Objective: To evaluate the functional outcomes after extended curettage and reconstruction using a combination of bone graft and bone cement (sandwich). Methodology: In this prospective case series 16 skeletally mature patients with primary giant cell tumor around the knee were included. Patients with previous surgically treated, malignant transformation, degenerative knee changes and those presenting with pathological fracture were excluded. The tumor was excised with bone graft filling space beneath the articular cartilage and a block of gel foam was placed over the cortical surface of picked bone graft. Remaining cavity was filled with polymethylmethacrylate cement (sandwich) with or without internal fixation. The func tional evaluation was done us ing Musculoskeletal Tumor Society (MSTS) Score six months postoperatively and after one year. Schatzker and Lambert Score was used in the last visit to assess the functional outcome Results: The mean MSTS Score was 27.13±3.030 (range, 20-30) and the mean functional arc of motion around the knee was 123.13±12.230 degrees (range, 90–135). According to Schatzker and Lambert Score 75% had excellent results, 12.5% had good results and 12.5% had fair results. Two patients (12.5%) had a recurrence of the tumor, and one (6.25%) developed postoperative fracture in the distal femur. Conclusion: Sandwich reconstruction for giant cell tumor is a good option for definite management and there is improvement in the quality of the patient's life. (Rawal Med J 202;45:637-640).
An integrated seismic sequence stratigraphy and facies analysis has been carried out with a view to understanding the depositional environment and stratal stacking pattern of Nandy Field of Niger Delta. Well logs and biostratigraphic information were used to identify the lithologies, stratal stacking patterns, stratigraphic surfaces, system tracts and reservoir potentials of the field. Seismic sequence stratigraphy and seismic reflection patterns were used to identify the seismic facies. Facies-related attributes were employed to identify the continuity and amplitude of seismic events. Three seismic facies packages and three reservoir sands were identified. The environments of deposition of the area consist of marginal marine to continen
... Show MoreWorld War II has brought suffering for all people; it has led people to have a nostalgic feeling. The war has many faces all of them are ugly, like death, separation, loneliness, violence, crime, betrayal, and disconnection and many other meanings. Michael Ondaatje in his novel The English Patient (1992) portrays a picture of the effect of World War II on four different characters; Hana a Canadian nurse, The English patient who is Hungarian, Caravaggio a Canadian-Italitan thief, and Kip an Indian sapper. They live together in one house, share their secrets and memories about World War II. Ondaatje brings them together to reveal their secrets and to heal their wounds of the war experience.
World War II has brought suffering for all people; it has led people to have a nostalgic feeling. The war has many faces all of them are ugly, like death, separation, loneliness, violence, crime, betrayal, and disconnection and many other meanings. Michael Ondaatje in his novel The English Patient (1992) portrays a picture of the effect of World War II on four different characters; Hana a Canadian nurse, The English patient who is Hungarian, Caravaggio a Canadian-Italitan thief, and Kip an Indian sapper. They live together in one house, share their secrets and memories about World War II. Ondaatje brings them together to reveal their secrets and to heal their wounds of the war experience.
Communication and media technologies have seen several changes in the last two decades. These changes put the basis for the emergence of communicative and media practices on several levels including political, economic, technological and artistic. And these, in turn, led to the emergence of new media trends and phenomena in various areas of media worthily to be studied and researched for example online advertisings. Online advert
... Show MoreBackground: Pain is one of the most postoperative complications of surgical wound especially within first 24 hrs. leading to delay hospital discharge, stress gastritis and increasing blood pressure. As wound infiltration with long acting local anesthetic (bupivacaine) has been proved to be effective after orthopedic surgeries especially total hip and knee replacements.Objective: our study was designed to determine theeffectiveness of local infiltration of 0.5% of bupivacainebefore closure of surgical wounds in controllingpostoperative pain and improve patient’s outcome after totalhip and knee replacement surgeries in first 24hrspostoperative period.Methods: Twenty patients from class I (healthy patients) and class II (patients mild sys
... Show MoreThe research aims to assess the local accounting procedures related in one of developments that have taken place, and largely on the structure of the Iraqi economic activity. But a partnership between the (public and private sector), or one of the types of joint arrangements, and through the use of the analytical method and extrapolate the reality of the accounting treatments in Company research sample. Research found to a number of conclusions that the unified accounting system applied in the economic units that deal with contracting joint arrangements formula suffers from obvious shortcomings, and reflected the common arrangements suffer from obvious shortcomings. and reflected on the quality of financial reporting, and the urgent need
... Show MoreThe research included the introduction to the research and its importance as knee joint is an important joint in the human body that is prone to injury. One such injury is knee roughness injury that occurs as a result of the stress of the knee joint and age. The importance of examining the need for the use of rehabilitation exercises, especially in the watercourse system, is highlighted by the fact that the aquatic environment is one of the most important factors helping to alleviate pain and rehabilitate the knee joint and thereby improve the mobility of those with knee roughness. The problem of research is that rehabilitation exercises have been developed in the watercourse system on the basis of scientific bases with a repetitive and sys
... Show MoreConstructing a fine 3D geomodel for complex giant reservoir is a crucial task for hydrocarbon volume assessment and guiding for optimal development. The case under study is Mishrif reservoir of Halfaya oil field, which is an Iraqi giant carbonate reservoir. Mishrif mainly consists of limestone rocks which belong to Late Cenomanian age. The average gross thickness of formation is about 400m. In this paper, a high-resolution 3D geological model has been built using Petrel software that can be utilized as input for dynamic simulation. The model is constructed based on geological, geophysical, pertophysical and engineering data from about 60 available wells to characterize the structural, stratigraphic, and properties distribution along
... Show MoreAneurysms of the cortical branches of the middle cerebral artery (MCA) are rare. They usually are secondary to traumatic or infectious etiologies and are rarely idiopathic. The specific characteristics of idiopathic aneurysms in such location are not well defined in the literature. The authors report a rare case of a ruptured giant idiopathic cortical MCA aneurysm with review of the available literature on this clinical entity.
A 24-year-old female presented with headache, disturbed level of consciousness, and right-sided weakness. Imaging studies showed a left frontoparietal intracer