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: The international community now places significant emphasis on achieving zero carbon emissions, requiring both new researchers and experienced policymakers to prioritise this goal. This article examines the effects of carbon taxes, carbon cap and trade, renewable energy (RE) production and consumption, and economic growth (EG) on carbon emission reduction in the United States, Japan, Canada, and Australia. The study collected secondary data from the World Development Indicators (WDI) secondary source spanning the years 1991 to 2022. The study examines the relationship between variables using the cross-sectionally augmented autoregressive distributed lag (CS-ARDL) approach. The findings indicate that carbon taxes, carbon cap and tr
... Show MoreThe theater can be considered a media that the effectiveness of its tools and the perceptions it produces cannot be abandoned according to patterns or aesthetic artistic trends, and at the same time it carries a large amount of information that can be worked on activating it with conscious directions within the elements of the theatrical performance, and these can be counted The study is an attempt to trace the functioning of the communication and media elements in the structure of the theatrical performance, as the study included: An introduction that defines the research problem and its importance, which crystallized around the following question: Does the media communication through theatrical presentation form its desired effectivene
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This research aims to identify the challenges faced by families of children with intellectual disabilities and to identify the impact of the challenges facing them on the mental health of their children with intellectual disabilities. Based on the following questions: What is the nature of the challenges faced by families of children with disabilities and how do these challenges affect the mental health of their children with intellectual disabilities? The study was conducted on a sample of four families of six children with intellectual disabilities, depending on the degree and type of disability. To achieve the study's objectives, the qualitative approach was used, Because of the importance of accessin
... Show MoreThis research aims to show the nature of the impact of proactive and analytical strategic orientation in the dimensions of tax organizational excellence (leadership, strategic planning, information and analysis and knowledge management, focus on taxpayers, focus on operations, focus on workforce, business results), in the General Tax Authority The questionnaire was used as a tool to collect data and information from the sample of (110) who are (Associate Director General, Head of Department, Under-Head of First Division, Under-Head of Second Section, Division Officer). Arithmetic mean, intestinal deviation the research has reached a number of conclusions, the most prominent of which are: -
- There is an effect of
The reason behind choosing this topic " internal marketing (IM) of human resource management (HRM)" is to highlight the advantages of using IM in the organization framework. The problem of the research paper lies in not paying enough attention to employees genuine needs as they interact with each other in the sake of organization prosper. This research paper can be used as indictor to expose the weaknesses that the organization encounters daily. The current research paper attempts at examining the possibility of developing philosophy of internal marketing of human resources and its most practices, empowering staff, training courses, motivations and recognitions, and within departments communication, in order to reach targeted res
... Show MoreThe research aims to measure the impact of positive and negative fiscal policy shocks on monetary stability in Iraq, which represents monetary stability as an indicator of real and price stability. Fiscal policy shocks are quantitative changes in public spending and public revenue affecting the output and price cycle, and fiscal policy despite the accompanying time gaps, but it remains a policy Influential and has a significant degree of impact on economic growth and development in developing countries. The fiscal policy represents a numerical translation of the economic and social objectives planned in the state's general budget tool consistent with the GDP cycle. The economic and social goals stem from the core of the functions and the ma
... Show MoreFour localities were selected in Euphrates River and Ramadi sewage treatment plant to collect water samples monthly during the period between October 2001 to July 2002 . Total cell count of phytoplankton and its physico- chemical concentrations were determined . The study aimed to demonstrate the effect of Ramadi sewage treatment plant on Euhprates River . It is concluded that the sewage had an dilution effect for the total hardness , total alkalinity , electrical conductivity and salinity of Euphrates River , but it is also caused in the presence of a contaminated area . This was cleared from the depletion of dissolved oxygen and high values of biological oxygen demand with lower valuse of pH in this area . The water of Euphrates
... Show MoreSearch procedures on the treatment research has tended include what cam followers Astaratejaat available to the business organizations to achieve competitive advantage and continued benefits of the form in which the organization can maintain its success in the race competitive and increase production efficiency.
The objectives of the study , the study came with the number of goals and the most important one the knowledge of the relationship and the influence between the variables of the study and review of the latest literature frameworks intellectual and philosophical to the variables of the study and come up with recommendations that could help the organization improve its performance .
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