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Article
Thyroid Surgery with Drain Versus without Drain

Authors: Ammar Noori Muhammed --- Wassem Ahmed AL-Kateb --- Ramez AL-Mukhtar --- Tharwat Idrees Sulaiman
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 3 Pages: 343-348
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:The nature and indications for thyroid surgery vary and a perceived risk of postoperative complications such as seroma , haematoma , wound infection and haemorrhage post-surgery is one reason why wound drains are frequently inserted. They are generally used as a matter of the surgeon’s habit or preference more than a matter of proven benefit in the patient’s postoperative period.OBJECTIVE:To evaluate the differences in outcome and complications following thyroid surgery whether draining the wound or not .PATIENTS AND METHODS:One hundred forty five patients with different thyroid diseases requiring surgical intervention presenting to the first surgical unit in Baghdad teaching hospital between the first of October 2007 to the 31th of December 2009(27 months period) were enrolled. Patients were divided into two groups : those who had their wounds drained postoperatively ; (the drain group DG) and those who had their wounds closed without drain ; (the non drain group NG).RESULTS:Seroma occurred in three patients (3%) in the DG, and in two patients (4.4%) in the NG. Small haematoma occurred in three patients (3%) in the DG, and in two patients (4.4%) in the NG. Large haematoma occurred only in one patients (1%) in the DG, and it didn't occur in the NG. Wound infection occurs only in two patients (2%) in the DG, and in one patient (2.2%) in the NG. The mean of in-hospital stay was 2.07 days in the DG, and 1.06 days in the NG.CONCLUSION:The use of drain showed no effect on the prevention of wound infection , seroma , haematoma formation or the need for re-exploration, indeed the use of drain had lengthened the in hospital stay .So the Routine use of drains after thyroid surgery might be therefore not necessary, if not detrimental.


Article
A Comparative Study of Laparoscopic Bariatric Surgery: An Iraqi Experience

Author: Ramiz S. Mukhtar* FRCS. رامز المحتار
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2012 Volume: 54 Issue: 4 Pages: 287-293
Publisher: Baghdad University جامعة بغداد

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Abstract

Summary:Background: The World Health Organization has declared that obesity is a disease of pandemic significance. The number of performed bariatric procedures has rapidly and considerably increased over the past decade. The most frequently performed and best studied procedures are laparoscopic gastric banding (LAGB), laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB).Objectve: To provide a critical appraisal of the most important scientific evidence comparing the short term outcomes of these three weight-reduction procedures (laparoscopic gastric banding (LAGB), laparoscopic sleeve gastrectomy (LSG), and laparoscopic Roux-en-Y bypass (LRYGB)) using retrospectively collected data for patients with morbid obesity in Iraq.Patients and Methods: Between August 2010 and November 2012, three types of bariatric operations (LAGB, LSG, LRYGB) were performed in a hospital in Baghdad for patients with morbid obesity by the same team. A total of 32 patients underwent LAGB operation (21 women and 11 men) with a mean age of years = 33.77 (range 16 to 52 years), and of the 29 patients underwent LSG operation (22 women and 7 men) with a mean age of years = 33.86 (range 20 to 52 years) and of the 9 patients underwent LRYGB (7 women and 2 men) with a mean age of years= 35.11 (range 25 to 45 years). Thereafter patients were followed up monthly for the first 3 months postoperatively.Results: Using statistical Package for the Social Sciences Software (SPSS) version 15,we found the mean weight loss 1 month after surgery was 10.97kg (range 5-25 kg) for LAGB, 12.34 kg (range 6-21 kg) for LSG and 12.33 kg (range 10-20kg) for LRYGB. Mean weight loss 3 months after surgery was 18.81kg (range 7-38 kg) for LAGB, 22.48kg (range 10-59 kg) for LSG and 24.33kg (range 16-40kg) for LRYGB.Conclusion: The results from our study showed that all the studied procedures had a significant weight reduction rate in the first three months post operatively and that LRYGB is superior to the LAGB and LSG in weight reduction, although, all procedures are associated with marked weight loss. The age of the patients did not influence the decrease in BMI or affect the type of the procedure in weight reduction for the studied group. The results of this study do not diverge from those previously reported in the literature regarding the complications and the resolution or at least improvement of medical co-morbidities after these three procedures had been proved in this study.Keyword: laproscopy . Barialric, Surgery, Iraq.


