There are lots of construction projects been implemented in Khartoum State in the last decades. And, in order to implement construction projects successfully, there should be a perfect flow of materials, services and information related to those projects. The provision of providing projects with those essential needs lies within the concept of the logistics management; so, there will be a critical need for developing perfect planning for logistics services. The provision of supplying construction requirements should be conducted and handled in best manner with all the related aspects including quality, safety, time and cost to the proper execution of the construction projects. Many projects are failed and terminated because problems of the flow of logistics services. Those problems are occurred as result of many factors, but bad planning of logistics services is the one of the most important factors. Thus, in order to implement construction projects, there is a great need for the logistics supply service. Because, without delivering construction inputs in the required manner to the location of project, the project shall never be executed. And, in order to provide the project with the needed inputs in the best way and at a required time, there must be an effective planning for the logistics services of projects; in details, there must be a greater concern with the processes of purchasing, transporting and storing, handling as well as flow of information of all materials that used in the execution of projects. The study finds out that applying project management as well as perfect planning of logistics services play vital roles in better execution of construction project in Khartoum State and help maintaining the urban development master plan.
Aim: The aim of this article is to report on the safety and long-term efficacy of Cerament® BoneVoid Filler bone substitute for repairing craniofacial bone defects. Post-traumatic cranioplasty is a complex and challenging procedure for all maxillo-craniofacial surgeons and neurosurgeons, especially when repairing large areas. The standard criterion for repairing small cranial defects is the use autogenous bone from the iliac crest or split calvarial grafts. Autogenous grafts may result in donor-site morbidity, increased surgical time, reabsorption, blood loss, and longer recovery time . Alloplastic materials used for bone repair, such as methyl methacrylate, hydroxyapatite, titanium, or porous polyethylene, are expected to have optimal properties, including easy adaptation, biocompatibility, ingrowth of new tissue, stability of shape, and low rate of reabsorption. A cranial implant should be easily shaped and positioned, allowing easy tissue growth. In very wide cranium defects the new technology is a custom made cranial implant constructed three-dimensionally with different types of materials. However, this procedure is very expensive with various infection rates depending on the kind of material used and on the chemicophysical composition of the implant. Methods: The authors report the case of a 50-year-old man with a severe deformity of the forehead-supra orbital area as a result of a previous complex fronto-facial trauma treated in an emergency Unit. Secondary correction and reconstruction of the residual deformities were performed by using Cerament® Bone Void Filler, an alloplastic biphasic material, composed of 40% hydroxyapatite, 60% calcium sulfate and the radio-contrast agent iohexol. The unique ratio of hydroxyapatite and calcium sulfate is designed to enable Cerament to resorb at the same rate that bone forms. Calcium sulfate acts as a resorbable carrier for hydroxyapatite which is highly osteoconductive, promoting bone ingrowth.It seems to be a promising bone graft substitute in the management of bony irregularities in the fronto-orbital…
Perceived obsolescence has been displayed experimentally in many situations, but remains understudied theoretically. We develop a model of consumer demand, where ﬁrms aim to maximize their proﬁt from consumers who enjoy network beneﬁts from updated products. Firms face two key choices, pricing and whether to obsolete their product through introducing a new mod-el. In this paper, we demonstrate that perceived obsolescence can be an eﬀective strategy for ﬁrms, but must be employed with caution. We then use our ﬁndings to derive several testable implications that enable businesses to determine for themselves whether perceived obsolescence can be a viable strategy for them. In particular, we categorize the key diﬀerences in optimal strategies between ﬁrms that sell products with network beneﬁts, such as social media products, as opposed to those that sell status symbols, such as watches.
This effort suggests that aberrant social behavior found in school-age seen as a Symbolic Interaction issue.
The milk – cheese cycle with alpha emitters – pulmonary contribution to the refeeding of the hormonal system in unoptimal conditions
There is a material truth behind the expression “French people are cheese-eating surrendering monkeys” that involves the higher natural radioactivity in France (averaged) in comparison with the USA, the United Kingdom, Spain and Poland. This comes from the hormone loss related to internal alpha emitting nanoparticulate contamination and involves a compensation with among other things milk drinking and cheese eating. The basic hormone loss can be related to the “surrendering” reputation entirely (testosterone for instance was shown to be destroyed in uranium miners). A secondary cycle emerges to re-establish the sexual difference, where women in these regions typically drink fresh milk whereas men typically eat cheeses that have stayed long in caves and where the hormones have disappeared. This is globally spontaneous. Inhalation of cheese odors serve for cerebral confirmation that hormones have disappeared. That general theorem is a subpart of what was already denominated earlier the meat-pollution cycle for reasons of desire to adopt an easily memorizable name, due to the essentiality of the concept for humankind.
