AIM: To analyse our experiences in the management of traumatic retroperitoneal hematoma (RPH), highlighting the various challenges faced and to report on the outcome of these patients. METHODS: From May 2014 to May 2017, all patients with traumatic RPH who underwent surgical treatment were retrospectively analysed. The kind of injury, intraoperative findings, sites of hematoma, postoperative morbidity and the overall outcomes were recorded. RESULTS: Ninety-six patients; 53 with blunt trauma and 43 with penetrating injury, were included in this study. The centre-medial hematoma was observed in 24 (25%) patients, lateral hematoma in 46 (47.9%) patients, pelvic hematoma in 19 (19.8%) patients, and multiple zone hematomas in 7 (7.3%) patients. All cases were managed surgically. Exploration of the retroperitoneal space was done in 72 cases. Thirty-three patients died, and the overall death rate was 34.4%. CONCLUSION: Surgical exploration should be done in RPH caused by penetrating injury, but the need for urgent exploration in blunt injury is not so high, and it depends on the anatomical site of hematoma, concomitant organ injury and the hemodynamic status of patients.
This article proposes a new strategy based on a hybrid method that combines the gravitational search algorithm (GSA) with the bat algorithm (BAT) to solve a single-objective optimization problem. It first runs GSA, followed by BAT as the second step. The proposed approach relies on a parameter between 0 and 1 to address the problem of falling into local research because the lack of a local search mechanism increases intensity search, whereas diversity remains high and easily falls into the local optimum. The improvement is equivalent to the speed of the original BAT. Access speed is increased for the best solution. All solutions in the population are updated before the end of the operation of the proposed algorithm. The diversification f
... Show MoreBackground: Animal bite is one of the public health problems all over the world, especially in poor countries. Animal bites have an impact on human health due to rabies disease, which is a viral transmitted disease from animal to human with a high mortality rate.
Objective: To determine the epidemiological characteristics of animal bite cases by person, time, and place.
Method: Descriptive cross sectional study was done by reviewing cases caused by animal bites., Data including the demographic characteristics of age, gender, occupation, site of bite, and attending health institutions searching treatment were all included.
Results: There were 11600 animal bite cases. Most of bites caused by stray dogs 11577(99.8%), and the males
Personal intelligence is thinking about an other person , understanding him, have sympathy and differentiation between people, and to appreciate their own point of view, with the sensitivity to their motives, behavior, and goals, so this intelligence involves dealing with a person or group of persons effectively and in normal or logical manner.
Emotions management is to achieve emotional balance by controlling the emotions continuously, self disciplining, keeping away from excitement sources, and dealing with bad situations in constructive way to achieve the psychological stability .
- the study aims
Nitrogen (N) fertilizer rate is important for high yield and good quality of potato tubers. In this dissertation, I seek to study the response of different potato cultivars under different N fertilizer rates and how that can impact tuber quality, examine the performance of active optical sensors in improving a potato yield prediction algorithm, and evaluate the ability of active optical sensors (GreenSeeker (GS) and Crop Circle (CC)) to optimize a N recommendation algorithm that can be used by potato growers in Maine. This research was conducted at 11 sites over a period of two years (2018–2019) in Aroostook County, Maine; all sites depended on a rainfed system. Three potato cultivars, Russet Burbank, Superior, and Shepody, were planted u
... Show MoreThe systems of governance in Europe are characterized by ancient democratic systems that have developed and developed through a long history of political conflicts that have emerged from a social reality that feeds them and receives the resulting effects. This is an achievement that has been achieved after the sacrifices and great efforts in formulating models of good governance through which to realize the aspirations of their peoples. . The democratic system operates within a balanced mechanism of two competing parties to manage and direct the work of the government and the parliament. The parties that achieve the majority in the elections carry out the functions of the government supported by their parliamentary base belonging to one
... Show MoreBackground: Transradial compared to classic transfemoral coronary intervention has been shown to have similar efficacy rates, while being more cost-effective and most importantly safer due to fewer access site complications. Furthermore, patient comfort is increased and outpatient treatment may be feasible..Objectives: To start trans-radial intervention program and the initial learning curve for fellows and the catheterization –laboratory nursing staff. To test how could it be applicable and comfortable for our patientsMethods: This prospective study was performed in Ibn-Albitar hospital for cardiac surgery over a period of 6 months from the 1st of August 2012 till the 1st of February 2013. Every patient referred for percutenuos corona
... Show MoreObjectives Acid sphingomyelinase deficiency (ASMD) is an inherited autosomal recessive disease caused by pathogenic variants in the sphingomyelin phosphodiesterase-1 (SMPD1) gene, which encodes acid sphingomyelinase (ASM). ASMD has 3 broad phenotypes (type A, type A/B, and type B) characterized by the age of onset, symptomatology, and the rapidity of disease progression. The diagnosis of ASMD can be delayed or missed because of the wide spectrum of severity and its variable manifestations. Analysis of genotype-phenotype correlations can help to determine ASMD disease type and inform management. Here, we describe the clinical presentation of 47 patients with ASMD referred to a single center in Iraq since 2007, whose diagnosis was confirmed b
... Show MoreThis paper is concerned with pre-test single and double stage shrunken estimators for the mean (?) of normal distribution when a prior estimate (?0) of the actule value (?) is available, using specifying shrinkage weight factors ?(?) as well as pre-test region (R). Expressions for the Bias [B(?)], mean squared error [MSE(?)], Efficiency [EFF(?)] and Expected sample size [E(n/?)] of proposed estimators are derived. Numerical results and conclusions are drawn about selection different constants included in these expressions. Comparisons between suggested estimators, with respect to classical estimators in the sense of Bias and Relative Efficiency, are given. Furthermore, comparisons with the earlier existing works are drawn.