AIM: To analyse our experiences in the management of traumatic retroperitoneal hematoma (RPH), highlighting the various challenges faced and to report on the outcome of these patients. METHODS: From May 2014 to May 2017, all patients with traumatic RPH who underwent surgical treatment were retrospectively analysed. The kind of injury, intraoperative findings, sites of hematoma, postoperative morbidity and the overall outcomes were recorded. RESULTS: Ninety-six patients; 53 with blunt trauma and 43 with penetrating injury, were included in this study. The centre-medial hematoma was observed in 24 (25%) patients, lateral hematoma in 46 (47.9%) patients, pelvic hematoma in 19 (19.8%) patients, and multiple zone hematomas in 7 (7.3%) patients. All cases were managed surgically. Exploration of the retroperitoneal space was done in 72 cases. Thirty-three patients died, and the overall death rate was 34.4%. CONCLUSION: Surgical exploration should be done in RPH caused by penetrating injury, but the need for urgent exploration in blunt injury is not so high, and it depends on the anatomical site of hematoma, concomitant organ injury and the hemodynamic status of patients.
The systems of governance in Europe are characterized by ancient democratic systems that have developed and developed through a long history of political conflicts that have emerged from a social reality that feeds them and receives the resulting effects. This is an achievement that has been achieved after the sacrifices and great efforts in formulating models of good governance through which to realize the aspirations of their peoples. . The democratic system operates within a balanced mechanism of two competing parties to manage and direct the work of the government and the parliament. The parties that achieve the majority in the elections carry out the functions of the government supported by their parliamentary base belonging to one
... Show MoreBackground: Transradial compared to classic transfemoral coronary intervention has been shown to have similar efficacy rates, while being more cost-effective and most importantly safer due to fewer access site complications. Furthermore, patient comfort is increased and outpatient treatment may be feasible..Objectives: To start trans-radial intervention program and the initial learning curve for fellows and the catheterization –laboratory nursing staff. To test how could it be applicable and comfortable for our patientsMethods: This prospective study was performed in Ibn-Albitar hospital for cardiac surgery over a period of 6 months from the 1st of August 2012 till the 1st of February 2013. Every patient referred for percutenuos corona
... Show MoreObjective: The aim of the study to evaluate the nursing care management for diabetes mellitus patient
with total hip replacement after fractured hip.
Methodology: A field study carried out on patients with diabetes mellitus and have total hip
replacement after fractured hip in orthopedic ward at the hospital of surgical specialization (malefemale)during
January 2002 to January 2003.Physical and psychological nursing
assessment
immediately after the surgery was done for the both subjects (control and experimental) and then a
scientific management with daily nursing care were provided to the experimental subject with daily
nursing care to the patient condition by using a scientific and practical methods and leave th
The construction industry in Iraq suffers from many problems, perhaps the most important of which is the delay in time and the increase in costs. Therefore, it was necessary to try to adopt a new methodology that would help in overcoming these problems. It was suggested to combine building information modeling with the agile management approach because this technique and methodology is modern and helps in reducing time and cost and improving quality. This paper aims to know the status of using Building Information Modeling (BIM) and Agile Project management (APM) in Iraq and to shed light on the merging of this integration, explaining the benefits, difficulties, and workflow practices, finding the most influencing factors on the tim
... Show MoreAbstract
The mine object for this research is determine the nature of the relation and effect between Human resources management strategic to less the work stress , Human resources management strategic represent a set of procedures and practices to manage the human resources at the organization. the stress of work effect on the performance of the human resources , al rasheed bank select to applied the qustioneer on the 32 person the work on the sebaa branch , using the qustioneer as a tool to collect data that is design according some of the standards and make the validity and stability. to analyses this data by using spss for computation " percentage , mean , standard , deriation
... Show MoreTrajectory tracking and vibration suppression are essential objectives in a flexible joint manipulator control. The flexible joint manipulator is an under-actuated system, in which the number of control actions is less than the degree of freedom to be controlled. It is very challenging to control the underactuated nonlinear system with two degree of freedom. This paper presents a hierarchical sliding mode control (HSMC) for a rotary flexible joint manipulator (RFJM). Firstly, the rotary flexible joint manipulator is modeled by two subsystems. Secondly, the sliding surfaces for both subsystems are constructed. Finally, the control action is designed based on the Lyapunov function. Computer simulation results demonstrate the effectiveness of
... Show MoreThe mixed-spin ferrimagnetic Ising system consists of two-dimensional sublattices A and B with spin values and respectively .By used the mean-field approximation MFA of Ising model to find magnetism( ).In order to determined the best stabile magnetism , Gibbs free energy employ a variational method based on the Bogoliubov inequality .The ground-state (Phase diagram) structure of our system can easily be determined at , we find six phases with different spins values depend on the effect of a single-ion anisotropies .these lead to determined the second , first orders transition ,and the tricritical points as well as the compensation phenomenon .
Based on Lyapunov exponent criterion, the aircraft lateral-directional stability during critical flight cases is presented. A periodic motion or limit cycle oscillation isdisplayed. A candidate mechanism for the wing rock limit cycle is the inertia coupling between an unstable lateral-directional (Dutch roll) mode with stable longitudinal (short period) mode. The coupling mechanism is provided by the nonlinear interaction of motion related terms in the complete set equations of motion. To analyze the state variables of the system, the complete set of nonlinear equations of motion at different high angles of attack are solved. A novel analysis including the variation of roll angle as a function of angle of attack is proposed. Furthermore
... Show More