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.
Abstract
This Study aimed to investigate the reality of the application of the degree of management practice by Walking Around, namely (discovery of facts, improvement of communication, motivation, development, creativity and feedback) and Its role in achieving organizational justice (procedural justice, distributive justice, Interactional Justice),The availability of the core principles of this system from the point of view of the senior management personnel in the Directorate of Anbar Education, and the importance of research in the philosophical rooting of the nature of the variables as a modern administrative terminology, the research dealt with a problem expressed by a number of intellectual and appl
... Show MoreThe research aims to show the relationship between the use of automated accounting systems technology and its impact on enhancing the efficiency and effectiveness of the internal control system in a sample of Bahraini universities in light of the rapid changes in the electronic business environment. Automated accounting and its impact on enhancing the efficiency and effectiveness of the internal control system, and it is concluded through the analytical study of the research sample that there is a percenta
... Show MoreThroughout this paper we study the properties of the composition operator
C
p1 o
p2 o…o
pn induced by the composition of finite numbers of special
automorphisms of U,
pi (z) i
i
p z
1 p z
Such that pi U, i 1, 2, …, n, and discuss the relation between the product of
finite numbers of automorphic composition operators on Hardy space H2 and some
classes of operators.
The semiconductor ZnO is one of II – VI compound group, it is prepare as thin films by using chemical spray pyrolysis technique; the films are deposited onto glass substrate at 450 °C by using aqueous zinc chloride as a spray solution of molar concentration 0.1 M/L. Sample of the prepared film is irradiating by Gamma ray using CS 137, other sample is annealed at 550°C. The structure of the irradiated and annealed films are analyzed with X-ray diffraction, the results show that the films are polycrystalline in nature with preferred (002) orientation. The general morphology of ZnO films are imaged by using the Atomic Force Microscope (AFM), it constructed from nanostructure with dimensions in order of 77 nm.
The optical properties o
المقدمة
تتعامل الجهات الضريبية في مختلف دول العالم بأساليب عديدة لجباية الضرائب من المكلفين بغض النظر عن فئات وأصناف هؤلاء المكلفين،وفي العراق تم اعتماد العديد من الأساليب لجباية الضرائب على امتداد المدد الزمنية المتعاقبة،وكان لأسلوب التقدير الذاتي وهو أحد تلك الأساليب مجالاً للتطبيق خلال مدة زمنية معينة،حيث جرى تطبيق هذا الأسلوب على وحدات اقتصادية معينة، وبالرغم من المساوئ التي قد ترافق تطبيق
... Show MoreThe study aims to identify the mechanical and electrical activities of the heart according to the energy systems of advanced players and to detect the differences between the energy systems in terms of the mechanical and electrical activities of the heart for advanced players. It was clear from the results of the significance of the differences between the three groups according to the energy systems of the advanced players in all research variables that (the non-oxygenic system "Lactic"), which represents the advanced players in the arches (800 m, 1500 m) was the first in most tests of mechanical and electrical activities of the heart, which is (Margaria-Kalamen, Wingate, systolic muscle strength of the heart FC, Stroke Volume SV
... Show MoreIn this paper, the dynamics of scavenger species predation of both susceptible and infected prey at different rates with prey refuge is mathematically proposed and studied. It is supposed that the disease was spread by direct contact between susceptible prey with infected prey described by Holling type-II infection function. The existence, uniqueness, and boundedness of the solution are investigated. The stability constraints of all equilibrium points are determined. In addition to establishing some sufficient conditions for global stability of them by using suitable Lyapunov functions. Finally, these theoretical results are shown and verified with numerical simulations.