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.
Praise be to God, Lord of the Worlds, and prayers and peace be upon the Master of Messengers, and upon his family and companions
And whoever follows his guidance until the Day of Judgment. As for what follows: Islamic law commands Muslims to unite, reject disagreement, and not dispute, and to spread the spirit of tolerance and love among them. God Almighty said: “And hold fast to the rope of God all of you and do not become divided, and remember the favor of God upon you when you are enemies and He has joined your hearts.” So, by His grace, you became brothers (1), and He said: (And You will be like those who became divided and disagreed after the clear proofs had come to them. It is they - for them is a great punishment.) (2
... Show MoreBegging is an ancient social phenomenon since the Man's creation. It was simple at its beginning to get a living and the family needed, but presently, this simple social phenomenon converted to a big phenomenon which controlled by competent groups away from the values and principles. Their doings are far from humanity representing by the cutting of a hand or a foot and facial distortion or removed eye as a way of attracting people's emotions to get material and incorporeal helps; these doings became a trade which is exchanged by slave traders. Furthermore, different illegal and greedy methods were followed as a way of blackmailing others; contrariwise other cases of begging are doing by a people who real poor and needy. In this case, the
... Show MoreThe current research aims to analyze the extent of the adoption of the standards of ISO 45001: 2018 for occupational safety and health management by the General Establishment of Civil Aviation. The research problem was the extent to which the General Establishment of Civil Aviation approved ISO 45001: 2018 for occupational safety and health management. The questionnaire was used as a primary data collection tool, the sample was distributed (50) form, they were selected from the category of employees of the establishment at different levels to represent the research community. Data were analyzed using the statistical package (SPSS), a number of vector statistical methods were used as well as arithmetic mean, standard deviation, an
... Show MoreThe research aims to determine the effectiveness of auditing in light of the relationship between the governance of investment policy and the cost of debt in companies listed on the Iraqi Stock Exchange. The problem of the research is to raise the question about the effect of the governance of investment policy and the cost of debt on the effectiveness of auditing and auditors. During the research, the most important of them were: the existence of an impact relationship on the effectiveness of auditing through the relationship between the governance of investment policy and the cost of debt. The companies listed in the Iraqi Stock Exchange lack an effective proposed guide or framework dealing with the governance of investment policy desp
... Show MoreThe earthly music has a clear influence on the religious music in the musical culture to read and recite the Holy Quran in the city of Baghdad. This research deals with this subject in an attempt to reveal the influence of the Iraqi maqam in the recitation of Hafiz Khalil Ismail. The methodological framework of the research included the problem of research and its importance as it is useful to the Iraqi schools concerned with the recitation of the Holy Quran in Iraq. The theoretical framework included three sections that serve the literature of its subject: the first is (Iraqi maqam), the second is (the recitation of the Holy Quran) and the third is (the biography of Hafez Khalil Ismail).
The most important procedures
... Show MoreAbstract
Heritage represents the center around which poets revolve around and take advantage of its inexhaustible specific, and the connotations that this heritage holds of various values, values and ideas, and the poet Bashar bin Bard from prominent poets who were inspired by that heritage and the culture of the first Abbasid era and whoever and others was worthy of studying and tracking his potentials and capabilities Creativity is based on the inspiration of the legacy of his predecessors, and the development of this legacy and renewal in it. The research methodology required its division into two topics, the first topic, a description of the beauty of women, a description of wine, while the second topic is a description
... Show MoreGalway Kinnell (1927-) is considered as one of the most important contemporary American poets who brought about a drastic change in the American poetry of the nineteen sixties. Kinnell's poetry is characterized by being simple in style and deep in content. Poetry for him is a means through which he perceives the inner levels of consciousness in an attempt to comprehend the depths of the American self. Therefore, he writes narrative poems in which the emphasis is not on the rhetorical effects, but on the inner transformations through which the poet goes.
"The Bear" (1968) is typical of Kinnell's introspective poetry. It takes the form of a journey in which the rituals of hunting are used allegorically to embody the state of the sp
... Show MoreThere are certain dates in the history of nations that have their effects on them ,and the 25th of January 2011 is considered one of them in the history of the state of Egypt .Since this date Egypt has passed through many events that led to changes in the political life and its actors . New rolls has arisen for actors that didn't take part in the political life before so clearly ,like the military establishment which started to practice more prominent political roll, till it became the most important actor in the political life of Egypt .This establishment tried to institutionalize its roll through constitutional means ,considering that controlling the authority is the only alternative to safeguard the state which we are trying to study
... Show MoreThis research attempts to evaluate the role of the information system by highlighting its importance in providing date and information to the tax administration the process of tax accounting for those who are subject to income tax whether they are individuals or companies where the effective information system provides accurate and reliable information in a timely manner.
At the theoretical part of the research, the research approaches the problem of the research represented in that whether the information system, applied in the General Commission for Taxes, is capable of achieving its role in reducing the phenomenon of tax evasion. The existence of a set of things which in the Commission may lead to increase tax evasion by taxpa
... Show MoreSince the law is the tool for implementing the state’s public policies, it is natural that its provisions (or at least some of them) seek to preserve human dignity as the source on which all rights and freedoms are based. One of the examples of humanizing the provisions of the law in France is what is known as the winter truce. What is this truce, what are the justifications for granting it, what is its historical origin, how did the legislative treatment of it develop, what are the similarities and differences between it and other legal periods included in French law, what is the scope of its application, and what are the effects resulting from it. These questions and others are what we will try to answer through this research.