Objectives To compare the clinical efficacy of microvascular decompression surgery (MVD) and gamma knife radiosurgery (GKR) as a treatment for patients with primary trigeminal neuralgia (TN) and evaluate the outcome regarding pain relief, recurrence, and complications with both modalities of treatment. Patients and Methods A randomized prospective study conducted in SaadAlwitry Neurosciences Hospital, Baghdad, Iraq. Eighty-four patients with TN from January 2016 to January 2018, 45 patients had GKR while 39 patients treated with MVD. The pain evaluated pre-and post-operatively using the Barrow Neurological Institute Pain Intensity scale (BNIPI), visual analog scale (VAS) and Brief Pain Inventory Facial (BPI-Facial) scoring systems. In GKR procedure, the trigeminal root entry zone targeted with a radiation dose of 80 Gy. MVD was performed using retro-sigmoid approach. Follow-up period was two years. Results Both groups showed a considerable decrease in BNIPI scores and VAS scores in the postoperative two years follow-up compared with the preoperative scores with a P-value< 0.01. However, pain relief rate was significantly higher in the MVD group (92.3%) compared to that of GKR groups (73.3%) with a P value of 0.02. Postoperative VAS scores of the MVD group were remarkably lower as compared with those treated with GKR during the same postoperative time.(P= 0.01).
Communication skills are essential for health professionals to achieve a positive relationship with patients, improving their health and quality of life. Communication is the foundation for obtaining medical history and conveying a diagnosis and treatment plan.
To assess the knowledge, practice of communication skills among primary care physicians, to find out any barriers related to the communication skills, and the association between the studied variables with knowledge and practice of communicati
This research is based on the descriptive and analytical methodology. The importance of studying labor laws and labor unions in Japan between 1889 and 1946 constitutions is because Japan was out of a feudal phase, and had no idea about the factory system and industrialization in their modern sense before the Meiji era. Generally, its labor system used to be mostly familial, and the economic system was based on agriculture. This called for the enactment of legislations and laws appropriate for the coming phase in Meiji era. Thus, this paper examines the role of Meiji government in enacting labor legislations and laws when he came to power in 1896, and his new constitution in 1889 and the civil code of 1896. It further examines the way Mei
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Since the Internet has been more widely used and more people have access to multimedia content, copyright hacking, and piracy have risen. By the use of watermarking techniques, security, asset protection, and authentication have all been made possible. In this paper, a comparison between fragile and robust watermarking techniques has been presented to benefit them in recent studies to increase the level of security of critical media. A new technique has been suggested when adding an embedded value (129) to each pixel of the cover image and representing it as a key to thwart the attacker, increase security, rise imperceptibility, and make the system faster in detecting the tamper from unauthorized users. Using the two watermarking ty
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Hands have consistently been an important vehicle in the transmission of disease (1). Thus, thorough hand-washing remains the single most important factor in preventing infection specially in hospitals and labs.Twenty-nine non-clinical volunteers (do not work or come in contact with a clinical or hospital setting) that lacked visible skin injuries, eczema or apparent skin disease were used, those subjects were all tested by a material of each of the three used in the study weekly and laboratory tests were done pre- and post washing.All three material were effective , Eugenol extract as effective as the bar and lotion soap. And this was confirmed statistically.Eugenol has a great antibacterial action even in small concentration and t
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In the present work the Buildup factor for gamma rays were studied in shields from epoxy reinforced by lead powder and by aluminum powder, for NaI(Tl) scintillation detector size ( ×? ), using two radioactive sources (Co-60 and Cs-137). The shields which are used (epoxy reinforced by lead powder with concentration (10-60)% and epoxy reinforced by aluminum powder with concentration (10-50)% by thick (6mm) and epoxy reinforced by lead powder with concentration (50%) with thick (2,4,6,8,10)mm. The experimental results show that: The linear absorption factor and Buildup factor increase with increase the concentration for the powders which used in reinforcement and high for aluminum powder than the lead powder and decrease with inc
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Multipole mixing ratios for gamma transition populated in from reaction have been studied by least square fitting method also transition strength ] for pure gamma transitions have been calculated taking into account the mean life time for these levels .
The research aims to reach a set of objectives concerning creation a clear vision about conceptual, philosophical and practical dimension of relations, and effects between knowledge management, costumer orientation and competitiveness to construct a framework of a pragmatic model as a solution to research problem and its questions which the main one is about the role of knowledge management and costumer orientation in competitiveness of business organizations. To achieving this goal, it was necessary to make, in priory, a review and discussion to the theoretical dimension of research variables to have a clear vision about constructing hypostatical research model implying a set of hypotheses which, by proving them in companies studied, repr
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