Successful treatment for intra-abdominal bleeding due to spontaneous rupture of huge liver cyst using transcatheter arterial embolization: a case report
Background: Non-parasitic simple liver cysts are one of the most common benign hepatic lesions. Although most liver cysts are asymptomatic and remain silent throughout the patient’s life, extremely large cysts can become symptomatic by direct compression to adjacent organs. Herein, we report a case of a spontaneously ruptured simple liver cyst, which is a rare presentation of a benign liver cyst. The patient’s liver cyst re-ruptured and was treated with transcatheter arterial embolization (TAE). Case report: A 62-year-old man presented to our hospital complaining of acute-onset lower abdominal pain. He had undergone laparoscopic fenestration of a huge liver cyst in another hospital 2 years prior. Computed tomography (CT) scan showed spontaneous rupture of a large liver cyst. Laparoscopic exploratory laparotomy showed no signs of ongoing intra-abdominal bleeding from the liver cyst; therefore, the operation was completed with peritoneal lavage. The patient was discharged from our hospital on postoperative day 5. Twelve days after the initial presentation, the patient was re-admitted to our hospital complaining of recurrence of lower abdominal pain. CT scan showed an enlargement of the previously ruptured liver cyst, with intra-abdominal bleeding and massive hematoma in the cyst. Extravasation of the cyst’s wall was also detected. Under the diagnosis of intra-abdominal bleeding from the artery in the wall of the huge cyst, emergent TAE was performed. Although the exact spot of extravasation was not detected, the anterior segment branch of the right hepatic artery, which corresponds to extravasation shown on the CT scan, was embolized. The patient was discharged from our hospital after 7 days, and the liver cyst remained stable without abdominal pain for more than 2 months. Conclusions: This case highlights a rare presentation of spontaneous rupture of a liver cyst with massive bleeding and the efficacy of TAE for the conservative treatment of ruptured liver…
Dislocation of the Mandible Condyle Towards the Middle Cranial Fossa: Case Report and Review of Literature
Introduction: Dislocation of the mandibular condyle into the middle cranial fossa is extremely rare in patients with craniofacial trauma. Methods: This report documents a case of an intact mandibular condyle intrusion into the middle cranial fossa in a 17-year-old woman following a traumatic incident treated by an intraoral approach that was performed to do an open reduction by condylectomy. Results: The causative mechanism, diagnostic features and a management option for reduction and treatment of these cases by performing a multidisciplinary approach involving neurosurgery and oral maxillofacial surgery are presented in this report. Conclusion: Adequate radiographic examination, including Tomography and Magnetic Resonance, is necessary to obtain the proper diagnosis and to determine an effective management.
Few cases of anal canal Merkel cell Carcinoma have been reported in the literature. Merkel Cell Carcinoma is rare neuroendocrine tumor which commonly found in sun-exposed areas such as extremities. We describe a case of 74-year-old male with anal canal Merkel Cell Carcinoma. He presented with peri-anal pain, tenesmus and itching. Besides, he was found to have chronic anemia. An anal nodule was found during per-rectum physical examination that was excised during endoscopy. Histological examination of the nodule confirmed the diagnosis of Merkel Cell Carcinoma. Thenceforward, patient died 7 months after diagnosis with marked metastatic disease despite initiation of Pembrolizumab therapy.
Burkitt Lymphoma of Central Nervous System in an elderly-patient: A new approach with a modified classic regimen
Burkitt’s lymphoma (BL) is one of the high-grade lymphomas, characterized by a rapid growth. They are usually treated with intensive chemotherapy regimens, being normally chemo-sensitive, but at the expense of high toxicity secondary to treatment. Additionally, the compromise of the central nervous system (CNS) implies a major risk as well as greater toxicity, taking into account a worse clinical prognosis with a requirement of more intensive schemes to achieve control of the disease. This implies doubts in the management of older patients with BL with CNS compromise, in whom toxicity is a limitation to these therapies, and there are no other alternatives that offer better benefit in terms of less frequent or severe adverse events, with similar outcomes in terms of progression-free survival (PFS) or overall survival (OS). Therefore, clarifying cases such as the one we report below allows us to provide a therapeutic alternative for older or unfit patients, in whom the intention of treatment should be to seek a good tumor response, but without ignoring the potential toxicity of chemotherapy.
Introduction: This manuscript will dealt with the outcome of emergency surgeries in COVID19 positive individuals. We are under the second wave of COVID pandemic. The research is ongoing regarding the outcome of patients who are undergoing, surgical treatment with COVID Rt-PCR positivity or become COVID positive during early postoperative period. Materials and Methods: All the patients who attended the emergency department of a tertiary care centre were screened for COVID -19 by RT-pcR and the patients who are COVID positive but needed emergency surgical procedure were included in the study. A cohort of 49 patients who were COVID positive and needed emergency surgical procedure due to various causes were included in the study. Results:The causes of acute surgical emergencies were acute appendicitis, appendicular perforation, perforative peritonitis, obstructed/ strangulated inguinal hernia, intestinal obstruction, diabetic foot and perianal abscess. Most of the patients belong to the age group between 40 – 70 years. 63.8% were males. The mortality rate was 12.8%. More than one co-morbid condition was present in 8.5% of individuals. Most of the patients got discharged in 10 – 12 days. 40.4% have co morbid conditions like diabetes or hypertension. 8.5% had more than one co morbid conditions. Diabetes was present in 27.7% of cases Conclusion: The mortality was high during the postoperative period of COVID positive cases, extreme care and precaution should be taken to avoid pulmonary complications