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).
The importance of this research is to clarify the nature and the relationship between the indicators of financial policy and banking stability in Iraq, as well as to find a composite index reflects the state of banking stability in Iraq in order to provide an appropriate means to help policymakers in making appropriate decisions before the occurrence of financial crises.
Hence, the problem of research is that the fiscal policy has implications for the macro economy and does not rule out its impact on banking stability. Moreover, the central bank does not possess a single indicator that reflects the stability of the banking system, rather than the scattered indicators that depend o
... Show MoreIn this research, our aim is to study the optimal control problem (OCP) for triple nonlinear elliptic boundary value problem (TNLEBVP). The Mint-Browder theorem is used to prove the existence and uniqueness theorem of the solution of the state vector for fixed control vector. The existence theorem for the triple continuous classical optimal control vector (TCCOCV) related to the TNLEBVP is also proved. After studying the existence of a unique solution for the triple adjoint equations (TAEqs) related to the triple of the state equations, we derive The Fréchet derivative (FD) of the cost function using Hamiltonian function. Then the theorems of necessity conditions and the sufficient condition for optimality of
... Show MorePing message focused on highlighting the fact commodity trading in Iraq, and increased exposure to world merchandise trade imbalance, which dominate Iraq's foreign trade major commodity is oil, and therefore the inability of Iraq to control financial revenue as a result of the fluctuations in the international market, the shortage of commodity products will lead inevitably to the weakness in the ability of the local market to meet the internal demand and due to the lack of flexible production machine For agricultural, industrial and economic sectors are responding to changes in the domestic or external demand which will open the door to merchandise imports to invade these markets, since the adoption of the Iraq oil exports,
... Show MoreHygienic engineering has dedicated a lot of time and energy to studying water filtration because of how important it is to human health. Thorough familiarity with the filtration process is essential for the design engineer to keep up with and profit from advances in filtering technology and equipment as the properties of raw water continue to change. Because it removes sediment, chemicals, odors, and microbes, filtration is an integral part of the water purification process. The most popular technique for treating surface water for municipal water supply is considered fast sand filtration, which can be achieved using either gravity or pressure sand filters. Predicting the performance of units in water treatment plants is
... Show MoreIntegrated project delivery is collaboratively applying the skills and knowledge of all participants to optimize the project's results, increase owner value, decrease waste, and maximize efficiency during the design, fabrication, and construction processes. This study aims to determine IPD criteria positively impacting value engineering. To do this, the study has considered 9 main criteria according to PMP classification that already covers all project phases and 183 sub-criteria obtained from theoretical study and expert interviews (fieldwork). In this study, the SPSS (V26) program was used to analyze the main criteria and sub-criteria priorities from top to bottom according to their values of the Relative Importance In
... Show MoreThe Child is the first sedum for the human society performing, and we deal in our
research to explain the nature of the mutual relations in between the form and the medicine
social caring foundation. So the motherhood and the childhood nowadays become the most
dedicated in the researchers works, whom interesting in the social affairs, and that whom
work in the medicine field as scientists.
So the child is the future man and must be in wright body construction that need to great
care and interest to make him wright mind through capability of performing anything support
to him.
In our research we deal with the main factors in which lead to infect the child by the
creative malfunction, like the environmental and m