Background: Chronic hepatitis B virus (HBV) infection is a common health problem that has a worldwide distribution. Apart from the direct effect of the virus on the liver, there are many extrahepatic manifestations among which the probable effect on bone turnover associated with low bone mineral density (BMD). Objectives: This study aimed to determine the association between treated and untreated chronic HBV infection with BMD. Methods: This is a cross-sectional study which included a total of 48 patients with chronic HBV (28 patients treated with tenofovir-disoproxil-fumarate [TDF] antiviral drug and 20 patients have not yet started treatment). Other age- and sex-matched 30 apparently healthy individuals were recruited to represent the healthy controls. BMD was measured using dual-energy X-ray absorptiometry on the anteroposterior lumbar spine (L1–L4 spine) views, from which T-score was calculated. Liver function tests were also evaluated from serum samples. Results: Treated patients showed a lower T‑score (−0.48 ± 0.72) than either healthy individuals (1.08 ± 0.84) or untreated patients (0.78 ± 0.51), with highly significant differences. In multivariate regression, only disease duration (adjusted odds ratio [OR] = 9.71, 95% confidence interval [CI] = 4.8–16.68) and TDF treatment (adjusted OR = 6.4, 95% CI = 4.18–97.05) were significantly associated with BMD. Conclusions: Prolonged use of TDF in the treatment of HBV infection can significantly reduce BMD. Moreover, BMD can also be inversely affected in long-standing HBV, regardless of treatment regimen.
Abstract
The research problem focuses on studying the interest of the Medical City Department of the Ministry of Health in improving the creative thinking skills of the administrative leadership through parallel & comprehensive thinking according to the of six thinking hats strategy. The research sample consisted of (170) administrative leaders in the upper & middle organizational levels, The questionnaire was used as a main tool for data collection, In addition to the observation & Interview, The research sought to answer the following questions: What is the extent to which the administrative leadership (Tpp & middle) in the organization investigated the concept of the six thinkin
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Performance evaluation is of great importance in all countries of the world, because it has a prominent and effective role in determining the efficiency and effectiveness of the optimal use of available resources, which are rare and important in achieving the desired objectives. With the continued growth of public spending and the limited resources, the State seeks to achieve its objectives through its units with minimal expenditure or deficit, rationality and wastefulness in the spending. In many countries, particularly developing countries, reforms are made in the public sector to achieve that goal through the adoption of IPSAS, which is reflected in the developmen
... Show MoreThis research deals with the poetic image of poets of the eighth century poetic, where they embodied the features of the religious life in which they live, and their impact on the Koranic text in the reflection of the image on their poems, where it becomes clear the ability of the poet at that stage to clarify the aesthetic components of the poetic text; Investigations, singled out the first topic: the analogy, and the second metaphorical picture, and the third: the picture.
The technology and modern social communication medias have contributed to changing many of our concepts about education to a large extent; these technological advancements have created new challenges for the Instructor of course, but on the other hand it did provided him with expressive media, models and strategies that the old methods cannot fulfill, including the flipped classroom strategy, which is one of the modern technical solutions and in it's optimal use it can correct the weakness of the traditional education and can develop the communication skills as a whole among the students, in order to create a positive, active and interactive student.
The current research contained - four chapters: the first one included the methodolog
ABSTRACT
Impkact of Knowledge sharing on organizational innovation Impriscal study in Arabic company .
of Knowledge Management is the main component Knowledge sharing system, it mean the exchange if Knowledge, ideas, and good practice with another individual . Knowledge sharing between persons, then its values can growth .
It is vry important because it can provide us with the contention between virus peoples . the interaction among the people can pass all kind of Knowledge among them. the connection and interaction and interaction enabl
... Show MoreThis paper assesses the impact of changes and fluctuations in bank deposits on the money supply in Iraq. Employing the research constructs an Error Correction Model (ECM) using monthly time series data from 2010 to 2015. The analysis begins with the Phillips-Perron unit root test to ascertain the stationarity of the time series and the Engle and Granger cointegration test to examine the existence of a long-term relationship. Nonparametric regression functions are estimated using two methods: Smoothing Spline and M-smoothing. The results indicate that the M-smoothing approach is the most effective, achieving the shortest adjustment period and the highest adjustment ratio for short-term disturbances, thereby facilitating a return
... Show MoreOccupy public investment spending, a great deal of attention since the thirties of the last century, to play important role in economic and social development process and therefore most of the countries are trying different degree of economic development to the completion of the largest amount of public investment, especially in infrastructure, which is one of the pillars essential to economic development, and in order to maximize utilization of the completion of public investment should focus on achieving efficiency in completion.
The current reality of public projects in Iraq, indicating the absence of several key characteristics that must be provided if these proje
The Coronavirus Disease 2019 (COVID-19) pandemic has caused an unprecedented disruption in medical education and healthcare systems worldwide. The disease can cause life-threatening conditions and it presents challenges for medical education, as instructors must deliver lectures safely, while ensuring the integrity and continuity of the medical education process. It is therefore important to assess the usability of online learning methods, and to determine their feasibility and adequacy for medical students. We aimed to provide an overview of the situation experienced by medical students during the COVID-19 pandemic, and to determine the knowledge, attitudes, and practices of medical students regarding electronic medical education.
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