Background: The surgical treatment of pilonidal sinus varies from wide excision and laying the wound open or excision with primary closure or excision with the use of skin graft in some special cases.
Objectives: The objectives of this study is to determine the efficacy of treating non complicated pilonidal sinus disease with minimal excision and primary closure technique, complications and recurrence rate.
Patients and methods: This is a prospective study conducted in shahid ahmed ismaiel hospital in rania – As sulaimania IRAQ during the period from December 2013 to January 2016 and was carried on one hundred (100) consecutive patients with non complicated non recurrent pilonidal sinus patients who were treated with minimal excision and primary closure technique. The data were analyzed focusing mainly on complications mainly infection, gapping, wound disruption, recurrence rate and patient’s compliance to antibiotics use and local wound care.The results obtained were compared with other similar studies.
Result: One hundred patients with non complicated pilonidal sinus were treated with minimal excision and primary closure technique.Fifteen patients developed superficial wound infection, seventeen patients developed simple superficial wound gapping .Three patients developed deep wound infection with disruption. Four patients developed recurrence and they were treated with re-excision and skin graft placement. Minimal follow up was six months, Operations were done under general or spinal anesthesia .operative time ranged between 12 to 22 minutes (mean time 17 minutes).
Conclusion: Minimal excision and primary closure technique for the treatment of pilonidal sinus disease is associated with short hospital stay, shorter off work time, less cost, low complications rate and low chance of recurrence.
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Whenever, the Internet of Things (IoT) applications and devices increased, the capability of the its access frequently stressed. That can lead a significant bottleneck problem for network performance in different layers of an end point to end point (P2P) communication route. So, an appropriate characteristic (i.e., classification) of the time changing traffic prediction has been used to solve this issue. Nevertheless, stills remain at great an open defy. Due to of the most of the presenting solutions depend on machine learning (ML) methods, that though give high calculation cost, where they are not taking into account the fine-accurately flow classification of the IoT devices is needed. Therefore, this paper presents a new model bas
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background: human epidermal growth factor receptor-2 (her2/neu) is related to growth factor receptors with alkaline kinase activity and it is regarded as important prognostic and therapeutic factor that can depended on in breast cancer therapy. HER2/neu expression by immunohistochemistry (IHC) is submitted to a great in terob server inconsistency. Subsequently additional confirmatory tests for assessment of gene alterations and amplification status are needed for patients with early or metastatic breast cancer. In situ hybridization techniques and specifically Chromogenic in situ hybridization (CISH) was arise as a practical, cost-effective, and alternative to fluorescent in situ hybridization in testing for gene alterationAims of the study
... Show MoreThe best optimum temperature for the isolate was 30○C while the pH for the maximum mineral removal was 6. The best primary mineral removal was 100mg/L, while the maximum removal for all minerals was obtained after 8 hrs, and the maximum removal efficiency was obtained after 24 hrs. The results have proved that the best aeration for maximum removal was obtained at rotation speed of 150 rpm/ minute. Inoculums of 5ml/ 100ml which contained 106 cell/ ml showed maximum removal for the isolate.
English is spoken by its native speakers in two different forms. Reduced form which marks the colloquial and rapid speech so that it is easily produced and a citation or unreduced form which is a characteristic of careful, emphasized and slow speech.
This paper investigates Iraqi EFL university students’ production of the two forms mentioned above. The sample chosen includes twenty fourth year students, of which ten are males and the other ten are females from the Department of English of the College of Languages of the University of Duhok in Kurdistan Region of Iraq in the academic year 2020-2021. The material tested is six connective words which represent the commonest ones in every-day co
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Activation of farnesoid X receptor (FXR) markedly attenuates development of atherosclerosis in animal models. However, the underlying mechanism is not well elucidated. Here, we show that the FXR agonist, obeticholic acid (OCA), increases fecal cholesterol excretion and macrophage reverse cholesterol transport (RCT) dependent on activation of hepatic FXR. OCA does not increase biliary cholesterol secretion, but inhibits intestinal cholesterol absorption. OCA markedly inhibits hepatic cholesterol 7α‐hydroxylase (
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The present study deals with the effect of self -observation on EFL University students` achievement in conversation classes. The process of self-observation helps the teacher to understand one’s own actions and the reactions in the process of teaching. The sample of this study is EFL students in the third stage at the Department of English Language, morning studies, College of Education /Ibn-Rushd .The sample of the study consists of (84) students distributed on experimental group(A) includes (42) students, and (42) students as control group(B). In order to achieve the aim of the study ,and to gain a closer idea about the impact of reflective teaching technique(self-observation) on the students achievement in conversation classes, a chec
... Show MoreThe personal drama in particular, and one of the key elements underlying the dramatic structure to convey ideas and visions presented by the author when writing the text of the dramatic fall after that on the way out the submission form that suits the proposals of the text and processors directorial would push the wheel of dramatic structure to the front. So take the maker of the artwork (writer) undertook the transfer of those events and personalities in art presumed sometimes real and sometimes, in order to enrich the art inspired by the human reality through the ages, and full of its themes and ideas that led to the development experiences of peoples experiences of living. Therefore, we find it important to research in the characters
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