Background : Xanthomatosis is a disease in which large tendon tumors can occur, especially in the Achilles tendon. This disease is a rare interesting orthopaedic condition. Case Report:A case of a twenty eight year old girl patient with giant bilateral Achilles tendon xanthomas in which both tumors were resected. There was no ulceration on the both sides. The patient was treated by total resection of the lesion and reconstruction using tendon transfer of the Peroneus brevis and Flexor hallusis longus. Postoperative treatment consisted of six weeks lower leg cast immobilization followed by partial weight bearing. After 4 months the patient was able to walk pain free without any difficulties. It has been suggested that total resection with augmentation had associated with fewer complication of recurrent as compare with a subtotal resection. 10 months after surgery our patient had no signs of recurrence of Achilles tendon swelling. Conclusion: Complete excision of the lesion is needed to reduce recurrence. Reconstruction of the defect is a challenge due to the large defect. Tendon transfer augmentation results in good functional outcome of the patient even in large defects
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The research has designed for studying the relationship between manufacturing strategy and its flexibility under the flexible manufacturing system with their reflection on the competitive environmental performance of the firm. To interpret and tackle the problem, a hypothesis has formulated stating that “ the competitive performance of a firm is interpreted by the manufacturing strategy and flexibility which are derived from the firm and its business strategies under the flexible manufacturing system”. Related literatures with their theoretical dissertations, which enhanced the thoughtful content, have analyzed. An illustrative case study on the flexible manufacturing system at Toyota Motors Corporation working at the g
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Purpose To test the effect of strategic Supremacy on strategic success A case study in Thi Qar Governorate, methodology/approach – this is a mandatory entry.
a case study was used and applied to the Department managers of Government of the province of Thi Qar, Research limitations/implications – It is clear that the strategic Supremacy variable is not being used effectively to achieve strategic success.
Practical implications – use strategic supremacy positively to Support for strategic success. implementing and monitoring ignorance of them in how to use thi
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The major climate changes that have affected the planet in addition to wave the big drought plaguing the study area, including the lack of water for imports Badra River fatigue because of the Iran constructing dams on this river and make use of the waters for the benefitof its territory. The subject of finding sources of water has become available with the possibility of exploiting them in an exemplary manner is one of the key things in order to be exploited somewhere.
The study area was chosen within the eastern border of the province of Wasit within the district of Badra border, an area of (1557.5 km2) almost "to study the characteristics of hydrological and identify possibilities for water harvesting them. In this study was conduct
Sewer system plays an essential task in urban cities by protecting public health and the environment. The operation, maintenance, and rehabilitation of this network have to be sustainable and scientifically. For this purpose, it is crucial to support operators, decision makers and municipalities with performance evaluation procedure that is based on operational factors. In this paper, serviceability and performance indicator (PI) principles are employed to propose methodology comprising two enhanced PI curves that can be used to evaluate the individual sewers depending on operational factors such as flowing velocity and wastewater level in the sewers. To test this methodology; a case study of al-Rusafa in Baghdad city is
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Sewer system plays an indispensable task in urban cities by protecting public health and the environment. The operation, maintenance, and rehabilitation of this network have to be in a sustainable and scientific manner. For this purpose, it is important to support operators, decision makers and municipalities with performance evaluation procedure that is based on operational factors. In this paper, serviceability and performance indicator (PI) principles are employed to propose methodology comprising two enhanced PI curves that can be used to evaluate the individual sewers depending on operational factors such as flowing velocity and wastewater level in the sewers. In order to test this methodology; a case study of al-Ru
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