Background: Thyroid surgery has undergone many changes during the past 2 decades, including the introduction of new surgical techniques such as endoscopic or video-assisted approaches, anesthesia care, intraoperative nerve monitoring and new hemostatic tools
Objectives: to assess the efficacy and safety of Harmonic Focus shears in total thyroidectomy compared with conventional surgical technique.
Patients and methods: prospective study conducted from October 2011 till January 2016, two handers and nine patients with benign and malignant thyroid diseases, scheduled for total thyroidectomy in a governor and private hospitals were enrolled randomly into 2 groups, group A consists of 105 patient who undergone a total thyroidectomy using a harmonic FOCUSTM , and group B consists of 104 patients who underwent total thyroidectomy with conventional surgical technique.
Results: Eleven patients had papillary thyroid carcinoma: 6 (5.7%) of them in group A and 5(4.8%) in group B. Eighty seven (82.9%) patients in group A had non toxic MNG, and 12(11.4%) patients had toxic MNG, 90 (86.5%) patients in group B had non toxic MNG while the other 9 (8.7%) had toxic MNG. Mean operative time was significantly lower in group A compared to Group B (100+/- 34 vs. 119+/- 30mins, respectively). In group A mean calcium level at first post-operative day was 8.36 +/- 0.54 mg/dl. In group B mean value was 8.12+/- 0.56 mg/dl. This difference was not statistically significant. There were no significant difference between the two groups concerning transient hypocalcemia requiring calcium and Vitamin D therapy: 11(10.5%) patients in group A versus 12(11.5%) in group B. No permanent hypocalcemia was found in both groups. Two patients had transient vocal cord palsy in group A(1.9%) versus 3 patients in group B (2.8%)
Conclusions: The HF is a reliable, comfortable and safe instrument alternative to knot tying technique, very suitable hand-piece for total thyroidectomy. It creates a clean, bloodless surgical field, and there is an advantage for the surgeon to use a single tool for both dissection and hemostasis. Moreover, the HF is a time-saving option, allowing for a significant reduction of operative time, without affecting parathyroid function, need for medical therapy, and hemostasis in the early post-operative period.
Background: Laparoscopic sleeve gastrectomy (LSG)is derived from the biliopancreatic diversion with duodenal switch operation(BPD-DS). Specific and potentially severe complications of LSG are bleeding from the staple line and staple line leakage (SLL). A staple line leak may result in severe morbidity with potential sepsis and multi- organ failure.
Objectives: To review our experience with the definitive surgical management of staple line leak Post sleeve gastrectomy and its outcomes.
Patients and methods: retrospective review of patients who underwent definitive surgical treatment of staple line leak post sleeve gastrectomy from May 2014 till June 2016 at Saint Raphael center of morbid obesity, Primary surgery was laparoscopic sle
Enrollment in kindergarten child accomplishes many positive aspects, that’s what Im sure a lot of modern educational trends in child education preschool in the importance of exposing children to a variety of sensory stimuli that contribute to impart a range of sound concepts.
Current research aims to know:
1.the level of sensory perception in the first primary grade students a sample search.
2.differences in perception of elementary first-graders with variable gender male, female)) 3.differences in perception of the first primary grade students attending and not attending kindergarten in accordance with variable attendance (attending, not attending).
school students (first grade) from attendi
... Show MoreYou Mohammed, you're prophet of God and I'm Gabriel)). With this heavenly call which Mohammed, the messenger of God (may God's mercies be on him), got and when he left Hiraa cave and after getting the aye ((read with your God's name)), a new period of mankind's history started. From that time, the greatest state was established. There was no public treasury and no public financial resources at that time. Abu Baker (God bless him) spent a lot of money to support the costs of the new mission. After Al-Hijra, the bases of establishing the Islamic state were available but it lacked administrative and financial organizing. Therefore the prophet was very keen to find Islamic system which ensures justice and availability of
... Show MoreExperimental investigations had been done in this study to demonstrate the effect of natural particles used as a reinforcement material to unsaturated polyester resin. The tensile test and water absorption were investigated according to (ASTM D638) and (ASTM D570), respectively. The influence of sunflower husk and pomegranate husk particles, used as a reinforcement material, on the tensile strength, Young's modulus and water absorption with different weight fraction (3%, 7% and 10%) and particle grain size (50µm, 100 µm and 150 µm), has been investigated. The water absorption of polymer composites was studied by measuring the specimen weight before and after immersion in water for one hundred days. In the experiments of tensile test,
... Show MoreA comprehensive practical study of typical mechanical properties of welded Aluminum alloy AA7020-T6 (Al-Mg-Zn), adopting friction stir welding (FSW) technique and conventional metal inert gas (MIG) technique, is well achieved in this work for real comparison purposes. The essences of present output findings were concentrated upon the FSW samples in respect to that MIG ones which can be summarized in the increase of the ultimate tensile strength for FSW was 340 MPa while it was 232 MPa for MIG welding, where it was for base metal 400 MPa. The minimum microhardness value for FSW was recorded at HAZ and it was 133 HV0.05 while it was 70 HV0.05 for MIG weld at the welding metal. The FSW produce 2470 N higher than MIG welding in the bending t
... Show MoreBackground: Alveolar ridge expansion is proposed when the alveolar crest thickness is ≤5 mm. The screw expansion technique has been utilized for many years to expand narrow alveolar ridges. Recently, the osseodensification technique has been suggested as a reliable technique to expand narrow alveolar ridges with effective width gain and as little surgical operating time as possible. The current study aimed to compare osseodensification and screw expansion in terms of clinical width gain and operating time. Materials and methods: Forty implant osteotomies were performed in deficient horizontal alveolar ridges (3–5 mm). A total of 19 patients aged 21–59 years were randomized into two groups: the screw expansion group, which invo
... Show MoreSarcasm is conceders one patterns of undesirable communication, which causes social problems in humans relationships because of the contradictory verbal and nonverbal expressions is known sarcasm may defined , statements with intent to belittle others in different situations, dealing with the individual deliberately, to diminish the will or overwhelmed by the recipe stupid, which generate a reaction when a person listener, raising the intentions of ridicule and undermine it, and this may happen is different from the irony interest increased in sarcasm since the development of scientists "Watzlawick '" and Bevin "Jackson's" in 1967 theory interactive and considered the sarcasm one interaction patterns in the social relationship, which use
... Show MoreThis research discussed, the process of comparison between the regression model of partial least squares and tree regression, where these models included two types of statistical methods represented by the first type "parameter statistics" of the partial least squares, which is adopted when the number of variables is greater than the number of observations and also when the number of observations larger than the number of variables, the second type is the "nonparametric statistic" represented by tree regression, which is the division of data in a hierarchical way. The regression models for the two models were estimated, and then the comparison between them, where the comparison between these methods was according to a Mean Square
... Show MoreBones were recorded in the skeleton of some species of Iraqi turtle Mauremys rivulata; the objectives of this study came in light of current conditions, environmental developments, talents and techniques of biological studies taking place in the country, need for an anatomy guide in river turtles of Iraqi species, to identify all kinds of similarities and differences with their preaching, this work or study has become written in response to those modern needs. It is designed to be one of the resources for those interested in biological studies, beginners or professionals, and veterinarians, distinguishing them from marine and global species. Turtles were dissected in the laboratories of the Research Center and Museum of Natural Hist
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