Application of Tanta algorithm reduces the recurrence rate significantly. The laparoscopic technique should be tailored according to criteria of each group of PIH to get the best outcome and reduced recurrence rate.
The dielectric constant, E', and dielectric loss, E", were determined for three solid carboxymethyl cellulose samples having different levels of substitution and different degrees of polymerization over a frequency range of 0.1 -IOOOO kHz at temperatures from 10-60°C. In contrast to the two relaxation processes, y and B, previously observed in native cotton cellulose, only one relaxation process within a frequency range of 0.1 -1 kHz was identified. It was found that the dielectric properties do not only depend on the degree of substitution, but also on the weight-average degree of polymerization and uniformity of distribution.
ZUSAMMENFASSUNG:Dielektrizitatskonstante (E') und dielektrischer Verlust (E") von drei Carboxymethylcellulose-Proben mit verschiedenem Substitutions-und Polymerisationsgrad wurden im Frequenzbereich 0,l-IOOOO kHz bei Temperaturen zwischen 10 und 60 "C gemessen. Im Gegensatz zu nativer Baumwollcellulose, die zwei Relaxationsprozesse (B und y) zeigt, wurde nur jeweils ein Relaxationsprozerj zwischen 0,l und 1 kHz gefunden. Die dielektrischen Eigenschaften hangen dabei nicht nur vom Substitutionsgrad, sondern auch vom gewichtsmittleren Polymerisationsgrad und der Homogenitat der Substitution ab.
Background: Coccygodynia has been described as a disabling pain in the coccyx usually associated with sitting or with changing position from a sitting to a standing position. Pain may radiate to the sacrum, to the lumbar spine, or laterally to the buttocks. Treatment has rarely been studied in the adolescent population. Purposes/Questions: This study aimed to assess pain relief and satisfaction after partial or total coccygectomy in pediatric and adolescent patients suffering from coccygodynia that was resistant to conservative treatment. Methods: A retrospective, consecutive case series was performed to review the data from the hospital records of 29 patients who underwent partial or total coccygectomy from January 2016 to January 2020 in a university hospital setting. Patients suffered from coccygodynia resistant to conservative treatment. The study included 16 female (55%) and 13 male (45%) patients who ranged in age from 3 to 15 years. Patient records were assessed for postoperative complications, period of hospital stay, time to regain normal activity, postoperative pain improvement (using a 4-point Likert scale), and patients’ or parents’ satisfaction (using a 5-point questionnaire). Results: Total coccygectomy was performed in 19 patients and partial coccygectomy in 10 patients. Only 1 patient had a superficial infection after surgery. The length of hospital stay was 1.44 ± 0.97 days. Time to regain normal activity was 24.68 ± 4.32 days. Pain relief was excellent (complete pain relief) in 23 cases (79.3%) and good (relief of most pain but mild discomfort after prolonged sitting) in 6 cases (20.7%). There were no reports of fair (minimal or no pain relief) or poor (pain worse than before surgery) pain relief. In terms of patient or parent satisfaction, no one reported being “absolutely dissatisfied,” 1 person was “dissatisfied” (3.4%), 3 people were “neither dissatisfied nor satisfied” (10.4%), 9 were “satisfied” (31%), and 16 were “absolutely satisfied” (55.2%). Conclusion: This case series suggests that coccygectomy may be a feasible management option for pediatric and adolescent patients, with favorable outcomes including pain relief, patient or parent satisfaction, and early return to activity.
The present work introduces a new methodology for solving the topology optimization problem of a compliant gripper. A hybrid optimization technique is developed using simulated annealing as a random search method, while the simplex method (Nelder-Mead) is used as a direct search method. A new modified technique of motion from one search point to another based on the discrete nature of adding and/or removing a structural member is proposed. The traditional continuous simulated annealing technique is used to find the members’ heights. A discrete uni-variant search method is adopted following the simulated annealing and before the simplex method. This corresponds to about 14% of the number used in the old method and in the previous work in the literature, and about 86% of the optimization time is saved. The optimum design of a compliant mechanism is conducted for maximum flexibility and stiffness using the developed hybrid optimization technique.
Background: The congenital anomalies that indicate colostomies in neonates at any tertiary paediatric surgery centre are Hirschsprung's disease, anorectal anomalies, and colonic atresia and they constitute the main bulk of colostomy workloads.Objective: In this study, we aimed to evaluate the indications, site of creation, type of colostomy, and complications of colostomy in new-born in the last three years in a single tertiary center. Patients and Methods: This study was a retrospective cohort study that was carried out in the Paediatric Surgery
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