BackgroundCarcinoma of the larynx represent 10% of head & neck malignancies. The treatment of advanced carcinoma of larynx may include partial or total laryngectomy, with or without laser , radiotherapy,and or chemotherapy . Carcinoma of the larynx usually affect old age , heavy smoker with possible risk of pulmonary diseases & ischemic heart disease , which add risk to the general anaesthetic complication operative & postoperative - Objectives this study was designed to assess the feasibility of total laryngectomy under local anaesthesia in medically unfit patients for general anaesthesia & to re-establish practice doing total laryngectomy under local anaesthesia in those patients.
Methods a prospective study on 12 patients who underwent total laryngectomy under local anaesthesia in the otolaryngology department at Al-Jirahat hospital over a period from September 2007 to the end of July 2010.
Results all patients tolerated the surgical procedure under local anaesthesia without disturbing the general condition of the patient, or the technique of surgery , with good postoperative recovery & early mobility of patient .
Conclusion total laryngectomy can be done under local anaesthesia in case the patient is medically not fit for general anaesthesia , & in some other selected cases .
The City of Ember is a very interesting novel that is although intended for young readers, have so many layers and messages that are misunderstood. In this research, both the novel and the film adaptation are studied with the intent to decode the warning messages that the novelist and the director tried to introduce to the audience. The research studies four vital messages; the first message is that history repeats itself for the novel has many allusions to the history of Jews and their painful holocaust and even goes back in history the days of Moses and the Exodus, the second message tackles the conspiracy theory that states nothing happens by accident and that everything is planned and connected hence comes the third message
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The goal of current research to describe and diagnose the level of attention of doctors to design and regulatory dimensions, (strategic vision, organizational structure, organizational processes, business systems, personnel), and the performance of hospitals and dimensions, in six hospitals in medicine and selected a sample for research, as well as identify organizational design effect in the performance of hospitals and dimensions (efficiency, the development of human resources, patient satisfaction, achieve financial results, quality of health care).
Research has focused in part theoretical on key variables to look organizational des
... Show MoreFor a long time, the intensification of profit represented a major goal for the company management ,but this goal confirmed a series of restrictions such the constriction on short period, the time rather than on long and medium strategic goal, the relationships with customers ,the supplies, employees , This goal is replaced by another one (intensification of the company's value) ,and the fortune of the share holders itself ,for the purpose of creating value, the company must generate great outcomes to cover the operating expense and to insure the a suitable compensation to the invested capital (the market value added) is the indication used to estimate the company ability to create value –added the development
... Show MoreThe bodies responsible for the organization of accounting in the world seek to keep abreast of repaid development, by provide the information required by users, which they need to make efficient decision that return them to the desired benefits, and avoid the risks they could face if they made their decision based on misleading information, or insufficient, or not accurate, Hence, the IASB has undertaken to review the standards, and make the necessary adjustment and clarifications to remove the ambiguities that some of the paragraphs may have in IFRS issued.
And the Iraqi Central Bank obliges banks to convert from local accounting standards to apply IFRS only a step towards keeping pace with developments
... Show MoreThis research reviews studies that identify the habitats of the redbelly tilapia, Coptodon zillii, in Iraq, the environmental conditions favorable to this species distribution and proliferation, as well as its economic and social significance as a food source. Additonally, the study examines its effects on biodiversity through competition with native fish species for resources, as well as its role as reservoirs of pathogens, its adverse effect on human health due to the tendency to retain oil crude inside the tissues, and its impact on environmental and water quality by increasing water turbidity. Finally, the review exhibits recommendations for strategies to mitigate its detrimental effects on biodiversity as well as environment.
The constructivist learning model is one of the models of constructivist theory in learning, as it generally emphasizes the active role of the learner during learning, in addition to that the intellectual and actual participation in the various activities to help students gain the skills of analyzing artistic works. The current research aims to know the effectiveness of the constructivist learning model in the acquisition of the skills of the Institute of Fine Arts for the skills of (technical work analysis). To achieve the goal, the researcher formulated the following hypothesis: There are no statistically significant differences between the average scores of the experimental group students in the skill test for analyzing artworks befor
... Show MoreThe rental activity receives "significant" interest from accounting organizations interested in issuing accounting standards worldwide, such as the Financial Accounting Standards Board (FASB), the International Accounting Standards Board (IASB). As leases represents an important source of finance for economic units as an alternative to financing assets through purchase or borrowing. Professional organizations have focused on addressing the situation of extra-budgetary funding through which the lessee hides many leases that are classified as financing without It shows in the budget, which gives an incorrect picture of the reality of the financial situation of economic unity, IASB has issued IFRS 16, which terminates off- Balance s
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