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.
In recent years, there has been a rise in interest in the study of antibiotic occurrence in the aquatic environment due to the negative consequences of prolonged exposure and the potential for bacterial antibiotic resistance. Most antibiotic residues from treated wastewater end up in the aquatic environment as they are not eliminated in facilities that treat wastewater. Antibiotics must be identified in influent and effluent wastewater using reliable analytical techniques for several reasons. Firstly, monitoring antibiotic presence in aquatic environments. Secondly, assessing environmental risks, computing wastewater treatment plant removal efficiencies, and estimating antibiotic consumption. Therefore, this work aims to provide an overview
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In the last decades, using mineral admixture in concrete became very necessary to improve concrete properties and reduce CO2 emissions associated with the cement production process. Subsequently, more sustainable concrete can be obtained. Ternary blended cement containing two different types of mineral admixture can achieve ambitious steps in this trend. In this research, the synergic effects of mineral admixtures in ternary blended cement and its effects on concrete fresh properties, strength, durability, and efficiency factors of mineral admixture in ternary blended cement, were reviewed. The main conclusion reached after reviewing many literature pieces is that the concrete with ternary blended cement
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The past several years have seen an increase in awareness of the pervasiveness of medications as pollutants in the aquatic environment. The main reason for concern regarding the release of pharmaceuticals into the environment is the possibility that biological agents may become opposing to them. The development of precise and reliable analytical techniques for pharmaceutical determination in a range of samples is necessary for their safe use in the pharmaceutical industry and medical treatments. This review offers a summary of chromatographic techniques for identifying and quantifying the examination of pharmaceuticals in a range of environmental samples. Both the general public and the scientific community are currently very intere
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Purpose A diagnosis of tuberculosis (TB) of the head and neck has been a dilemma for clinicians, because the clinical and pathologic features tend to mimic different pathologies. Our study aimed to identify the demographic, clinical, and pathologic features of head and neck TB to help healthcare providers in the early detection of the disease. Materials and Methods We performed a retrospective analysis using the medical archives at the pathology laboratory. Twenty-one patients with a clinical and pathologic diagnosis of head and neck TB were identified from 2010 to 2019. Results The age distribution was broad, with 28.5% of the patients younger than 15 years old. Seven patients had oral TB, with the most common sites affected the labial ves
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The unpredictable and huge data generation nowadays by smart computing devices like (Sensors, Actuators, Wi-Fi routers), to handle and maintain their computational processing power in real time environment by centralized cloud platform is difficult because of its limitations, issues and challenges, to overcome these, Cisco introduced the Fog computing paradigm as an alternative for cloud-based computing. This recent IT trend is taking the computing experience to the next level. It is an extended and advantageous extension of the centralized cloud computing technology. In this article, we tried to highlight the various issues that currently cloud computing is facing. Here
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Coronavirus: (COVID-19) is a recently discovered viral disease caused by a new strain of coronavirus.
The majority of patients with corona-virus infections will have a mild-moderate respiratory disease that recovers without special care. Most often, the elderly, and others with chronic medical conditions such as asthma, coronary disease, respiratory illness, and malignancy are seriously ill.
COVID-19 is spread mostly by salivary droplets or nasal secretions when an infected person coughs or sneezes.
COVID-19 causes severe acute respiratory illness (SARS-COV-2). The first incidence was recorded in Wuhan, China, in 2019. Since then it spreads leading to a pandemic.
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A case of angiolymphoid hyperplasia with eosinophilia (ALH) is reported in a 42-year-old woman who developed multiple nodules behind the ear. Angiolymphoid hyperplasia with eosinophilia usually occurs on the head and neck of young adults and is more common in women than in men. Characteristic histologic features of ALH present in this case included proliferation of thick-walled blood vessels lined by prominent endothelial cells, infiltration of the interstitium by chronic inflammatory cells (mainly eosinophils), and presence of lymphoid follicles with germinal centers. The patient referred for surgeon for complete excision. in this context , cases previously described in the literature, and the differential diagnosis of ALH are discussed
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