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 design of components subjected to contact stress as local compressive stress is important in engineering application especially in ball and socket Joining. Two kinds of contact stress are introduced in the ball and socket joint, the first is from normal contact while the other is from sliding contact. Although joining two long links (drive shaft in steering cars) will cause the effect of flexural and tensional buckling stress in hollow columns through the ball and socket ends on the failure condition of the joining mechanism. In this paper the consideration of the combined effect of buckling Load and contact stress on the ball and socket joints have been taken, epically on the stress distribution in the contact area. Different
... Show MoreThe process of coordination and joint cooperation between SAIs and internal auditors in the public sector is considered one of the very important matters in performing efficient audits and are of high quality, especially if this coordination and cooperation is implemented in accordance with international standards, as it leads to avoiding duplication in auditing work. And the distribution of work in a distribution that achieves the objectives of auditing in general and is of general benefit to the economic unit.
The research problem lies in the weakness of the relationship between internal auditing and external auditing as a result of not applying INTOSAI Standard (9150) coordination and joint cooperation
... Show MoreInhibition of T cell derived cytokine production could help suppress osteoclast differentiation in inflammatory skeletal disorders. Bisphosphonates are typically prescribed to prevent inflammatory bone loss but are not tolerated by all patients and are associated with an increased risk of osteonecrosis of the jaw. In light of this other anti-resorptives such as phytoestrogens are being considered. However the effect of phytoestrogens on T cell-induced osteoclast formation is unclear. The effect of genistein and coumestrol on activated T cell-induced osteoclastogenesis and cytokine production was therefore examined. Concentrations of genistein and coumestrol (10−7 M) previously shown to directly inhibit osteoclast formation also suppressed
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The current research aims to identify the level of partnership between school and community agencies to improve secondary school outcomes for students with intellectual disabilities and develop strategies that help enhance community partnerships between schools and agencies. The researcher used the qualitative research approach; he utilized the interviews as a tool for data collection. The sample of research included (12) participants: three female school leaders, three male-school leaders, three female-school supervisors, and three male-school supervisors in schools that have programs for students with intellectual disabilities in Riyadh. The results of the study showed that the level of partnership bet
... Show MoreBackground: As photochemical reaction that can stiffen the cornea, CXL is the only promising method of preventing progression of keratectasia such as KC and secondary ectasia following refractive surgery. The aim of CXL is to stabilize the underlying condition with a small chance of visual improvement. Objective: To show the sequences of changes in visual acuity and topographic outcomes during 1 year post CXL for patients with progressive Keratoconus.Type of the study: Cross sectional studyMethods: CXL procedure was done for 45 eyes with progressive KC. The following parameters had been monitored pre operatively, 1, 3, 6 and 12 months postoperatively: K apex, K2, corneal thickness at thinnest location, anterior and posterior elevation po
... Show MoreBackground: Immediate implant placement in the maxillary anterior region was challenging, especially with the jumping gap and limited primary implant stability. Objective: To assess the autogenous dentin graft biomaterial's ability to improve the esthetic outcomes of an immediately inserted implant. Methods: Twenty patients with non-restorable retained roots in the maxillary non-molar region surrounded by natural sound teeth were included in this study after a complete clinical and radiological examination, including patient health and clinical fitness for the immediate dental implant procedure. A single dental implant was inserted for each patient, and the resulting jump distance was filled with the mineralized dentin graft and co
... Show MoreABSTRACT : Fifteenth isolates of C. sakazakii were obtained from previous studies of the sample (infant formula, cerebrospinal fluid and blood). All isolates C. sakazakii identification based on microscopic, biochemical test and confirmed by 16SrRNA. We studied the movement of all isolates and study adhesion to polystyrene plate, adhesion and invasion to Esophageal adenocarcinoma (SKG-GT-4) for four isolates [Cerebrospinal fluid (CSF5), Bloods (B 1), Dialak (A1c), Novolac Allernova (C1)] and its cytotoxicity. Results showed that all isolates can move after 4 hours of incubation and increased after 8 hours, the isolates moved to different distances strong, medium, and weak. The results showed that the number of C. sakazakii colony adherent t
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