Article
Evaluation of Management of Closed Spinal Injury

Author: Dr. Haider K. Radhee. FICMS,.Dr. Ayad Yousif AbdulnabI.. FICMS, Dr. Basim Saed. FICMS
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2012 Volume: 8 Issue: 2 Pages: 80-83
Publisher: Baghdad University جامعة بغداد

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Abstract

Objectives: to evaluate the role of conservative, decompression, spine fixation in management of closed spinal injury.Methods: The study was conducted at Specialized Surgical hospital and Al-Kadhemayia Teaching Hospital, in the period between July 2003 and July 2005.The study included 61 patients categorized Into many groups according level of vertebral injury (cervical, cervicodorsal, dorsal, dorsolumbar, Lumbar and lumbosacral), type of injury (compressed fracture, burst fracture and fracture dislocation) And according the severity into three groups as G1( complete motor paralysis and sensory loss ) G2 ( complete motor paralysis and incomplete sensory loss) and G3 ( incomplete motor paralysis And incomplete sensory loss ).The methods of treatment include (conservative, decompression, And open reduction and internal fixation).Results: no deterioration of the neural function occurred in any case .All patients who had full neural Function on admission remained so. The patients who at time of admission was completely paraplegic Or tetraplegic did not show any neural improvement .Internal fixation was done to maintain good alignment of the spine and stabilize the fracture dislocation segment for early mobilization and rehabilitation no significant improvement in the neural status has occurred in patients with complete motor and sensory loss below the level of the injury at time of admission. The value of decompression of the spinal Canal may improve neurologic recovery or rate of recovery in some patients with an incomplete deficit.Conclusion: clinical awareness is the most important diagnostic point. Other associated injuries which frequently co-exist should not be forgotten. Adequate radiological examination must be done.MRI is very helpful especially in incomplete spinal cord injury. Conservative treatment consists of immobilization. Laminectomy was performed for patients who have incomplete neural deficit. Internal fixation Performed for patients who have fracture dislocation.Key word: closed spinal injury, conservative, surgery.


Article
SURGICAL REVISION OF VENTRICULOPERITONEAL SHUNT IN HYDROCEPHALUS PATIENTS WITH INTRACRANIAL TUMORS

Author: Bassam M Flamerz بسام محمود فلامرز
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2012 Volume: 10 Issue: 2 Pages: 173 -182
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background: Patients with intracranial tumors are predis¬posed to persistent hydrocephalus, often requiring a per-manent CSF diversion procedure with shunts.Objective: This study reviews the long-term experience with ventriculoperitonealshunts for the management of hydrocephalus in patients with intracranial tumors.Methods: Patients with intracranial tumors who underwent ventriculoperitoneal shunt placement for hydrocephalus from January 1999 to January 2009 were included in this study from four neurosurgical centers in Baghdad/Iraq. During the 10-year period, medical charts, operative reports, imaging studies, and clinical follow- up evaluations were reviewed and analyzed retro¬spectively for all patients. A total of 187 intracranial tumor patients with hydrocephalus were included. The median follow up was 391 days. Malignant tumors were present in 40% of the patients.Results: Overall shunt failure was 27.8%. Single shunt revision occurred in 13% of the patients and 14% had multiple shunt revision. Tumor histology, age and a procedure prior to shunt placement (ventriculostomy/ Ommaya reservoirs) were significantly associated with the shunt revisions. Shunt system replacement and proximal shunt complication were significantly attributed to multiple shunt revisions. The overall shunt revision within 3 months, 6 months, 1 year and 2 years was 17.7%, 18.7%, 19.8% and 24.1%, respectively.Conclusions: The results of the studydemonstrate that VP shunting is an effective procedure for the man¬agement of hydrocephalus in patients with intracranial tumors. Age, tumor histology, and a procedure prior to shunt placement (ventriculostomy/Ommaya reservoirs) were significantly associated with the shunt revisions.Key words: Brain neoplasm, Cerebrospinal fluid, Surgery, Shunt


