فهرست مطالب somayeh souri

Pilonidal sinus of the sacrum is a relatively common chronic infectious disease. Surgical management of pilonidal sinus is a challenging matter, and despite the different surgical techniques, the recurrence rate is still high.

This double-blind clinical trial study was conducted on 60 patients with pilonidal sinus (2023). These patients underwent surgery randomly and based on the available sampling method in three

open, semi-closure, and primary closure. Recovery time and intraoperative bleeding were recorded. The McGill Pain Questionnaire was used to evaluate postoperative pain, and the Southampton scale was employed to assess infection and secretions.

The recovery time was longer in the open method than in the closure and semi-closure methods (P=0.001). However, this difference did not exist between the closure and semi-closure methods (P=0.402). There were two cases of recurrence in the closed method, while no recurrence was observed in the open and semi-closure methods. The patients undergoing the closure surgical method experienced less bleeding postoperatively (P=0.002). No significant relationship was found between surgical method and infection (P=0.189). There was no significant difference in the intensity of pain experienced by patients after the operation (P=0.789).

For the treatment of pilonidal sinus, primary surgical closure is not recommended due to recurrences, despite the shorter recovery time and less bleeding. The semi-closure surgical method seems to be safer than the open and primary closure methods.

By considering the complexities of seaborne carriage of crude oil on the one hand and the traditional restrictions of voyage charter parties from the other, this Article tends to study the effects and the number of contractual flexibilities of under-investigation standard forms of agreements on the charterers’ legal obligations in crude oil voyage charters. Investigation of mostly used standard forms of charter party agreements including BPVOY4, SHELLVOY6 and ExxonMobil VOY2005 indicates that charterer obligations in those agreements, in the light of high bargaining power of voyage crude oil charterers due to the reasons such as high price of crude oil in comparison with other cargos and even in comparison with  price of tanker itself and the strategic nature of crude oil in contrast with other cargos, has taken distance from its traditional strict framework and has found remarkable flexibilities.

In spite of 60 years of past experience، Agricultural extension in Iran still faces problems، obstacles and limitations. Researchers believe that during these years، the service available to farmers has been neither successful nor satisfactory. With respect to the presently available problems and limitations، a thorough identification and analysis of these issues is necessary as well as inevitable to improve the existing situation. Therefore، this study is aimed at an identification of and priority given to the problems and limitations in Extension Education Activities from the viewpoints of Agricultural extension Specialists of the Ministry of Agricultural Jihad and as well from the view points of Extension Specialists in Qom Province. A survey research was conducted applying a questionnaire. Reliability of the questionnaire was approved by experts while its validity confirmed through Cronbach alpha coefficient test the coefficient being found out as 0. 92. Out of all the extension experts and staff of the Department of Agriculture، 117 individuals were chosen through Stratified Random Sampling، using Morgan & Kerjcie Table. Finally، 111 questionnaires were collected and analyzed. Results show that according to priority، the most important problems and obstacles which limit educational-extensional activities could be listed as follows: problems related to the researches (as the current researches do not match every day problems and needs of farmers)، problems related to human resource management (lack of proper motivation and accountability on the part of extension personnel)، administrative problems (legal discrimination against extension personnel as compared with the staff engaged in some other sections)، problems related to human resource educational development (as educational programs in agricultural colleges do not match today''s needs)، executive problems (budget deficiency)، social problems (daily migration of rural youth to urban areas) as well as physical problems (scattered farm lands). The results also indicate that there is a positive relationship between educational، extensional as well as communicative capabilities، and experts'' points of view. A comparison of the viewpoints of different experts (according to their fields of study) shows a meaningful difference between extension graduates، the graduates of other agriculturally related fields vs. those of other disciplines.