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.
Meditationsuggetsthat the theatrical world and the receiptindicatethattherie a thread connection or relationshipbetweenthembecausetheateris an art thatfailsinto the abyss of the humanfield ,receivingis a practice thatisreffered to by corners of society and islocated in the context of thisfield. Thus, the relationshipbetweenalgeriantheater and the recepientissanctified by the nature of theaterwhichisbased on a social basis thatbuildsitsexistance and continuityfrom the recepient.Its impossible to imagine a real theaterthatwillbeestablishedunlessit’sassociatedwith an audience so one hand never claps to makesound. This connectionis the first phenomenonthatcanbecome accessible to all people and itremains the second phenomenonthatrequires th
... Show MoreThis research discusses one of the most important means of reducing corruption in public sector companies and government departments, a relationship of cooperation and coordination between the external auditor and internal auditor, in the light of ISA (610), the recommendations of the International Organization of Supreme Audit Institutions (INTOSAI) and the National Strategy to combat corruption. The research was based on two assumptions: the first was weak relationship of cooperation and coordination between the external auditor and internal auditor leads to weakne
... Show MoreThe aim of this research is to identify the impact of the effectiveness of digital transformation technology in improving the efficiency of the insurance service in the public insurance companies in Iraq through digital transformation technology in the insurance process "promotion of the insurance product, submission of insurance application, underwriting, settlement of losses" and to achieve this goal a questionnaire was designed A survey distributed in the surveyed community Which represents the decision makers in the researched companies under study, and one of the most important results of the research was the existence of a relationship between digital transformation and improving the efficiency of the insurance process, whether thr
... Show MoreCurrent research sought to evaluate the performance and results of employees in accordance with normative to people and people result for the European model of excellence EFQM 2013 quality management Foundation in the Inspector General's Office/Ministry of health, so as to pursue a modern and advanced management methods in evaluating performance and the performance of the Office's relationship with a citizen's life, since it takes him beyond the accepted service capabilities today, but it became budget duties between dealers servicing responsibilities and future planning, financial control, competitiveness, human resources needs and maintaining quality and continuous improvement and development as well as The primary role of the
... Show MoreBreast cancer has got much attention in the recent years as it is a one of the complex diseases that can threaten people lives. It can be determined from the levels of secreted proteins in the blood. In this project, we developed a method of finding a threshold to classify the probability of being affected by it in a population based on the levels of the related proteins in relatively small case-control samples. We applied our method to simulated and real data. The results showed that the method we used was accurate in estimating the probability of being diseased in both simulation and real data. Moreover, we were able to calculate the sensitivity and specificity under the null hypothesis of our research question of being diseased o
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Current research has sought to apply the criteria of potential for altmizalaorbi model EFQM 2013 in assessing the performance of the Inspector General's Office/Ministry of health, so as to keep up with a modern and advanced management methods in the evaluation of performance, as well as to link performance to a citizen's life, and it takes him beyond the accepted service capabilities today, but of budget duties between dealers servicing responsibilities and future planning, financial control, competitiveness, human resources needs and maintaining quality and development, as well as the constant quest for continuous improvement, is the spirit of the principle underpinning the European Foundation Quality managemen
... Show MoreThis research aims to examine the ability of impact of the cash flow statement indicators in the change in the market value of the industrial firms listed on the Palestine Stock Exchange. The research population consisted of (13) firms during the period (2015-2020). Data were collected from the annual financial statements of the firms. The research relies on the Pooled effects model to analyze the cross-section data (Panel Data), and the multiple regression method to test the hypotheses. The research finds a positive significant impact of (the ratios of cash flows from operating activities to sales, the return on assets from operating cash flows, and cash flows from operating activities to total current liabilities) in the change
... Show MoreThe aim of the research is to shed light on the dimensions of the strategic lens and its impact on achieving the pioneer tax performance and represented by the dimensions (strategic direction, growth, pilot indicator, renewal and modernization, efficiency and effectiveness) in the General Tax Authority. The questionnaire was adopted as a tool to collect data and information from the adult sample They are (91) who are on the site (Assistant Director General, Head of Division, First Division Deputy, Second Division Deputy, Division Officer, Division Officer Associate) The statistical program (SPSS) has been used to calculate (the mean, the standard deviation, the correlation coefficient, the difference coefficient, the F test, the
... Show MoreThis research is concerned with studying (the concept of freedom in the texts of Yaşar Kamal the play), as the Turkish playwright (Kamal Yasar) is one of the contemporary playwrights who have been interested in and criticize society, and perhaps the concept of freedom in his texts took a different form, through his ability to renew and present his attempts to create A theatrical form different from his earlier writers in dealing with the life of the peasants and the oppression that went through them, as the researcher identified the problem of his research with the following question: What is the concept of freedom in the texts of Yashar Kamal? The research aims to define the concept of freedom in the texts of Yashar Kamal of the play,
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