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 cholecystectomy is the standard treatment for symptomatic gallbladder disease. Preoperative prediction of a difficult laparoscopic cholecystectomy can help the surgeon to prepare better for intraoperative risk and the risk of conversion to open cholecystectomy.
Objectives: Evaluation of the influence of gallbladder wall thickness, assessed by sonography preoperatively, on the outcome of laparoscopic cholecystectomy and to evaluate any intra- or postoperative complications in relation to them.
Patients and Methods: This prospective clinical trial conducted in Department of Surgery, Al-yarmouk Teaching Hospital, between October 2010 and October 2012.Abdominal sonography performed in 122 consecutive patients b
The contractual imbalance is perceived today by the majority of the doctrine as being one of the pitfalls to the execution of the contracts. As a result, most legislations grant judges the power to intervene to restore it. Granting the judge the power to complete the contract raises the question of the extent to which the judge can obtain such power. Is it an absolute authority that is not limited? If so, is it a broad discretion in which the judge operates in his conscience, or is it a power of limited scope by specific legal texts and conventions? This is what we will try to answer in this research.
Electoral campaigns are one of the stages of the electoral process, and it means the sum of the activities and activities carried out by the candidate or the political party within a period of time, usually one day or more before the polling date, according to the legislation. To vote for this candidate or party, and this process affects the results of the elections, whether parliamentary or presidential, because it targets the votes that lead the candidate or political party to a boost to the presidency of the state or the legislative authority, so that this right is not abused in promoting political ideas and visions, considering This is one of the branches of freedom of opinion and expression that is guaranteed by most constitutions.
... Show MoreAddressed the problem of the research is marked: (Performing processors for the time between Impressionism and superrealism) the concept of time and how to submit artwork. The search came in four sections: general framework for research and identified the research problem and the need for him. With an indication of the importance of his presence. Then determine the research objectives of (detection processors performing to the concept of time in works of art in each of Impressionism and superrealism. And a comparison between them to reveal similarities and differences), followed by the establishment of boundaries Find three (objectivity, the temporal and spatial) were then determine the terms related to the title. Then provide the theore
... Show MoreThe ultimate goal of any sale contract is to maximize the combined returns of the parties, knowing that these returns are not realized (in long-term contracts) except in the final stages of the contract. Therefore, this requires the parties to the contract to leave some elements open, including the price, because the adoption of a fixed price and inflexible will not be appropriate to meet their desires when contracting, especially with ignorance of matters beyond their will and may affect the market conditions, and the possibility of modifying the fixed price through The elimination is very limited, especially when the parties to the contract are equally in terms of economic strength. Hence, in order to respond to market uncertainties, t
... Show MoreThis Research based on an empirical study and tested the hypothesis of transition effects on a sample of young people in Sharjah University and trying to identify a new form of Media which is based on the production of new types of habits and patterns and their cultural impact. Recently, New Media appeared to refer to new types of Communication using the Internet. It’s enormous in the exchange of Information. The new Media contains multiple forms, including the form in which users produce by them to refer the entry of a new area of Media in which exchange of roles between the Sender and the recipient.
This study is trying to identify a new form of Media Web used (Press online or only Press online, Digi
... Show MoreMost researchers concentrate their studies on the design, stress and pressure distributions of the prosthetic socket. A little attention is considered for the stiffness of the various materials of the prosthetic sockets. Prosthetic laminated sockets in Iraq are costly to be manufactured while polypropylene socket is relatively cheap in comparing with the laminates.
Experimental study is conducted to compare the stiffness of five prosthetic sockets made of different materials. Compression, three point flexural and tensile tests are implemented by the Testometric machine. The laminate sockets give better results in compression than polypropylene. Polypropylene gives good results in bending compared with the laminate sockets. When t
... Show MoreFirst of all, The annulment raises scientific and practical problems that reflect its peculiarity, as it relates to how the judge faces the dispute in a case in which reconciliation between the litigants took place, and what can be attributed to the judge’s judgment in this regard, whether that estimate is related to the factual elements in the case or the objective elements and their approach With the circumstances surrounding the dispute, and considering the possibility of applying the provisions of annulment established in the general rules, which is not easy in all cases due to the special nature of annulment in the conciliation contract, it is necessary to clarify the role that the judge plays, and his use of his legal tools that
... Show MoreCryptographic applications demand much more of a pseudo-random-sequence
generator than do most other applications. Cryptographic randomness does not mean just
statistical randomness, although that is part of it. For a sequence to be cryptographically
secure pseudo-random, it must be unpredictable.
The random sequences should satisfy the basic randomness postulates; one of them is
the run postulate (sequences of the same bit). These sequences should have about the same
number of ones and zeros, about half the runs should be of length one, one quarter of length
two, one eighth of length three, and so on.The distribution of run lengths for zeros and ones
should be the same. These properties can be measured determinis
Background: Chronic obstructive pulmonary disease (COPD) is a preventable disease with some significant extra pulmonary effects that may contribute to the severity in individual patients.. The systemic manifestations of COPD include a number of endocrine disorders , such as those involving the pituitary, the thyroid , the gonads, the adrenals and the pancreas. The mechanisms by which COPD alters endocrine function are incompletely understood but likely involve hypoxemia , hypercapnia , systemic inflammation and glucocorticoid administration.
Objective: To evaluate the relationship bet
... Show More