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.
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The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a pandemic of coronavirus disease 2019 (COVID-19) which represents a global public health crisis. Based on recent published studies, this review discusses current evidence related to the transmission, clinical characteristics, diagnosis, management and prevention of COVID-19. It is hoped that this review article will provide a benefit for the public to well understand and deal with this new virus, and give a reference for future researches.
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Rationale, aims and objectives: A review of studies published over the last six years gives update about this hot topic. In the middle of COVID-19 pandemic, this study findings can help understand how population may perceive vaccinations. The objectives of this study were to review the literature covering the perceptions about influenza vaccines and to determine factors influencing the acceptance of vaccination using Health Belief Model (HBM). Methods: A comprehensive literature search was performed utilizing PubMed and Google Scholar databases. Three keywords were used: Influenza vaccine, perceptions, and Middle East. Empirical studies that dealt with people/ HCW perceptions of influenza vaccine in the Middle East and writt
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The purpose of this study is to investigate the research on artificial intelligence algorithms in football, specifically in relation to player performance prediction and injury prevention. To accomplish this goal, scholarly resources including Google Scholar, ResearchGate, Springer, and Scopus were used to provide a systematic examination of research done during the last ten years (2015–2025). Through a systematic procedure that included data collection, study selection based on predetermined criteria, categorisation based on AI applications in football, and assessment of major research problems, trends, and prospects, almost fifty papers were found and analysed. Summarising AI applications in football for performance and injury p
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The integration of nanomaterials in asphalt modification has emerged as a promising approach to enhance the performance of asphalt pavements, particularly under high-temperature conditions. Nanomaterials, due to their unique properties such as high surface area, exceptional mechanical strength, and thermal stability, offer significant improvements in the rheological properties, durability, and resistance to deformation of asphalt binders. This research reviewed the application of various nanomaterials, including nano silica, nano alumina, nano titanium, nano zinc, and carbon nanotubes in asphalt modification. The incorporation of these nanomaterials into asphalt mixtures has shown potential to increase the stiffness and high-tempera
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Background: Although there is evidence of peer support in high-income countries, the use of peer support as an intervention for cardiometabolic disease management, including type 2 diabetes (T2DM), in low- and middle-income countries (LMICs), is unclear. Methods: A scoping review methodology was used to search the databases MEDLINE, Embase, Emcare, PsycINFO, LILACS, CDSR, and CENTRAL. Results: Twenty-eight studies were included in this scoping review. Of these, 67% were developed in Asia, 22% in Africa, and 11% in the Americas. The definition of peer support varied; however, peer support offered a social and emotional dimension to help individuals cope with negative emotions and barriers while promoting disease management. Conclusio
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A fixed firefighting system is a key component of fire safeguarding and reducing fire danger. It is installed as a permanent component in a structure to protect the entire or a portion of the building and its contents. The study aims to review the previous studies that deal with the evaluation of fire safety measures and their use in resolving problems associated with fire threats in buildings. For this reason, a number of previous studies in this field were reviewed compared with the NFPA code. The findings revealed that regulatory developments over the last several decades had created an atmosphere conducive to innovation. This has resulted in a growth in the number of fixed firefighting system types now obtainable. Th
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