Article
Effect of Administration of Crystalloid IV Fluids Preoperatively on Postoperative Pain
تأثير اعطاء محاليل وريدية جزيئية قبل العملية على شدة الألم بعد العملية

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Pain is a sensory and emotional experience that is influenced by physiologic, sensory, affective, cognitive, socio-cultural and behavioral factors. Postoperative pain is the commonest reason for delayed discharge and unanticipated hospital admission after ambulatory surgery. Our Objective is to test the hypothesis that administration of 2 ml/kg/hr preoperative IV fluids may attenuates postoperative pain.The study was carried out in the Baghdad Teaching Hospital, Al-Yarmok Teaching Hospital and Al-Karama Teaching Hospital from 12 May till 17 June 2009. The total number of patients was 120 (35 males and 85 females) with their age ranged between 10-90 years. The patients were divided into two groups according to administration of preoperative IV fluids, group A (65 patients) did not receive IV fluids and group B (55 patients) received IV fluids preoperatively. Regarding group A, the pain scale was ≤ 5 in 15.3% of patients, and it was >5 in 84.7% of patients and these results obtained within 0-5 hours after awaking from anesthesia. Whereas in group B, the pain scale was ≤5 in 29.09% of patients and was >5 in 70.9% of patients. We have demonstrated that the preoperative administration of 2ml/kg/hr IV fluids (crystalloid) to patients who had fasted from fluids decreased the severity of postoperative pain, and the need for postoperative analgesia. We report for the first time that administration of large volume preoperative IV fluids significantly reduce the incidence and severity of pain in patients at high risk for pain.

الألم تجربةُ حسّيةُ وعاطفيةُ التي تُتأثّرُ بالعواملِ السلوكيةِ والثقافيةِ والاجتماعية والإدراكيةِ والعاطفيةِ والحسّيةِ والفسلجيةِ .الألم ما بعد الجراحة المسببُ المشتركُ للإطلاقِ المتأخرِ ودخولِ المستشفى الغير متوقّعِ بعد الجراحةِ المتنقلةِ.هدفنا كان لاختبار الفرضيةِ التي تفيد بأن اعطاء سوائل وريديةِ (بمقدار 2ملكغمساعة) قبل الجراحةِ قَدْ تُخفّفُ ألمَ ما بعد الجراحةَ. الدراسة نُفّذتْ في مستشفى بغداد التعليمي، مستشفى اليرموك التعليمي، ومستشفى الكرامة التعليمي مِنْ 12 حتى 17 يونيو/حزيرانِ 2009. العدد الكليّ للمرضى كَان 120 (35 ذكر و85 أنثى) بأعمار تَراوحتْ بين 10-90 سَنَة. المرضى قُسّموا إلى مجموعتين المجموعةِ الف (65 مريض) لَمْ تُستلمْ آي محاليل وريدية والمجموعة باء (55) استلموا سوائل وريدية قبل الجراحة.بخصوص المجموعة الف ، مِقياس الألمَ كَانَ< 5 في 3 . 15 % مِنْ المرضى، وكَانَ> 5 في 84.7 % مِنْ المرضى وهذه النَتائِج تم الحصول عليها خلال 0 -5 ساعات بعد الصَحوة مِنْ التخديرِ بينما في المجموعة باء ، مِقياس الألمَ كَانَ< 5 في 29.09 % مِنْ المرضى وكَانَ> 5 في 70.9 % مِنْ مرضى بَيّنَّا بأنَّ تقديم سوائل وريدية بكميات كبيرة ما قبل الجراحة للمرضى الذين عانوا من نقص بالسوائل قد قلل من شدَّةَ الألمِ ما بعد الجراحةِ، والحاجة لمسكنات الألم ما بعد الجراحةِ.نَذْكرُ للمرة الأولى بأنّ تقديم سوائل وريديةِ (بمقدار 2ملكغمساعة) ما قبل الجراحةِ تُخفّضُ بشكل ملحوظ حدوث الألم وشدَّةَ الألمِ في المرضى المعرضين للخطرِ العاليِ للألمِ.


