No abstract

Background: Tonsillectomy is one of the most common operations performed in otolaryngology departments, various techniques used for this purpose including dissection method and powered instrumentation like electrocautery, harmonic scalpel, radiofrequency techniques, laser technique and coblation technique.Objective: This study aimed to compare the intraoperative time, intraoperative bleeding and post. Operative pain among patients underwent harmonic and cold steel dissection techniques. Patients and Method: This was prospective randomized study p erformed in AL-Hilla Teaching Hospital. It included fifty patients scheduled for tonsillectomy for chronic tonsillitis from July 2016 to October 2017. Harmonic tonsillectomy (HT) was done on right side and traditional tonsillectomy on left side by same surgical team. Results: Patients reported significantly less intraoperative bleeding (HT mean was 4.8 ml, while CDT mean was 64.7), less operative time (HT mean was 4.76 min., while CDT mean was 10.1 min) and less postoperative pain (from 0,3,7 and 14 postoperative days HT means pain score were 1.68, 3.6, 1.64 and 0.65 respectively and CDT means pain score were 5.8, 4.5, 2.4 and 0.78 respectively) on the harmonic scalpel tonsillectomy side compared with the Cold steel dissection tonsillectomy side. In the day 11 to 14 pain difference disappeared and reached plateau phase. There was no post tonsillectomy bleeding among the 50 patients. Conclusions: Harmonic scalpel tonsillectomy reduces discomfort, intraoperative hemorrhage, and postoperative morbidity. Harmonic scalpel tonsillectomy is effective, although the handpiece is disposable.

The purpose of this paper is to explore the concept of supply chain partnering practiced in Industrialised Building System. The relationship was based on the elements of trust, share a vision, decision-making and continuous improvement. The methodology adopted used quantitative and qualitative approach. Outcomes of the results, the public clients point out on the element of trust in between contractors were based effectiveness of communication. Meanwhile, the private client indicates competence of work as a successful element of trust in supply chain partnering in Industrialised Building System.