Recent Articles

  • TREATMENT SEQUENCE OF COMBINED PELVIC INJURY, CONSISTED OF UPPER PUBIC RAMUS FRACTURE, SACROILIAC JOINT DISLOCATION WITH OPEN BOOK INJURY, USING STOPPA APPROACH

    Among pelvic serious injuries is the so-called “open book” injury of the pelvis, with Sacroiliac Joint Disruption (SIJD) in combination with upper pubic ramus or anterior column fracture, contralateral or ipsilateral, or both. This combination of pelvic injury could be classified according Young and Burgess classification as LCIII or CM type (Combined Mechanism) and as 61-B3.1 61-B3.2 following AO/OTA classification. Specifically, the upper pubic ramus fracture can be classified according to Nakatani classification as type I medial of the foramen, type II within the foramen and type III lateral to the foramen. The difficulty to deal with these fractures is how to close and reduct the pubic symphysis in mechanically stable way since there is fracture in one or both the upper pubic ramus. The existence of these fractured elements, in this type of pelvis injury allow a lot of degrees of freedom which must be managed from the surgeon in the proper sequence. The incision and the approach are also mandatory for successfully treating these lesions. Anterior Intrapelvic Approach (AIP) or Stoppa approach in conjunction with the first window of ilioinguinal approach is the most appropriate surgical exposure for reduction and fixation.

  • AN ISOLATED PILOMATRICOMA OF THE LEG: A RARE LOCATION – A CASE STUDY

    Pilomatricoma is a rare, benign skin tumour arising from the hair matrix. The usual locations are the head and neck. Localization in the lower limbs is exceptional. The diagnosis of certainty is histological. Treatment is complete surgical removal to avoid recurrence. We report in this article the case of a rare localization of a pilomatricoma on the right leg, in a 25-year-old patient operated with complete surgical removal. The postoperative course was simple and without recurrence after 2 months of follow-up.

  • Logistics Planning and Its Role in Developing Construction Projects in Khartoum State

    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.

  • RECONSTRUCTION OF ANTERIOR FRONTAL WALL AND CONTOURS DEFECTS USING BONE SUBSTITUTE

    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…

  • Firm Utilization of Perceived Obsolescence

    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.

  • Symbolic Interaction, The Looking Glass Self and Aberrant Social Behavior in School Aged Children

    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.

  • Merkel Cell Carcinoma of Anal Canal: Case Report and Literature Review

    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.