Article
Single Stage Surgery for Treatment of Congenital Vertical Talus in Children 1 – 4 Years old

Authors: Issam H. Ali --- Mohammed H. Salal --- Ahmad Shakir Qaddori
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: supplement Pages: 658-667
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: Congenital vertical talus is an uncommon foot deformity that is present at birth and results in a rigid flatfoot deformity if left untreated and is more commonly associated with other neuromuscular conditions which have more rigid deformity and less favorable outcome. OBJECTIVE: To find the extent of radiological and clinical improvements after using a single stage surgical treatment for children aged 1 to 4 years having congenital vertical talus. METHOD: Single stage surgery was performed on 15 patients (19 feet) with congenital vertical talus starting from October 2008 to September 2010; all the patients were evaluated clinically and radiologicaly by measuring talocalcaneal and tibiocalcaneal angles, and categorized into 2 age groups for sake of treatment selection. Patients younger than 2 years were treated by soft tissue release, tendon lengthening and k-wire fixation of talonavicular joint, while in patients aged 2 years to 3 years and 6 months of age we added a tibialis anterior transfer to the surgery. Postoperatively the cases were evaluated in a way similar to that used prior to surgery. Analytic studies were performed, comparing the postoperative scores to those scores prior to surgery. RESULTS: Clinical improvements by increasing of the mean of clinical score from (12.79) preoperatively to (18.50) on last follow up evaluation and radiological improvements after single stage surgery showed by highly significant decrease in mean of lateral talocalcaneal angles with difference of (14.53°) and the highly significant decrease in mean of lateral tibiocalcaneal angles with difference of (35.06°). CONCLUSION: Single stage surgical treatment is very useful for treatment of congenital vertical talus in children 1 – 4 years old and can help to avoid the need for two-stage surgical correction and excisional surgeries.


Article
Effects of Hypothermia on Renal Functions for Patients undergo Coronary Artery Bypass Graft Surgery

Authors: Khalid M. Sabri --- Hakema S. Hassan
Journal: nursing national Iraqi specility المجلة العراقية الوطنية للعلوم التمريضية ISSN: 18122388 Year: 2012 Volume: 25 Issue: 2 Pages: 51-61
Publisher: Baghdad University جامعة بغداد

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Abstract

Objective: To determine the effectiveness of hypothermia on renal functions for patients undergoing coronary artery bypass graft CABG surgery.Methodology: A purposive (non-probability) sample of (50) patients undergoing Isolated coronary artery bypass graft surgery consecutively admitted to the surgical ward, and they were followed up in the intraoperative, Intensive Care Unit (ICU) and in the postoperative (surgical ward). Post-operative renal function test (glumeruler filteration rate (GFR) by using the Crockroft-Gault formula and serum creatinine level) was determined first week post operative and post operative renal function was classified on the base of peak of the serum creatinine level and decline of glomeruler filteration rate(GFR) as following : normal renal function serum creatinine concentration and decline in(GFR) less than 25% from preoperative, moderate renal dysfunction increase serum creatinine concentration and decline in(GFR) 25%-50% from preoperative, sever renal dysfunction increase serum creatinine concentration and decline in(GFR) more than 50% from preoperative test.Results: results of this study show that (78%) from the sample develop post operative renal dysfunction and the highly percentage of them are male (50%), advance age 60-70 (60%), smoking (47.0%), diabetes mellitus DM (68%), cardiopulmonary bypass 180 and more (57.20%), New York Heart Association calcification NYHA class III(47.5%) and patient without Intra Aortic Balloon Pump IABP(50,0%) . We conclude from the study that highly percentage of patient undergoing isolated CABG may develop postoperative renal dysfunction even when using hypothermic strategy as a protective measure and the patients with DM, male, advance age, smoker, prolong time of CPB (more than 180 minutes), NYHA class III and patient without IABP are considered as patient at high risk to develop postoperative renal dysfunction. Recommendations: The researcher recommended that to find addition strategy rather than hypothermia to protect renal function especially with the high risk patients during isolated CABG surgery.

