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.
Primary 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.
In 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 MoreThis systematic review aimed to investigate the relation between orthodontic treatment (OT) and the incidence of the gingival black triangle (GBT) after completing treatment with a fixed orthodontic appliance, as well as the associated risk factors and the level of alveolar bone. Electronic and hand searches were conducted in three electronic databases for relevant articles published up to March 2022. Retrieved articles went through a two-step screening procedure, and the risk of bias (RoB) was assessed by the Joanna Briggs Institute checklists. The incidence of GBT after OT was set as the primary outcome, while the secondary outcomes were the risk factors associated with GBT and alveolar bone loss following OT. Out of 421 papers, 5
... Show MoreIn the recent years the research on the activated carbon preparation from agro-waste and byproducts have been increased due to their potency for agro-waste elimination. This paper presents a literature review on the synthesis of activated carbon from agro-waste using microwave irradiation method for heating. The applicable approach is highlighted, as well as the effects of activation conditions including carbonization temperature, retention period, and impregnation ratio. The review reveals that the agricultural wastes heated using a chemical process and microwave energy can produce activated carbon with a surface area that is significantly higher than that using the conventional heating method.
The energy requirements of corn silage harvesters and the application of precision agricultural techniques are essential for efficient and productive agricultural practices. The article aims to review previous studies on the energy requirements needed for different corn silage harvesting machines, and on the other hand, to present methods for measuring corn silage productivity directly in the field and monitoring it based on microcontrollers and artificial intelligence techniques. The process of making corn silage is done by cutting green fodder plants into small pieces, so special harvesters are used for this, called corn silage harvesters. The purpose of harvesting corn silage is to efficiently collect and store as many digestible nutrien
... Show MoreWe 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.
Organizations must interact with the environment around them, so the environment must be suitable for that interaction. These companies are now trying to become Learning Organizations because it try to face that challenges may rise from its environments. The Learning Organization is a concept that is becoming an increasingly widespread philosophy in modern companies, from the largest multinationals to the smallest ventures. What is achieved by this philosophy depends considerably on one's interpretation of it and commitment to it. This study gives a definition that we felt was the true ideology behind the Learning Organization and Group Working. A Learning Organization is one in which people at all levels
... Show MorePurpose: The current research attempts to diagnosis the reflection level of Information Technology (IT) Capabilities (Architectural, infrastructure, human resources, relationships resources, and dynamic capabilities) at Baghdad soft drinks Company/Al- Zafaraniya to achieving the competitive superiority represented by indicators (Cost, quality, flexibility, delivery and innovation). Recognizing the importance of the subjects studied, and because of the importance of the expected results of the field under consideration.
Design/Methodology/Approach: The experimental method has been used, the questionnaire used to collect th
... Show MoreAmis: NAFLD is considered to be the most common cause of liver conditions worldwide. Also, it is a primary reason that leads to coronary artery diseases, limiting blood flow to the heart. Therefore, This study aimed to evaluate the serum level of Nesfatin-1 and its ability to indicate the prognosis of CAD in patients with NAFLD. Material & Methods: one-hundred eighty Individuals were enrolled in the study, including In both genders, blood was collected from each Individual and sent to the laboratory for biochemical tests. Findings: Data from the current study showed a significant increase in Nesfatin-1 in the CAD group and a significant decrease in Nesfatin-1 in the NAFLD group compared to the control group. In addition, there w
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