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).
Effective decision-making process is the basis for successfully solving any engineering problem. Many decisions taken in the construction projects differ in their nature due to the complex nature of the construction projects. One of the most crucial decisions that might result in numerous issues over the course of a construction project is the selection of the contractor. This study aims to use the ordinal priority approach (OPA) for the contractor selection process in the construction industry. The proposed model involves two computer programs; the first of these will be used to evaluate the decision-makers/experts in the construction projects, while the second will be used to formul
Abstract:
The issues related to foreign trade is a broad field for discussions and captures the interest of economists for their contribution to the process of economic development in the economies of the countries, especially developing ones. The imports of goods and services in foreign trade constitute an important part of the local by which the economy gets goods and services that the economy cannot produce because of the incompetent base of production. Further, the demand function of imports occupied a good deal of the attention of researchers in the field of international economics for which agricultural imports constitute an important part. The reason for the interest in the subject is due to its im
... Show MoreThe bank deposits is fuel banking activity and raw material products for the commercial bank and the basis of its activity and its lifetime So the bank, which seeks to continue the successful development of the volume of cash deposits has translated the work of the bank to meet the needs of different sectors by providing the necessary funding, and from this point of view was the research problem a lack of interest departments of banking services to commercial banks as a means for the development of electronic cash deposits have, and which represents the basis for the supplier commercial bank fund.
Mammals are under threat worldwide due to deforestation, hunting, and other human activities. In Iraq, a total of 93 species of wild mammals have been recorded including species with global conservation concern. Bamo Mountain is situated within the Zagros Mountains in northern Iraq which is a suitable habitat for wild mammals. Due to scarcity of the field survey efforts and cryptic behavior, monitoring of the wild mammals fauna in Zagros Mountain seems challenging. Therefore, we used a camera trap which seems to be an ideal way to determine species diversity of wild mammals in Bamo Mountain. Moreover, interviews with local villagers were performed. The mammalian diversity of Bamo Mountain is not fully explored but seemed threatened by lo
... Show MoreThe negotiation phase is gaining great importance in investment loans due to the magnitude of the amounts awarded and the need to obtain adequate lending guarantees and the development of better conditions, and this requires that negotiating policy with fixed principles that balance between meeting the demands of customers and maintain market share and achieve profits and avoid defaults and losses the bank, and so I have touched Find the concept of investment loans and procedures for granting and the concept of the negotiation process for the granting of loans. The practical side to ensure the preparation of examination form consists of questions commensurate with the methodology developed by the researchers, were directed to the officia
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This study aims to identify the extent to which the criteria of the American Council for Teaching Foreign Languages (ACTFL) are included in the English language books for the fifth and sixth graders. To achieve the objective of the study, a content analysis card was prepared, where the classification of language proficiencies was divided into five main levels (beginner, intermediate, advanced, superior, and distinguished) of the four language skills (listening, speaking, reading, and writing), The content analysis card consisted of (89) indicators distributed at the four levels of language skills as follows: Listening (17), speaking (33), reading (15), and writing (26). The study sample consisted of Engl
... Show MoreAsthma is one of the most common chronic, non-communicable diseases affecting children worldwide. The estimated prevalence of pediatric asthma in Iraq is 15.8%. Physiologic, inflammatory and structural factors contribute to the development of asthma. Assessment and monitoring of asthma control can be done by a validated children asthma control test (CACT). Management of asthma must address three components which are an appropriate management plan, the most appropriate medication if necessary, and the use of safe and effective medication. The management plan should consider patient counseling and education about the definition of asthma, signs, and symptoms, the pathophysiology of asthma, common triggers for asthma and how can avoid them,
... Show MoreA simulation study is used to examine the robustness of some estimators on a multiple linear regression model with problems of multicollinearity and non-normal errors, the Ordinary least Squares (LS) ,Ridge Regression, Ridge Least Absolute Value (RLAV), Weighted Ridge (WRID), MM and a robust ridge regression estimator MM estimator, which denoted as RMM this is the modification of the Ridge regression by incorporating robust MM estimator . finialy, we show that RMM is the best among the other estimators