الهدف: التعرف على تأثير انخفاض حرارة المرضى على وظائف الكلية للمرضى الخاضعين لعملية زرع الشرايين القلبية.المنهجية: اختيرت عينة غرضيه (غير احتمالية) تكونت من (50 مريضا) من مرضى عملية زرع الشرايين التاجية والذين ادخلوا بالتتابع إلى ردهة الجراحة القلبية وتم متابعة المرضى في صالة العمليات وفي وحدة العناية المركزة وفي ردهة الجراحة القلبية بعد عملية زرع الشرايين التاجية. تم تحديد تحاليل وظائف الكلية في الأسبوع الأول بعد العملية (نسبة ترشيح كبيبات الكليتين بالاعتماد على معادلة Crockroft-Gault مستوى الكرياتنين في الدم) و صنفت وظائف الكلية بعد العملية استنادا إلى قمة مستوى الكرياتنين في الدم والهبوط بنسبة ترشيح كبيبات الكليتين كالآتي: وظائف كلية طبيعية ( أي زيادة مستوى الكرياتنين في الدم وهبوط نسبة ترشيح كبيبات الكليتين اقل من 25% من قبل العملية, عجز كلوي متوسط بزيادة مستوى الكرياتنين في الدم وهبوط نسبة ترشيح كبيبات الكليتين أكثر من 25% إلى 50% من قبل العملية, عجز كلوي شديد بزيادة مستوى الكرياتنين في الدم وهبوط نسبة ترشيح كبيبات الكليتين أكثر من 50% من قبل العملية.النتائـج: أظهرت الدراسة (78%) من العينة تطور لديهم عجز كلوي بعد العملية، النسبة العالية منهم كانت: من الذكور(50%), التقدم في العمر60-70 سنة(60%), التدخين(47%), مرضى السكري(%68), وقت ماكينة القلب والرئة الصناعي أكثر من 180دقيقة(57%), الفئة الثالثة من تصنيف جمعية القلب الأمريكية في نيويورك لمرض القلب (47.5%) و عدم استخدام مضخة المنفاخ داخل الابهر (50%).نستنتج من الدراسة بأن المرضى الخاضعين لجراحة زرع الشرايين التاجية قد تتطور لديهم عجز الكلية بعد العملية حتى مع استخدام إستراتيجية خفض حرارة المريض كوسيلة حماية وان مرضى السكري, المرضى الذكور, التقدم في العمر, التدخين, وقت ماكينة القلب والرئة الصناعي أكثر من 180 دقيقة, الصنف الثالث من تصنيف جمعية القلب الأمريكية في نيويورك لمرض القلب و عدم استخدام مضخة المنفاخ داخل الابهر تعتبر عوامل خطورة رئيسية للعجز الكلوي بعد العملية.التوصيـات: أوصى الباحث بإيجاد إستراتيجية إضافية بالإضافة لخفض الحرارة لحماية الكلية خاصة مع المرضى ذوي الخطورة العالية للإصابة بالعجز الكلوي بعد عملية زرع الشرايين التاجية.


