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).
One of the most important phenomena facing the athlete is the anxiety of sports competition, as he faces many psychological problems during training and in competitions of psychological tension, fear and anxiety that accompany him sometimes, which leads to affecting his level, and sports competition anxiety is a special type of anxiety that occurs in the athlete It is related to the attitudes of sports competitions and that participation in sports competitions and the associated emotional experiences are among the important factors that motivate the practice of sports activity and try to advance and develop his sports level. It is assumed that when the individual begins to practice any activity, he aims to reach a level or degree of achie
... Show MoreIt is known that energy subiect has ocuppied a lot of scientests minds about
how to treat the traditional energy and the renewing energy . we know that
most traditional energy coal , oil , Natural gas, neuclear fuel , are limited
guantiy and alsow subjected to be ended .Statics studies refer to reserve
of oil in world will exhausted btween ( 2075- 2100) and alsow cosl too .
While neuclear fuerl which the world seek today through explod the uranium
atom ( 233) the therum atom (239) and neuclear mxied through ruemlear
mixing , These energy have effect on environment and humanity speciaty if
they are used in militery purposes .
For all theses scientests srarch for resources of renewing enery through
researches
This study aimed at some of the criteria used to determine the form of the river basins, and exposed the need to modify some of its limitations. In which, the generalization of the elongation and roundness ratio coefficient criterion was modified, which was set in a range between (0-1). This range goes beyond determining the form of the basin, which gives it an elongated or rounded feature, and the ratio has been modified by making it more detailed and accurate in giving the basin a specific form, not only a general characteristic. So, we reached a standard for each of the basins' forms regarding the results of the elongation and circularity ratios. Thus, circular is (1-0.8), and square is (between 0.8-0.6), the blade or oval form is (0.6-0
... Show MoreThe aim of the research is to evaluate the response of the researched leaders towards practicing the concept of the lens, which is its dimensions with (stakeholders, resource mobilization, knowledge development, culture management) and the nature of its relationship to tax pioneer performance represented in its dimensions (strategic direction, leadership indicators, growth, renewal and modernization, efficiency, Effectiveness) The questionnaire was approved as a main tool in collecting data and information from the sample members in the General Authority of Taxes, which number (91) Who are on (M. General Manager, Division Director, Deputy Director, Senior Division Director, Deputy Director, Second Division, Division Officer, M. D
... Show MoreI dealt with this study of one of the hadiths of the Prophet and judged him after studying his deed, especially one of his narrations for the similarity in his name and the name of his father (Abdul Rahman bin Ishaq) Is he a civil "Sadok" or Wasti "weak" and they are in one layer which is called in the science of Hadith (agreed And after a review of Kutkut translations and wound and amendment and other evidence and evidence that it was "weak" and not as he went to him and asserted by the updated Muhammad Nasser al-Din al-Albani may God have mercy on him that in Sindh is a civil rule for the hadeeth "Hassan" and not as said The hadeeth is “weak” because he showed that it is the weak Wasti.
I ask God to be successful in this work an
Abstract
The decision maker needs to understand the strategic environment to be addressed through different means and methods. It is obvious that there is a difference between the three strategic environments (conflict environment, peace environment, post- peace environment) in terms of inputs and strategies to deal with each one of them. There is an urgent need to understand each pattern separately, analyze its inputs, and identify the factors and variables that affect the continuity of this situation (conflict, peace, post-peace). It is not appropriate to identify treatment without diagnosis of the condition, so it is very important to understand the type of strategic environment to be dealt with it.
... Show MoreThis research aims to show the nature of the impact of proactive and analytical strategic orientation in the dimensions of tax organizational excellence (leadership, strategic planning, information and analysis and knowledge management, focus on taxpayers, focus on operations, focus on workforce, business results), in the General Tax Authority The questionnaire was used as a tool to collect data and information from the sample of (110) who are (Associate Director General, Head of Department, Under-Head of First Division, Under-Head of Second Section, Division Officer). Arithmetic mean, intestinal deviation the research has reached a number of conclusions, the most prominent of which are: -
- There is an effect of
Sultan Said bin Sultan bin Ahmed bin Said Al-Busaidi (1223-1273 AH / 1806-1856 AD) was able to rule Oman and Zanzibar in a unified Arab-African state during his reign. However, it was separated for several reasons. Thus, the study aims to clarify the efforts made by Sultan Said for annexing Zanzibar to Oman, establishing the Arab-African Sultanate, and shedding light on the role played by Britain in dividing the Arab-African Sultanate and separating Zanzibar from the Omani rule in (1275 AH-1861 AD). The study has adopted the historical descriptive analytical approach. The study has reached several conclusions, such as: The economic motivators were the most important factors that pushed Sultan Said to move his capital from Muscat to
... Show MoreAbstract
The aim of the research is to identify the level of awareness and emotional experience among university students and to identify the effect of the educational program based on (Guttmann) model for developing awareness and emotional experience among university students by verifying the validity of the following zero hypotheses: 1) There are no statistically significant differences in the development of awareness and emotional experience among university students at the level of (0.05) between the mean scores of the experimental group in the pre and post-tests. 2) There are no statistically significant differences in the development of awareness and emotional experience among university students at the lev
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