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.
The duty of care is the essence of the error of negligence under the English legal system, and without it, responsibility for negligence cannot be judged, regardless of the extent of the damage incurred. contained in English law. In view of the importance of proving the existence of the duty of care on the defendant so that it is possible to judge his responsibility for negligence, the need arises to find a general principle to which the defendant is subject in order to decide whether he owes the plaintiff with the duty of care and therefore responsible for the negligence, and this is what we will explain in the research topic the study.
Receipt date:3/13/2021 accepted date:5/26/2021 Publication date:12/31/2021
This work is licensed under a Creative Commons Attribution 4.0 International License.
energy is one of the strategic resources within international politics, and this is through the existing competition between the international powers on it, and the global powers have begun to rely on interest in new areas, such as import, depending on new projects an
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The result showed that all the items are intense, the item of (Students do not know how to use their leisure time) obtained the hi
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... Show MoreA geological model was built for the Sadi reservoir, located at the Halfaya oil field. It is regarded as one of the most significant oilfields in Iraq. The study includes several steps, the most essential of which was importing well logs from six oil wells to the Interactive Petrophysics software for conducting interpretation and analysis to calculate the petrophysical properties such as permeability, porosity, shale volume, water saturation, and NTG and then importing maps and the well tops to the Petrel software to build the 3D-Geological model and to calculate the value of the original oil in place. Three geological surfaces were produced for all Sadi units based on well-top data and the top Sadi structural map. The reservoir has
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... Show MoreGiardia lamblia is the worldwide most common intestinal protozoan parasite. It was indicated that Giardia is the most important agent that causes acute and chronic diarrhea in infants, young children and travelers. The aim was to detect the influence of host HLA alleles on the susceptibility to infection with G. lamblia in a sample of Iraqi patients. A total of (40) patients with giardiasis aged (14-39) years were registered. All of them were symptomatic and (40) healthy individuals matched age and sexes were included as controls. All patients were prepared to stool examination to detect G. lamblia and eliminated other pathogens, as well as human leukocyte antigen (HLA) class II alleles (DRB1) typing. The most common detected alleles in pat
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