Article
Management of Pediatric Facial Trauma by Pyriform Suspension
المعالجة الجراحية لكسور عظام الوجه عند الأطفال

Author: Tahrir N. N. Aldelaimi تحرير نزال الدليمي
Journal: Al- Anbar Medical Journal مجلة الأنبار الطبية ISSN: PISSN: 27066207 / EISSN: 26643154 Year: 2012 Volume: Vol.10 Issue: 1 Pages: 8-12
Publisher: University of Anbar جامعة الانبار

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Abstract

Background: Surgical treatment of pediatric maxillofacial region is a complex and challenging task to maxillofacial surgeons. Incorrect and inappropriate treatment of trauma will end with secondary deformity that is very difficult to correct.Objectives: This study discusses types of pediatric maxillofacial injuries and evaluates the management of child patients with injuries to the maxillofacial region using pyriform suspension in Anbar Province, Iraq.Materials & Methods: Twenty-eight child patients with maxillofacial trauma were seen at Maxillofacial Surgery Department at Ramadi Teaching Hospital during the period from December 2009 till November 2010; including 21(75%) boys and 7(25%) girls. Age, sex, etiology, associated injuries, pattern of fractures and treatments were reviewed. Results: Road traffic accident was the most common cause for pediatric facial trauma, mandibular trauma was found in 13 children while Midfacial trauma was found in 15 children.Conclusions: Significant advances have been made in the management of these injuries, decreasing the incidence of secondary deformities.

خلفية البحث: التداخل الجراحي في منطقة الوجه والفكين عند الأطفال هو عملية معقدة وتمثل تحدي كبير للجراحين, والمعالجة الغير سليمة تؤدي الى مضاعفات ومشاكل من الصحب معالجتها في المستقبل.الغرض من البحث: مناقشة إصابات الوجه والفكين عن الأطفال وتقديم المعالجة الجراحية لهم باستخدام طريقة التعليق بالأسلاك المعدنية.طرق البحث: تمت المعالجة الجراحية لــ 28 مريضا" يعانون من إصابات في منطقة الوجه والفكين في شعبة جراحة الوجه والفكين في مستشفى الرمادي التعليمي.النتائج : وجد ان حوادث الطرق من السيارات والدرجات النارية تمثل نسبة عالية من أسباب الإصابة عن الأطفال وان نسبة إصابة الفك الأسفل كانت 13 مريض بينما نسبة إصابة عظام الوجه والفك الأعلى كانت 15 مريضا".الاستنتاجات: تطور كبير وملحوظ تم الحصول عليه من خلال التداخل الجراحي لإصابات الوجه الفكين عند الأطفال باستخدام طريقة التعليق باستعمال الأسلاك المعدنية.


Article
Solar Surgery Optical System Design
تصميمٌ منظومه بصريهٌ للجراحه الشمسيهٌ

Authors: Shaima'a Riyadh Tahhan شيماء رياض الطحان --- Munqith S. Dawood منقذ سليمٌ داود
Journal: AL-NAHRAIN JOURNAL FOR ENGINEERING SCIENCES مجلة النهرين للعلوم الهندسية ISSN: 25219154 / eISSN 25219162 Year: 2012 Volume: 15 Issue: 2 Pages: 245-252
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

The sunlight is suggested to be used in solar surgery as an alternative to the laser surgery. The rays of powerful sunlight are collected, concentrated and transported to the operating theatre from outside through a system of optical fibers in order to use this solar energy in tumor and cancer cell evaporation instead of lasers. The idea of solar surgery is still new and need more practical and design enhancements. This study is a step on this way. A Schmidt Cassegrainien arrangement is suggested for this optical solar system design calculations. It consists of a parabolic dish to concentrate the solar radiation on a secondary flat mirror which directs the light into a fused silica optical fiber cable used to carry the concentrated solar beam from the concentrating system to the operation room.The parabolic reflector dish rim half angle was chosen to be 45o to realize high flux and high efficiency.MATLAB program (version 7.00) has been used to calculate the diameter of the primary parabolic dish, the diameter of the secondary flat mirror and its recession from the fiber tips by two design procedures. The first procedure of these calculations is based on starting with the choice of the optical fiber diameter, while the second design procedure is based on the choosing first the distal end diameter of the optical fiber.The calculations of the second procedure showed more practical results. As the most often used fiber distal diameter in surgery is 0.6mm, then according to calculations the diameter of the primary parabolic dish reflector will be 180mm with a focal length of 108.64mm. The small secondary mirror is perfectly flat of 10.5mm in diameter and its recession from the fiber tip is 5.27mm.Another MATLAB program has been written to find the suitable numerical aperture for the optical fiber of the concentrator system to reach maximum efficiency of the system. It was found to be 0.7 theoretically. The nearest available value of NA for fused silica fiber was 0.66. Fused silica optical fiber of 1mm for core diameter was chosen because of its ability to withstand the high degree of temperature. It is found that this optical system could deliver a flux density as high as 73Wmm-2 for contact surgery and 32Wmm-2 for noncontact surgery.

