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.
Harriet Jacobs was a writer and a reformer. As a female writer in the nineteenth century, Jacobs wrote her narrative as a means of resisting the system of slavery. She wrote her book Incidents in the Life of a Slave Girl: Written by Herself, (1842) to reflect upon the exploitation of the black people and the need to change the hierarchal attitude that governs white/black relations. She was engaged in many abolitionist events and her anti-slavery approach appeared clearly in her writings. She shares Du Bios ideas about freedom and emancipation and the need for a political and cultural change. Thus, Du Bois’s theory provides a framework for her autobiographical novel where she portrays Linda Brent, the main character, a strong w
... Show MoreThe behavior and shear strength of full-scale (T-section) reinforced concrete deep beams, designed according to the strut-and-tie approach of ACI Code-19 specifications, with various large web openings were investigated in this paper. A total of 7 deep beam specimens with identical shear span-to-depth ratios have been tested under mid-span concentrated load applied monotonically until beam failure. The main variables studied were the effects of width and depth of the web openings on deep beam performance. Experimental data results were calibrated with the strut-and-tie approach, adopted by ACI 318-19 code for the design of deep beams. The provided strut-and-tie design model in ACI 318-19 code provision was assessed and found to be u
... Show MoreIntroduction and Aim: Diabetes mellitus patients almost always struggle with a metabolic condition known as chronic hyperglycemia. According to the World Health Organization, osteoporosis is a progressive systemic skeletal disorder that is characterized by decreasing bone mass and microstructural breakdown of bone tissue that increases susceptibility to fracture and increased risk of breaking a bone. Here, we aimed to compare the levels of CatK and total oxidative state in patients with diabetes and osteoporosis among the female Iraqi population and study the possible relationship between them. Materials and Methods: This study included 40 females with diabetes (Group G1), 40 with diabetes and osteoporosis (Group G2) and 40 normal healthy f
... Show MoreBackground: Nasal obstruction is common in otorhinolaryngology outpatient visitors. The diagnosis of such compliant is by history, clinical examination and diagnostic procedures. Nasal endoscopy and computerized tomography scan are common diagnostic investigations. Nasal obstruction is either anterior or posterior (nasal septal deviations, hypertrophied turbinate pathological cyst, polyps, mass etc), or postnasal obstruction (hypertrophied turbinate, adenoid hypertrophy, nasopharyngeal cyst or nasopharyngeal tumors).
Aim of study: Prospective study to compare endoscopic finding and computerized tomography of nose, paranasal sinuses and postnasal space as diagnostic methods for nasal obstruction and other nose, p
... Show MoreDeposits with the Industrial Bank, together with loans received from others, are non-financial financial resources, which are sources of supply to the Industrial Bank of funds that allow the Bank to expand the granting of loans. The increases in this resource indicates that the bank is practicing comprehensive banking, which is consistent with the nature of the transformation of the banking system towards multiple businesses. Therefore, the research comes to highlight the causality of the trend between total deposits and total loans. And if the causality is found, is it one-way or two-way? How long is the impact?
Countries are developing the spatial development of their societies through the projects that they undertake in various ways, and this development may be cause great impact on the environment, which also depend on the type of development, whether industrial, agricultural, or service and after the problems that occurred as a result of development on the environment, most of the countries currently did to legislating laws Environmental and some other procedures before granting environmental approvals for the purpose of establishing spatial development projects. One of the most important of these laws and regulations is Environmental impact assessment (EIA). The environmental impact asse
Data generated from modern applications and the internet in healthcare is extensive and rapidly expanding. Therefore, one of the significant success factors for any application is understanding and extracting meaningful information using digital analytics tools. These tools will positively impact the application's performance and handle the challenges that can be faced to create highly consistent, logical, and information-rich summaries. This paper contains three main objectives: First, it provides several analytics methodologies that help to analyze datasets and extract useful information from them as preprocessing steps in any classification model to determine the dataset characteristics. Also, this paper provides a comparative st
... Show MoreThis research aims to identify and measure the role of TQM in the process of developing the financial performance of Diyala State Company and show the reality and obstacles, after applying the company's management to the requirements of ISO 9001: 2008 and compare it with its performance before applying this standard, The researcher measured the financial performance by conducting financial analysis of the financial statements and conducting a number of interviews at the company's headquarters, Diyala State Company (one of the Iraqi Ministry of Industry and Minerals formations) was sele
... Show MoreThe research aims to review the concepts of banking efficiency and its relationship to performance, productivity and efficiency, as well as analyze the efficiency of the banking in micro-economic view.
In order to achieve the objectives of the research We have been employed graphic, Econometrics and Mathematical methods to derive the different concepts of banking efficiency.
We showed that there are two main methods used to measure the bank efficiency, the first called Stochastic Frontier Analysis , this technique depends on the parametric methods, The other method is called Data Envelopment Analysis is based on mathematical programming methods
This research Find semantic relations between the Holy Quran and readings anomalous in particular, does not mention the readings anomalies are all but signed the examples of them where he found a marked contrast between them and what is known in the Holy Quran, and the intervention of research in the words of the commentators and between their views and stated what is unacceptable and what before, nor Luck meaning significantly different in some readings, leading to different Islamic ruling as well, also found that of the readings made clear what is meant by the blessed verse in the Holy Quran and signed to be even if it was abnormal.