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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
In the field of implantology, peri-implantitis is still a common complication of implant failure. Similar to periodontal disease, this kind of pathological condition is characterized by inflammation of the tissues surrounding dental implants or fillings. The sources of infection have been shown to be chronic periodontitis and poor maintenance of the communion. A thorough examination of the intricate components of peri-implantitis was sought in this review in order to identify common characteristics of the disease with regard to bacteria, biofilm formation, host immunological responses, diagnostic tools, and therapeutic treatments. The aim of this study was to provide a detailed overview of the different bacterial species associated
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Numeral recognition is considered an essential preliminary step for optical character recognition, document understanding, and others. Although several handwritten numeral recognition algorithms have been proposed so far, achieving adequate recognition accuracy and execution time remain challenging to date. In particular, recognition accuracy depends on the features extraction mechanism. As such, a fast and robust numeral recognition method is essential, which meets the desired accuracy by extracting the features efficiently while maintaining fast implementation time. Furthermore, to date most of the existing studies are focused on evaluating their methods based on clean environments, thus limiting understanding of their potential a
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This work proposes a new video buffer framework (VBF) to acquire a favorable quality of experience (QoE) for video streaming in cellular networks. The proposed framework consists of three main parts: client selection algorithm, categorization method, and distribution mechanism. The client selection algorithm was named independent client selection algorithm (ICSA), which is proposed to select the best clients who have less interfering effects on video quality and recognize the clients’ urgency based on buffer occupancy level. In the categorization method, each frame in the video buffer is given a specific number for better estimation of the playout outage probability, so it can efficiently handle so many frames from different video
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