يمٌكن استخدام ضوء الشمس ف الجراحه الشمسيهٌ كاختياٌر اخر بدلا من الجراحه الليزٌريهٌ وذلك بتجميعٌ الطاقه الكبيرٌه في الاشعه الشمسيهٌ وتركيزٌها ونقلها خلال الالياٌف البصريهٌ من الخارج الى داخل صاله العملياٌت لاجل استخدامها فًي عملياٌت استئصال الاورام و تبخيرٌالخلاياٌ السرطانيهٌ بدلا من الليزٌر.أستخدمت طر يقٌه شميتٌ كاساغرينٌ في تصميمٌ هذه المنظومه البصريهٌ للاشعه الشمسيهٌ التي تتكون من الصحن ذو المقطع الدائري الذي يجٌمع الاشعه ويسٌقطها على مراة مستويهٌ لتوجهها الى مدخل ليفٌ بصري مصنوع من السليكٌاالمنصهره لتوصيلٌ هذه الطاقه الشمسيهٌ المركزه الى داخل صاله العملياٌت ,وتم اختياٌر زاويهٌ حافه الصحن لتكون بقيمٌه 54 درجه للحصول على افضل كفائه واعلى طاقه اشعه.استخدمت ف البحث طر قٌت نٌ للتصم مٌ نفذتا على برنامج المصفوفات نوع 0077 لاجراء حسابات قطر الصحن ذوالمقطعالدائري وقطر المراة المستو هٌ الثانو هٌ والمسافه المناسبه ب نٌها وب نٌ مدخل الل فٌ البصري.اما الطر قٌه الاولىفتستند الى اجراء حسابات التصم مٌ ابتداء من اخت اٌر قطر الل فٌ البصري ف ح نٌ ان حسابات الطر قٌه الثان هٌ تبداءمن اخت اٌر القطر المناسب لطرف الل فٌ من الجهه البع دٌه ألت تخرج منها الاشعه وقد اثبتت الحسابات ان هذه الطر قٌهتعط نتائج عمل هٌ افضل من الطر قٌه الاولى .اظهرت حسابات التصم مٌ ف هذه الحاله ان قطر صحن المقطع الدائري جٌب ان كٌون 087 مللمتر وببعد بؤريق مٌته 07801 مللمتر وكذلك حددت قطر المراة المستو هٌ بمقدار 0704 مللمتر وبعدها عن الل فٌ البصري 40.0مللمتر.وللحصول على اعظم كفائه لهذه المنظومه الشمس هٌ تم اعداد برنامج اخر لاجل حساب افضل فتحه عدد هٌ لل فٌالبصري فتم تحد دٌها بق مٌه 700 للحصول على افضل كفائه لهذه المنظومه ولكن بما ان اقرب فتحه عدد هٌ متوفره عمل اٌلهذا الل فٌ ه 7011 لذلك تم اخت اٌرها ه وقطر الل فٌ البالغ 0 مللمتر لهذا التصم مٌ لضمان تحمل الحراره العال هٌجراء نقل طاقه شمس هٌ بهذه المنظومه تصل كثافتها الى 07 واط/مللمتر مربعف حاله الجراحه بالاتصال المباشروكثافه . 7 واط/مللمتر مربع ف حاله الجراحه بالاتصال غ رٌ المباشر.

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