ObjectivesHarmonic Scalpel (HS) and Maxium (MAX) are surgical shears that enable simultaneous vessel sealing and tissue coagulation. This study compares the outcome of Total Thyroidectomy (TT) using Conventional Suture Ligation (CSL) technique versus (vs) two sutureless techniques; H S and MAX techniques in terms of safety, operative time, blood drainage volume, hospital stay and surgical complications.Study designThis is a prospective observational cohort study.SettingThis study was performed in AL-Karama Teaching Hospital/College of Medicine/University of Wasit/Iraq.Patients and methodsThis study was performed from June 2012 to 2015. A total of 80 patients, 60 patients were females and 20 patients were males (average/mean of age was 39/38 years). They underwent TT after been randomized into the following three groups: CSL group when Suture Ligation Technique was used, HS group when Harmonic Scalpel was used and MAX group when bipolar electrosurgery Maxium was used.ResultsThe postoperative evaluation of operative time, blood drainage volume and surgical complications revealed no statistically significant differences between HS group & MAX group, but there were statistically significant differences between CSL group vs. HS and MAX groups. Operative time statistics showed significant differences between CSL vs. HS and MAX groups, 113 ± 10.9 minutes (min), 93 ± 13 min and 92 ± 10.6 min respectively, p-value < 0.001 and 95% confidence interval [CI] (92.3712, 101.6288). The postoperative blood drainage volumes were significantly different between the three groups: CSL group = 150 ± 12.7 ml, HS group = 89 ± 16.21 ml and MAX group = 118 ± 9.6 ml, P-value = 0.046 and 95% [CI] (89.9932, 99.6068).ConclusionsHS and MAX are safe, effective, and time-saving techniques. They are also associated with low blood loss and low complication rates. HS and MAX are good alternative techniques to CSL for thyroid surgery.

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IntroductionPatients that are complaining from tinnitus but have normal hearing comprise an uncommon group and there is rare literature about them. Deficiency in B-complex vitamins has been shown to result in tinnitus and supplementation may improve the symptom which means manipulation of cochlear status. Distortion Product Otoacoustic emissions (DPOAEs) used frequently to assess cochlear status.ObjectivesThe uses of DPOAE changing amplitude as a parameter to estimate effect of vitamin B complex on changing the severity of tinnitus in patients with tinnitus only in comparison to patients have tinnitus with Sensory Neural Hearing Loss (SNHL) and a control group.MethodsProspective observational cohort study was performed in AL-Karama Teaching Hospital as a secondary medical care center, from 01/01/2012 to 31/12/2016. A three groups had been evaluated clinically and by OAE device (ECHOLAB) to study the DPOAE changing amplitude before and after one month of supplementation of B-complex vitamins to 25 patients in study group (1) have (tinnitus only) and also to 25 patients in study group (2) have (Tinnitus + SNHL) but leaving control group who were a 25 medical staff (No Tinnitus and nor SNHL) without treatment.ResultsIt has been found that among Study group 1 (patients had Tinnitus only), Study group 2 (patients had Tinnitus + SNHL) and the control group: 16 patients (44%), P-value = 0.000 HS; 28 patients (78%) P-value = 0.000 HS; and 0% respectively, they had low Amplitude of DPOAE recorded by OAE device (ECHOLAB). After one month from treatment with Neurobine ampules for study group 1& 2 but not control group (whom receive no treatment), those who got clinical improvement + increase Amplitude of DPOAE (i.e. subjective + objective changes) after treatment were 10 patients (28%) P-value = 0.000 HS in study group1, and two patients (5%) P-value 0.321 NS in study group 2, and there was no changes (zero) among control group.ConclusionsThe uses of DPOAE changing amplitude could be used as a parameter to estimate effect of vitamin B complex on changing the severity of Tinnitus in patients with tinnitus only or those have Tinnitus with SNHL. The supplementation of vitamin B complex could improve the tinnitus severity especially in patients with tinnitus without SNHL.

Background: Noise Induced Hearing Loss (NIHL) is used to symbolize accumulative and persistent hearing loss due to progressive exposure to high levels of noise for months or year. Design: A cross-sectional study. Setting: Al-Karama Teaching Hospital and Wasit Co. Textile Industries. Aims and objective: To specify frequency of hearing loss among workers in the knitting industry, to registration the level of the noise in the weaving department and to specify the realization about the impact of noise on the hearing. Materials and methods: From June to August 2011, the level of noise in the weaving department has been recorded. 200 workers had been sent to our hospital, interviewed according to already prepared questioner and audio logically assessed. Results and discussion: The mean level of noise at 12measurement points was 87-96dB. Which was greater than the allowable noise level for continuous 8 hours working per day? It has been established that 113 workers had NIHL, 29% of hearing loss (the greater percentage) was in the mild category (26-40dB) at high frequency (4-6KHz) group and the minimal NIHL notch within 2 kHz and 4KHz were 6% and 22% from the workers respectively. The hearing difficulty was not the most common complaints 29.4%, while ear discomfort was 55.4% and tinnitus was 43%, because NIHL usually include the high frequencies at first hence the worker can promote the NIHL and he didn't complain from loss of hearing. No one used the personal noise protective devices (PPD) and only 44 workers (24%) (P-value≤ 0.1) who considers that the noise is a hazard on health. Conclusion: Wasit Co. Textile Industries Noise measurement is greater than the allowable noise scale for 8 hours. NIHL can be developed many years before worker will complain from hearing loss.

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