzolanic activity of clay brick powder, it can be utilized as substitute for cement in replacement level up to 10%. Whereas,
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