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 technology and modern social communication medias have contributed to changing many of our concepts about education to a large extent; these technological advancements have created new challenges for the Instructor of course, but on the other hand it did provided him with expressive media, models and strategies that the old methods cannot fulfill, including the flipped classroom strategy, which is one of the modern technical solutions and in it's optimal use it can correct the weakness of the traditional education and can develop the communication skills as a whole among the students, in order to create a positive, active and interactive student.
The current research contained - four chapters: the first one included the methodolog
The study aims to identify the impact of competency-based training in its dimensions (skills, cognitive abilities, attitudes, and attitudes) in improving the performance of employees (achievement, strategic thinking and problem solving) in Jordanian university hospitals.
The study based on analytical descriptive method. The study population consisted of the Jordanian University Hospitals, the University Hospital of Jordan and the King Abdullah Hospital, as applied study case. The sample of the study consists of all upper and middle administrative employees of these hospitals; questionnaire distributed all of them and the number of valid questionnaires for analysis were 182 questionnaire.
... Show MoreThe treasury bills one internal government debt instruments in iraq that were used to finance temporary deficits in the government budget, There fore the government resorted to issuing for the purpose of providing liquidity, As well as to invest in productive progects, After that it was financing the budget deficit by the monetary authovity of the central baalpennek [the new cash velease] which led to negative effects on the Iraqi econome, Thus we find that the treasury transfers have formed alarge proportion of the gross domestic government debt to finance the deficit ayear ago 2003. &nbs
... Show MoreThe aim of the research is to indicate the degree of arrangement of the tax branches discussed and the level of efficiency of their performance according to the dimensions approved in the tax diagnostic tool (TADAT). The checklist has been approved as a main tool in collecting data and information from the tax branches of the General Authority for Taxes and the number (8) branches represented by (Karrada , Karakh Center, Al-Rusafa, New Baghdad, Al-Dora, Karakh Al-Tafim, Al-Kadhimiya, Al-Bayaa), The statistical program (spss) was used to calculate the weighted arithmetic media, and we reached the research to a number of conclusions, the most important of which were: - Each of the subsections (Karkh Al-Ahram and Karrada) achieved an
... Show MoreThe aim of this research is to measure and analyze the gap between the actual reality and the requirements of the environmental management system in the middle refineries company/refinery cycle according to ISO14001: 2015, as well as to measure the availability of a clean production strategy and test the relationship and impact between the availability of the requirements of the standard and a clean production strategy for the actual reality in the company.
The research problem was determined by the extent to which the requirements of the environmental management system are applied according to ISO14001: 2015 in the middle refineries company? To what extent are the required clean production strategies ava
... Show MoreThis research seeks to clarify the regulatory and educational role of the regulatory and educational institutions in reducing the phenomenon of financial and administrative corruption as a dangerous phenomenon of the communities, as it touched search kinds of financial and administrative corruption and the causes and effects, as well as to the role of educational institutions in reducing this phenomenon, and finally between experiments some SAIs and accounting Arab and foreign countries on how to reduce the phenomenon of financial and administrative corruption.The research aims to several targets which shed light on the role of educational and supervisory institutions in reducing corruption, a statement origins and evolution of and justi
... Show MorePersonality regard as one of the human soul pillars that has been built throughout the life of people, starting from the fertilizing process to different stages of people ages. Over time, numerous scientific studies have shown that fetus has the ability to hear and feel and he is being stereotyped since the first stages of formation. Accordingly, the process of forming human personality set up since that date. Besides, the socialization means that take different resources to enhance human personality such as holy Quran, school, social media, and social environment. The emergence of social media made the world as a small village which gives the chance for all people, over the world, to obtain the knowledge easily and limitless. Thus, the
... Show MoreThe article considers metaphors as one of the fundamental means used by L. Ulitskaya when writing the family chronicle "Medea and her Children" (1996), for the formation of images of heroines - representatives of the pronounced feminine principle in the work. Here I describe the results of the next stage of research related to the work of Lyudmila Evgenievna Ulitskaya as a representative of modern Russian prose.
In spite of the contemporary development over the world in pertaining of modernization and its differences about the transformation of the knowledge but, the important instrument to transfer the thoughts and information did not have change except the language. So the evolutionary process became as a torrent or fusillade above the cliff which drifted anything. So that the objective inquiry and impressed with varieties of development the casement to evaluate the linguistic or re - correction highlight article in order to preserve on the origins of the language and its sobriety.
Today, we have different correspondence and social media as
This qualitative study was conducted on eight types of commercial baking yeast which available in local markets to estimate their fermentation activity as affecting the Bread industry and the impact of the salt added to DoughLeavening, The results showed a great variation in the fermentation capacity of yeast samples (their role in swelling the dough), most notably the sample value Y3 and least sample Y7 and reached 80% and 20% respectively, and the value of Leavening by using the two types of yeast with addition of three levels of salt (0 , 1 and 2%) have 20.0 , 19.7 and 15.7 of the sample Y3, compared with 10.5 , 10.3 and 8.8 of the sample Y7 for each of the levels of salt respectively, reflect
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