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 research aims to test the effect of the behavioral factors (intangible) represented by an explanatory variable represented by organizational silence and a responsive variable of quality of Function life. The problem was the negative effects of the organizational silence on the morale of the employees and consequently their performance and the quality of function life. To collect the data and information needed to measure the two variables of research conducted in the health center / Sulaikh by taking a sample of (40) employees to test the hypotheses of research through the survey of their views, using statistical tools non parametric using the program. The most important recommendations were the establishment of training workshops fo
... Show MoreOrganizations must interact with the environment around them, so the environment must be suitable for that interaction. These companies are now trying to become Learning Organizations because it try to face that challenges may rise from its environments. The Learning Organization is a concept that is becoming an increasingly widespread philosophy in modern companies, from the largest multinationals to the smallest ventures. What is achieved by this philosophy depends considerably on one's interpretation of it and commitment to it. This study gives a definition that we felt was the true ideology behind the Learning Organization and Group Working. A Learning Organization is one in which people at all levels
... Show MoreThe purpose of the study is to identify the need to improve health services in Iraq by determining the efficiency of service in health care centres and working on exploiting limited resources through choosing the most efficient technological art represented by using precast concrete technology to fill the shortfall in the establishment health centres for primary care and to explain the impact of this on saving resources, time, and increasing production efficiency. To achieve this, the quantitative analysis adopted as a methodology in the study by determining the size of the deficit in the infrastructure of health centres for primary care according to the standard of a he
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The current, research, aims, to, verify, the relationship between talent development practices and organizational performance through a mediating role of creative organizational climate at the Institution of Industrial Development and Research- the Iraqi Industry Ministry. The descriptive and analytic approach was adopted as a research design. The research sample was represented by a number of managers and employees who work at the middle management level. The researchers used the questionnaire as the main method for collecting data to achieve the main research objective. It was distributed 162 questionnaires, of which 146 received; and then all of those were used on the final statistical analysis. The sample response-rate rate w
... Show MoreThe research aims to identify the impact of the merger of the companies affiliated to the Ministry of Industry and Minerals on their financial profitability since the companies before the merger suffered a rise in losses and the deficit reached very high levels that affected its overall performance and even on the morale of workers as losses are increasing and solutions Efficiency is absent. The problem stems from knowing the impact of the merger on the profitability ratios of the companies. The research field was represented by the companies affiliated to the Ministry of Industry and Minerals (21) companies, while the research sample reached (6) companies after the merger (14) companies before the merger, was based on data The f
... Show MoreKnowing the nature of the relationship in federal systems lies in studying the political, social, economic and cultural forces, for their role in laying the foundations and the federal system. No matter how important the pillars of that system are, and through this research, we will learn how the political elites were able to crystallize this unique system, until it became one of the political systems that some countries seek to copy and apply its experience.
Abstract
In this work, diabetic glucose concentration level control under disturbing meal has been controlled using two set of advanced controllers. The first set is sliding mode controllers (classical and integral) and the second set is represented by optimal LQR controllers (classical and Min-, ax). Due to their characteristic features of disturbance rejection, both integral sliding mode controller and LQR Minmax controller are dedicated here for comparison. The Bergman minimal mathematical model was used to represent the dynamic behavior of a diabetic patient’s blood glucose concentration to the insulin injection. Simulations based on Matlab/Simulink, were performed to verify the performance of each controll
... Show MoreComparative morphological study has been treated for two species of the genus Chaenorhinum (D.C.) Richb., These species were: 1. Chaenorhinum calycinum 2. Chaenorhinum rubrifolium (Robill. & cast. Ex Lam. & DC.) Fourr. The genus belong to the family Scorphulariaceae. Morphological characters has been studies for: root, stem, leaves, flowers (calyx, corolla, androcium including filaments and anthers, gynocium including ovary, style and stigma), fruits and seeds also has been characterized. Key for there two species presented using some quantitative characters. Other characters like shape of fruits and seeds were used too, and they were of a useful taxonomic value
In this paper, a cognitive system based on a nonlinear neural controller and intelligent algorithm that will guide an autonomous mobile robot during continuous path-tracking and navigate over solid obstacles with avoidance was proposed. The goal of the proposed structure is to plan and track the reference path equation for the autonomous mobile robot in the mining environment to avoid the obstacles and reach to the target position by using intelligent optimization algorithms. Particle Swarm Optimization (PSO) and Artificial Bee Colony (ABC) Algorithms are used to finding the solutions of the mobile robot navigation problems in the mine by searching the optimal paths and finding the reference path equation of the optimal
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