Background: Extracorporeal Shock wave lithotripsy (ESWL) is widely used in treating patients with ureteralstones because it is effective, safe, and noninvasive. Based on factors such as size and the location of stones,there is a significant variation in the overall stone-free rate (SFR).Aim of the study: To evaluate the effect of ureteral wall thickness (UWT), stone attenuation, the time fromfirst attack of pain till first session of ESWL and stone/ rib density on the outcome of SWL in the treatmentof upper ureteral stones (UUS).Patient and methods: A prospective study when 127 patients with radio-opaque UUS ranging from 7 to 20mm and treated by ESWL were included in this study. The effect of (stone/ 12th rib) density by KUB, ureteralwall thickness by NCCT and the time from first attack of pain till first ESWL session was studied.Results: The overall successful fragmentation was 75.5%, with the overall success rates in the low density(LD) and high density (HD) groups were 83.8% and 52.94%, respectively. The average number of SWLsessions needed in the two groups for success was 1.9 compared with 2.7 sessions (p<0.05). For stones <10 mm; those with ureteral wall thickness <3.25 mm have success rate about 90.3% VS 69.7% with uretericwall thickness > 3.25 mm which is highly significant. Early ESWL within the first 24 hours of acute attackof first pain has successful fragmentation of 85.45%. With significant effect on number of ESWL sessions.The stone free rate reaches 91.1% for stones <10 mm.Conclusions: The stone free rate is inversely affected by stone /12th rib density ; ureteral wall thickness andthe time from first attack of pain till first session of ESWL, were important predictors of successful ESWL.
Increasing interest in planning at the level of government units as a means to manage the physical and human resources, direct and invest in areas that would include an increase in the economies of the general government units that are part of the general economics of the state.The research problem lies in the introduction of the factors influencing the ongoing expenses that adversely affect the financial planning process at the level of the Ministry of Health Planning, which affects the quality of services provided to citizens, so I sought the researchers to study the reality of financial planning in some of the Ministry of Health and health departments through the analysis of current budgets and diagnose deviations in the implementatio
... Show Moreالخلاصة لقد شكل المحافظون الجدد وهم بالأساس نخبة من المثقفين ومن السياسيين الأمريكيين كتلة ضغط كبيرة التأثير على الإدارة في عهد الجمهوريين. حمل هؤلاء المحافظون مشروعاً إيديولوجياً البسوه لسلطة الجمهوريين وهو يهدف إلى جعل أمريكا سيدة العالم من دون منازع خاصة بعد انهيار الاتحاد السوفييتي ونهاية الحرب الباردة. واكب هذا الحدث التاريخي الكثير من الأفكار ومنها (نهاية التاريخ)، وصراع الحضارات، وكذ
... Show MoreVarious theories have been proposed since in last century to predict the first sighting of a new crescent moon. None of them uses the concept of machine and deep learning to process, interpret and simulate patterns hidden in databases. Many of these theories use interpolation and extrapolation techniques to identify sighting regions through such data. In this study, a pattern recognizer artificial neural network was trained to distinguish between visibility regions. Essential parameters of crescent moon sighting were collected from moon sight datasets and used to build an intelligent system of pattern recognition to predict the crescent sight conditions. The proposed ANN learned the datasets with an accuracy of more than 72% in comp
... Show MoreArtificial roughness applied to a Solar Air Heater (SAH) absorber plate is a popular technique for increasing its total thermal efficiency (ηt−th). In this paper, the influence of geometrical parameters of V-down ribs attached below the corrugated absorbing plate of a SAH on the ηt−th was examined. The impacts of key roughness parameters, including relative pitch p/e (6–12), relative height e/D (0.019–0.043), angles of attack α (30–75°), and Re (1000–20,000), were examined under real weather conditions. The SAH ηt−th roughened by V-down ribs was predicted using an in-house developed conjugate heat-transfer numerical model. The maximum SAH ηt−th was shown to be 78.8% as predicted under the steady-state condition
... Show MoreIn this paper was discussed the process of compounding two distributions using new compounding procedure which is connect a number of life time distributions ( continuous distribution ) where is the number of these distributions represent random variable distributed according to one of the discrete random distributions . Based on this procedure have been compounding zero – truncated poisson distribution with weibell distribution to produce new life time distribution having three parameter , Advantage of that failure rate function having many cases ( increasing , dicreasing , unimodal , bathtube) , and study the resulting distribution properties such as : expectation , variance , comulative function , reliability function and fa
... Show MoreThis research aims to measure the productivity of nursing services and recognize the reality of providing such services in some public hospitals in the province of Diyala, as well as identify the most important factors affecting the productivity of nursing services, and developer measure adopted by the researcher (Kien, 2012), which includes seven factors (workforce , management team, stimulation, pressure of working hours (time), material / equipment, supervision, safety), Used the experimental method in the search, one of the private scientific research curriculum depends primarily on the scientific experiment and study of the subject, or a scientific phenomenon, which provides an opportunity to learn the facts
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