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Outcome of surgical untethering of tethered cord syndrome in adults due to spina bifida occulta
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Background:. Children with spina bifida occulta require early surgery to prevent neurological deficits. The treatment of patients with a congenitally tethered cord who present in adulthood remains controversial.

Objective: The aim of this study is to describe the outcome obtained in 61 adult patients with congenital TCS and no prior surgical treatment who underwent surgical untethering.

Methods: This prospective study was conducted on 61 adult patients who underwent surgical untethering for spina bifida occulta at four neurosurgical centers in Baghdad / Iraq  between March 2000 and January 2018. Patients who had undergone prior myelomeningocele repair or tethered cord release surgery were excluded.

The most common intraoperative findings were lipomyelomeningocele (41%) and a tight terminal filum (36%). The follow-up duration ranged from 10.8 to 149.5 months (mean 20.9 months). Of the 34 patients with back pain, status improved in 65%, worsened in 3%, remained unchanged in 18%, and improved and later recurred in 15%. Lower-extremity pain improved in 16 patients (53%), remained unchanged in 23%, improved and then recurred in 17%, and worsened in 7%. Lower-extremity weakness improved in 47%, remained unchanged in 47%, and improved and then recurred in 5%. Finally, of the 17 patients with lower-extremity sensory changes,

status improved in 35%, remained unchanged in 35%, and the information on five patients was unavailable. Surgical complications included three wound infections, one cerebrospinal fluid leak, and two pseudomeningoceles requiring surgical revision. One patient developed acute respiratory distress syndrome and sepsis postoperatively and died several days later.

Conclusions: Adult-age presentation of a congenital tethered cord is unusual. Despite a slight increase in postoperative neurological injury in adults, surgery has relatively low risk and offers good potential for neurological improvement or stabilization. As in children, we recommend early surgery in adults with this disorder. The decision to undertake surgery, however, should be modulated by other factors such as a patient’s general medical condition and risk posed by anesthesia.

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Publication Date
Wed Jun 01 2011
Journal Name
Journal Of The College Of Languages (jcl)
From Personal Issues to National Concerns: A Study in E.M Forster’s Where Angels Fear to Tread & Howards End
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            E.M. Forster (1879-1970) is one of the important novelists who dealt with the personal and social lives of the people in England during the early beginning of the twentieth century. During his literary career, he developed gradually his views about man and his position in society.

 In his first novel, Where Angels Fear to Tread (1902), the focus is laid on local and personal issues in the lives of the characters. It is limited to the relations between neighbours in small communities. Though the setting is shifted to Italy, Forster does not make full use of this shift to present cultural or racial conflicts; rather he limits his plot to the private tr

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Publication Date
Fri Apr 15 2022
Journal Name
Alustath Journal For Human And Social Sciences
The Intersectionality in I've Been Meaning to Tell You: A Letter to My Daughter: A Post-Colonial Perspective
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Intersectionality is a concept that focuses on social inequality towards black people and provides an analytical instruments for creating social justice issues in such a way in order to depict how social marginalization, or privilege occurs differently in various social positions. It does this by focusing on the interaction of multiple systems of oppression. Intersectionality is used to examines how the social factors; race, gender, and class can affect the people’s life especially the immigrants, black people, and refuges. This article will depicts how blacks in Canada are segregated and distinguished from white race. David Chariandy’s I’ve Been Meaning To Tell You: A Letter to My Daughter 2018 is analyzed through Kimberle Crenshaw

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
This study sought to determine the impact of spreading the culture of quality in improving the quality of tourism service in some hotels in Erbil governorate
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This study sought to determine the impact of spreading the culture of quality in improving the quality of tourism service in some hotels in Erbil governorate. The theme of excellence in providing service and attention to it has become the concern of most organizations in general and tourism service organizations in particular. Tourists try to establish the mental status of customers about their tourism organizations had to pay attention to the quality of service provided to the customer and work to develop them to the advanced stages of satisfaction and happiness of customers and this will certainly positively affect the improvement of service in the tourism sector, Of the research variables were examined statistically by distrib

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Publication Date
Mon Mar 01 2021
Journal Name
Iop Conference Series: Materials Science And Engineering
Enhancement of self-healing to mechanical properties of concrete
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Abstract<p>Concrete is the main construction material of many structures. Exposing to loads creates cracks in concrete, which reduce the performance and durability. The decrease of concrete cracks becomes a necessity demand to ensure more durability and structural integrity of the concrete structure. Autogenous healing concrete is a kind of new smart concretes, which has the ability to reclose its cracks by means of itself. Concrete self-healing is a type of free repairs processes, which is reduce direct and indirect cost of maintenance and repairing. This work targets to inspect the mechanical properties of concrete after using two combinations of two materials (20 kg/m3 calcium hydroxide Ca(OH</p> ... Show More
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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Transparency of government performance to the state of iraq
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The most important recommendations of this research are:-

1.The benefit of the other countries experiences about the transparency of the government performance, without depending on the transparency that imitating the other experiences; that may not fit with the Iraqi government units.

