Objective: To evaluate the functional outcomes after extended curettage and reconstruction using a combination of bone graft and bone cement (sandwich). Methodology: In this prospective case series 16 skeletally mature patients with primary giant cell tumor around the knee were included. Patients with previous surgically treated, malignant transformation, degenerative knee changes and those presenting with pathological fracture were excluded. The tumor was excised with bone graft filling space beneath the articular cartilage and a block of gel foam was placed over the cortical surface of picked bone graft. Remaining cavity was filled with polymethylmethacrylate cement (sandwich) with or without internal fixation. The func tional evaluation was done us ing Musculoskeletal Tumor Society (MSTS) Score six months postoperatively and after one year. Schatzker and Lambert Score was used in the last visit to assess the functional outcome Results: The mean MSTS Score was 27.13±3.030 (range, 20-30) and the mean functional arc of motion around the knee was 123.13±12.230 degrees (range, 90–135). According to Schatzker and Lambert Score 75% had excellent results, 12.5% had good results and 12.5% had fair results. Two patients (12.5%) had a recurrence of the tumor, and one (6.25%) developed postoperative fracture in the distal femur. Conclusion: Sandwich reconstruction for giant cell tumor is a good option for definite management and there is improvement in the quality of the patient's life. (Rawal Med J 202;45:637-640).
The concept of TQM is based on one of the concepts that combine administrative and innovative methods. The aim of the research is to demonstrate the dimensions of TQM in enhancing the satisfaction of the taxpayers through a survey of a sample of officials in the General Authority for Taxation and 50 officials. In the collection of data and information, and the results were analyzed using the SPSS program to find the most important compounds and factors in he method of analysis.
The research problem was represented by the non-application of the General Authority for Taxation to the entrances and modern practices in the administrative work. The results of some of the complications that accompany the tax accounting process, which af
... Show MoreThe study aimed to reveal the extent of the first intermediate grade science curriculum focus on the national values, health, environmental, economic values, in the light of the education policy in the Kingdom of Saudi Arabia, in addition to present a proposed vision to strengthen it in the science curriculum for the first intermediate grade. The study was applied to the two books student and the two books of activity on the first-second semesters for the academic year 1441 AH. To analyze the curriculum content, the study used a verified card prepared by the researchers and a criterion for interpreting percentages. The study reached the following results: environmental values ranked first with a concentration of (43%), i.e. with an avera
... Show MoreAbstract:
Central banks seek to control and supervise credit and follow it up effectively due to the high credit risks surrounding it that may lead to damage to banks, and may even lead to damage to the reputation and confidence of the banking system as a whole.
The main role of supervisory control is to control credit by controlling it from excessive expansion during periods of economic inflation or its revitalization and improvement and expansion of credit transactions in cases of economic recession, or when central banks desire to support the national economy or support a sector of various
... Show MoreThe research aims to know (the effect of the pdeode strategy) in acquiring historical concepts among the fourth-grade literary female students in the history module. To achieve the goal of this research, the following null hypothesis was formulated. There is no statistically significant difference at the level of (0.05) between the average scores of the experimental group students, who study history according to the PDEODE strategy, and the average scores of the control group students who study the same module in the traditional way of the historical concepts acquisition test.The researcher chose the experimental method for the current research and adopted the experimental design of partial control with a post-test, which depends on the
... Show MoreThis research discusses one of the largest and most important issues of a doctrinal and philosophical dimension at the same time, which is the issue of man’s freedom to choose his actions, and thus his responsibility for those actions, by looking at the nature of these acts, their being and the origin of their creation. He showed that they were created in man by force, and that he was their original creator, and that they were among the creatures of the God Almighty God like others, but they are attributed to man through acquisition. So to the first saying went Jahmiyya or Jabariyya, and to the second saying went to fatalism in the past, and the existentialists shared with them in the modern era, and to the third saying went to the Sun
... Show MoreRandom laser gain media is synthesized with different types of dye at the same concentration (1×10-3 M) as an active material and silicon dioxide NPs (silica SiO2) as scatter centers through the Sol-Gel technique. The prepared samples are tested with UV–Vis spectroscopy, Fluorescence Spectroscopy, Field Emission Scanning Electron Microscopy (FESEM), and Energy Dispersive X-ray Diffraction (EDX). The end result demonstrates that doped dyes with silica nanoparticles at a concentration of 0.0016 mol/ml have lower absorbance and higher fluorescence spectra than pure dyes. FESEM scans revealed that the morphology of nanocrystalline silica is clusters of nano-sized spherical particles in the range (25-67) nm. It is con
... Show MoreToday, more than ever before, the business organizations’ initiatives should seek to design themselves and delivery them to the environment because of its change, and the increasing of uncertainties and the growing opportunities. What is required by the business organizations is that to adopt good approaches to stimulate the modern thinking and non traditional thinking and exploit the valued concepts and overcome the old thinking. Substantially, the scenario planning is the art of thinking about what is unexpected.
Therefore the research’s problem is reflected to answer the following questions:
- What
In this study, light elements for 13C , 16O for (α,n) and (n,α) reactions as well as α-particle energy from 2.7 MeV to 3.08 MeV are used as far as the data of reaction cross sections are available. The more recent cross sections data of (α,n) and (n,α) reactions are reproduced in fine steps 0.02 MeV for 16O (n,α) 13C in the specified energy range, as well as cross section (α,n) values were derived from the published data of (n,α) as a function of α-energy in the same fine energy steps by using the principle inverse reactions. This calculation involves only the ground state of 13C , 16O in the reactions 13C (α,n) 16O and 16O (n,α) 13C.