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.
The security environment for Northeast Asia is extremely important, as it includes most of the international actors (United States of America, China, Russian Federation and Japan), which gives the nature of the interactions of these forces a special importance for the region.
Because of the multiplicity of policies and interests of the active forces in the region, the result has been an unstable regional environment where the interests of the major powers often clash repeatedly on many related issues, which is coupled with the growing efforts of many powers to adopt policies that differ from what they did in the past This resulted in different patterns of relations, which were mainly characterized by competition over regional lea
... Show MoreAfter the spread of the function of the scenographer in the modern theater, his vision has become present in most of the theatrical works and because the director is the master of the work and the owner of the vision that appears in front of the audience, the overlap between the visions of each of them was required. This research is an attempt to detect the overlap and disengagement in the work of each of them.
The research is divided into a methodological framework that included the research problem, importance, limits, and purpose, and then the definition of terms. In the theoretical framework, the research dealt with two theoretical sections that pave the way for raising ideas related to this subject: the first section (scenography
The nature of the political system of any country in the international system must have an impact on the policy of the State, whether in the interior or exterior, both regional and international, Turkey is one of the most important countries in the Middle East, which have a place and effectiveness on the surrounding environment, hence the importance of research lies in its political system and the transfer of power in it and its transformation from the form of the parliamentary system to the presidential system of the repercussions of the task and mutual effects between Turkey and the countries of the surrounding region in terms of the extent of achieving political stability in the Turkish interior or not and how this can be refl
... Show MoreThis study examines the dynamic relationship between stock market and economic activity in the United States to verify the possibility of using financial indicators to monitor the turning points in the expected path of future economic activity. Has been used methodology (Johansen - Juselius) for the Co-integration and causal (Granger) to test the relationship between the (S & P 500 , DJ) index and gross domestic product (GDP) in the United States for the period
(1960-2009). The results of the analysis revealed the existence of a causal relationship duplex (two-way) between the variables mentioned. which means the possibility of the use stock market indicators to pre
The researcher studied transportation problem because it's great importance in the country's economy. This paper which ware studied several ways to find a solution closely to the optimization, has applied these methods to the practical reality by taking one oil derivatives which is benzene product, where the first purpose of this study is, how we can reduce the total costs of transportation for product of petrol from warehouses in the province of Baghdad, to some stations in the Karsh district and Rusafa in the same province. Secondly, how can we address the Domandes of each station by required quantity which is depending on absorptive capacity of the warehouses (quantities supply), And through r
... Show MoreWhen a person found himself in a life he did not understand، he tried to create in his imagination powers and gods that tried to protect him from his ignorance of that world، and when he was reassured internally through those fantasy creatures when he made them the greatest protector and the source of his existence and his being، he began to weave myths and myths until he created his reality that he did not have. Any hint، and when we go back to the mechanism of embodying those myths، myths and fantasias in which he lived، we will find that the first building blocks were written on the walls of the caves in which he lived during that period. And when his thought developed and thus his expressive means developed، he began to embody
... Show MoreBackground: perniosis is a common dermatological problem. Different modalities of treatment are available with conflicting results and no single effective therapy is universally accepted.
Objective: To evaluate the effectiveness of oral tadalafil and compare it with pentoxyfylline or prednisolone in treatment of perniosis
Patients and methods: This was a therapeutic comparative trial conducted in the department of Dermatology, Baghdad Teaching hospital, Baghdad, Iraq between November 2011 and March 2014.
Fifty eight patients with perniosis were enrolled in this study, and divided into 3 groups. Group (A) comprised 19 patients who received oral tadalafil (5 mg once daily); group (B) comprised 18 patients who received pentoxifylli
Most of the theorists and researchers and also those interested in cinema and television attributed the fact of the existence of the dramatic works to the directors may be due to a historical justification. At the same time, the existence of the production world came as a result of the emergence of the production city (Hollywood). This is also a historic fact. The research would tackle all the formative truths to prove the relation and the timeline, i.e., before and after and the synergy that resulted in the existence of the dramatic works that benefited the humanity and those interested in this giving art. The objective of the research is to uncover the formative truth of the dramatic work between direction and production.
The s
... Show MoreThis study is concerned with organizational learning and its impact on total quality management in the education sector. Organizational learning is a process that provides the educational sector with the ability to adapt and respond rapidly to developments and changes in a better way according to its main dimensions (Mental Models, Personal Mastery, Team Learning, Shared Vision, System Thinking) by adopting the philosophy of Total Quality Management (TQM) in accordance with its basic dimensions (leadership, customer satisfaction, participation of workers, continuous improvement, training and education). The main purpose of this study is to know (the impact of the Senge model of organizational learni
... Show MoreThis study is concerned with organizational learning and its impact on total quality management in the education sector. Organizational learning is a process that provides the educational sector with the ability to adapt and respond rapidly to developments and changes in a better way according to its main dimensions (Mental Models, Personal Mastery, Team Learning, Shared Vision, System Thinking) by adopting the philosophy of Total Quality Management (TQM) in accordance with its basic dimensions (leadership, customer satisfaction, participation of workers, continuous improvement, training and education). The main purpose of this study is to know (the impact of the Senge model of organizational learni
... Show More