Background: five clinical phases were described in patients with chronic (HBV) infection: HBeAg- positive HBV infection, HBeAg- positive chronic HB, HBeAg negative HBV infection, HBeAg-negative CHB and occult HBV infection. Aim: This study aimed to determine the incidence of the unclassified phase (gray zone) in chronic hepatitis B patients and its significant in the clinical practice. Patients and methods: The study was conducted retrospectively on 109 patients' who have HBsAg positive for more than 6 months. The data recorded include; HbeAg and anti-HBe Ab, ultrasound of the abdomen, HBV DNA load and alanine aminotransferase (ALT), accordingly; we classify the patients to known clinical phases. Patients who were unfit one of these phases considered to be in the gray zone and subsequently sent for liver fibroscan to determine the fibrosis stage. Results: The mean age of our patients was 34.25 (±13.93) years with 54.12% being males. The mean viral load was 5,885,490 IU/ml and mean ALT was 56.22 (±89.88) U/L. eight patients (7.3%) were in the HBeAg+ve HBV infection, 13 patients (11.9%) were in HBeAg+ve CHB . Thirty four patients (31.1%) were in the HBeAg-ve HBV infection and 23 (21.1%) were in HBeAg-ve CHB phase, both were showed a higher occurrence with age> 35 years. Thirty one (28.4%) further patients failed to identify with any of the four phases (normal ALT with HBV load > 2000 IU/ml), this group also showed significant relation to age above 35 years and 12 patients (38.8%) had significant fibrosis on fibroscan. Conclusions: A considerable number of patients with chronic HBV infection have persistently normal ALT levels, despite elevated levels of viral load; this is known as the "grey zone" phase. These patients merit close follow up with short-interval measurement of liver enzymes, liver fibroscan and biopsy may be considered.
This paper aims at the fact that most organizations today suffer from a waste of time, effort, and cost, and they have difficulty in achieving the best performance situations and compete strongly. The researcher distributed 108 questionnaires as a statistical analyzable sample society where the sample intentionally consists of general managers, department head, and division head. The questionnaire was formulated according to the Likert scale. The use of personal interviews and observations are additional tools for data collection and a number of statistical methods is used for data analysis such as simple regression and correlation coefficient (Pearson). One of the most prominent conclusions is that the company has adequate and c
... Show MoreThe present paper applies Fanon Psychological reading of the problem of the Black introduced in his book Black Skin White Mask to Crooks, The black Character in John Steinbeck’s Of Mice and Men. The analysis of this character infers three essential points regarding the artistic achievement of the author. First, he uses a fictional character that offers a psychological interpretation of the black problem of alienation and loneliness in a way that does not disgrace the black. Second, he applies Fanon’s way of showing the various attitudes that the black adopts in contact with the white society. Third, he affirms that the black inferiority complex comes as a result of double proc
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This research aims to identify the availability of the elements of the concept of citizenship, to identify the distribution ratios of the outputs of the musical skills curriculum at the levels of educational goals associated with the elements of the concept of citizenship in the guides of teachers of musical skills for grades (12-1) in the Sultanate of Oman. A content analysis card was designed to include the teacher’s guides of musical skills for grades (12-1), which included the outputs, according to the grades with the identification of the elements of citizenship (identity, belonging, rights, participation). The results of the research revealed that the percentage of inclusion of citizenship values
... Show MoreThe research aims to identify the effect of using the strategy of Roundhouse on the achievement of fourth-grade students of computer and their Attitudes towards it. The research sample consisted of (61) fourth-grade secondary school students distributed into the experimental group consisted of (31) students study computer according to the Roundhouse strategy, and the control group consisted of (30) students follow the traditional method. The researcher designed an achievement test consisting of (30) items of multiple choice. To measure the attitudes of students towards the computer, a questionnaire of (32) paragraphs with three alternatives was designed by the researcher. The results showed that there is a statistically significant diffe
... Show MoreThe Research aims to determine role of The Intellectual capital in the performance of small and medium enterprises , to achieve this goal through a researcher from the theoretical literature and studies related to the construction of the scheme shows the hypothetical relationship between the variables, which was adopted by the independent variable intellectual capital, distributed four variable are:( human capital, structure capital ,customer capital, innovation capital) as well as four variable (the financial perspective, the customer perspective, process perspective ,the learning & growth perspective) The study were getting to many results as bellow :the intellectual capital in the small and intermediate p
... Show MoreThe research gained its importance from the importance of technical reserves in the insurance activity and its impact on the result of the activity of insurance companies and their financial position and thus reflected on the insurance prices as the technical reserves are one of the most important and most valuable budget items usually, as well as that the insurance activity has a role in maintaining economic development where some countries develop laws and instructions for the formation of those reserves binding application to insurance companies and the fact that the financial statements in general are of interest to shareholders, banks, the General Tax Authority and other beneficiaries In the insurance activity as policyholders and t
... Show MoreThe wide use of pesticides in recent years leads to rapid distribution of these pollutants in the environment (air, water and soil).They were transported by means of air or water to biological ecosystems. They become more toxic through the processes of biological magnification while some of them persist for along period.The aim of this work is to show the negative effect that chemical pesticides causes, and in the same to show their side effect on the environment and health in Iraq. We could conclude that the bad use of these chemicals could cause an urgent impact now or in the future. Governmental offices dealing with these materials should take the right measures to minimize the danger and the misuse of these chemicals by seeking alternat
... Show MoreBackground: Waterpipe and cigarette are two products of tobacco consumption, tobacco use has detrimental effects on the oral cavity, numerous studies around the world have reported a significant relationship between smoking and increase dental caries and viable count of cariogenic bacteria, Materials and Methods: unstimulated saliva was collected from 84 subjects and divided equally into three groups waterpipe smokers, cigarette smokers, and non-smokers all of the participants are adult male aged between 25-60 years, dental caries was measured by use DMFT index, while S.mutans and S.sobrinus were isolated by using a selective medium SB 20M (Sugar bacitracin-20 modified) agar Results: this present study showed a significant (p≤0.01)
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