2.The Ministry of Finance has to prepare the citizen guidebook about the government performance which is considered an essential document, it should be simple and available for all the parties of relation; and for not specialized citizen for the purpose of simplifying the understanding of government performance details.

3.The benefit of the government units websites of inte

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Publication Date
Thu Jun 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Tooth wear in relation to physical salivary characteris-tics among gastroesophageal reflux disease
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Background: Gastroesophageal reflux disease, is a quite prevalent gastrointestinal disease, among which gastric content (excluding the air) returns into the oral cavity. Many 0ral manifestations related t0 this disease include tooth wear, dental caries also changes in salivary flow rate and pH. This study was conducted among gastroesophageal reflux disease patients in order to assess tooth wear in relation to salivary flow rate and pH among these patients and the effect of gastroesophageal reflux disease duration on this relation. Materials and methods: One hundred patients participate in this cross-sectional study for both genders and having an age range of 20-40 years old, patients had been endoscopically identified as having gastroeso

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Publication Date
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Adopting the green value chain to achieve sustainable competitive advantage: study to views of a sample from Ur General Company for Engineering Industries in Dhi Qar
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       In light of the developments and intense competition that the world has witnessed, the need to search for a sustainable and continuous competitive advantage for economic units has emerged, as the economic units must not lose sight of their interest in the activities they perform to achieve that advantage, and it can be said that the goal of the research is to identify the theoretical dimensions of the green value chain represented by: (Green research and development, green design, green manufacturing, green marketing, green services) and the dimensions of the sustainable competitive advantage represented by (quality, creativity, innovation, cost, response to the customer), as well as identifyi

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Publication Date
Sun Nov 27 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The extent to which the Iraqi environment responds to the requirements of IAS 12 in determining income tax: بحث تطبيقي في الهيئة العامة للضرائب/ قسم الشركات
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The importance of this research comes from the possibility of achieving positive interaction between accounting and tax through the interest in setting accounting standards and adapting them to local tax legislation, as the adoption of the application of the international standard (IAS 12) for income taxes helps to measure and determine the base for income tax and may lead to an increase in the tax outcome. Through the reliance of enterprises on many accounting bases, and that the tax administration in Iraq depends on the element of personal judgment in determining the tax base, which leads to lack of objectivity in determining the tax outcome, as the impact of the accounting standard (IAS 12) on the tax base and tax outcome is one of th

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Publication Date
Wed Jun 15 2022
Journal Name
Journal Of Baghdad College Of Dentistry
Potential of Salivary Matrix Metalloproteinase 9 to Discriminate Periodontal health and disease
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Periodontitis is a chronic inflammatory disease resulted from aggravated immune response to a dysbiotic subgingival microbiota of a susceptible host. Consequences of periodontitis are not only limited to the devastating effect on the oral cavity but extends to affect general health of the individual and also exerts economic burdens on the health systems worldwide. Despite these serious outcomes of periodontitis; however, they are avoidable by early diagnosis with proper preventive measures or non-invasive interventions at earlier stages of the disease. Clinically, diagnosis of periodontitis could be overlooked due to certain limitations of the conventional diagnostic methods such as periodontal charting and radiographs. Utilization of re

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Publication Date
Sat Jun 08 2024
Journal Name
Obstetrics And Gynaecology Forum
Biochemical and Immunological responses to use dexamethasone in rats
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This study was conducted to determine the side effects of dexamethasone n some physiological and immunological criteria, which included, Measuring sugar level, liver (ALT, AST , LDH, Total protein) and kidney function (urea, createnine), total and differential count of W.B.C,CRP, TNF-α ,IL6,IL10. thirty rats were divided into two groups (15\ rat). G1: This group was considered negative control injection with normal saline, G2: This group was injected with 2 mg\kg dexamethasone. The results showed a significant increase in the level of enzymesALT, AST and sugar levels and decreased level of total protein in the group treated with the drug, also showed, a significant decrease in the total number of W.B.C an

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