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 pa

The bourgeoisie groups derived great advantages from the system upon which the Fatimids built up their Regime out the land-tax and other taxes against a fixed sum . The surpulus revenue was the prophet of the farmers . A striking feature of the Fatimid was freedom of enterprise .All sectors of economic life were free-crafts , industry and trade . The government interfered in the trade in victuals only so far to in order to guarantee the supply of wheat to the big towns
The Egyptian Bourgeoisie enjoyed also the great prosperity which was produced among other reasons by the inflationary system of Fatimid economy .
The maintenance of gold dinar being almost pure and of full weight was only possible because Egypt steadily received cons

The using of recycled aggregates from construction and demolition waste (CDW) can preserve natural aggregate resources, reduce the demand for landfill, and contribute to a sustainable built environment. Concrete demolition waste has been proven to be an excellent source of aggregates for new concrete production. At a technical, economic, and environmental level, roller compacted concrete (RCC) applications benefit various civil construction projects. Roller Compacted Concrete (RCC) is a homogenous mixture that is best described as a zero-slump concrete placed with compacting equipment, uses in storage areas, dams, and most often as a basis for rigid pavements. The mix must be sufficiently dry to support

Previous experimental studies have suggested that hot mixed asphalt (HMA) concrete using hydrated lime (HL) to partially replace the conventional limestone dust filler at 2.5% by the total weight of all aggregates showed an optimum improvement on several key mechanical properties, fatigue life span and moisture susceptibility. However, so far, the knowledge of the thermal response of the modified asphalt concrete and thermal influence on the durability of the pavement constructed are still relatively limited but important to inform pavement design. This paper, at first, reports an experimental study of the tensile fatigue life of HMA concrete mixes designed for wearing layer application. Tests were conducted under three different temperatur

Standards of audit have been defined issued them by professional organizations the audit risk is: Failure of the auditor inadvertently to amend his opinion on the financial statements in suitable method, although these statements are Interpolated Essentially. As result the deep impacts caused by electronic operating systems in the accounting data in the audit process which audit risk has gained attention of many professional sides, especially the audit process and quality is relating with level of discovery the auditor for the mistakes of origin (misrepresentations) all their types and give the necessary confidence for the auditor to express his technical opinion in fidelity and certified financial statements which prepared electronicall