Background: Avascular necrosis (AVN) is defined as cellular death of bone components due to interruption of the blood supply; the bone structures then collapse, resulting in bone destruction, pain, and loss of joint function. AVN is associated with numerous conditions and usually involves the epiphysis of long bones, such as the femoral head. In clinical practice, AVN is most commonly encountered in the hip. Early diagnosis and appropriate intervention can delay the need for joint replacement. However, most patients present late in the disease course. Without treatment, the process is almost always progressive, leading to joint destruction within 5 years.Treatment of a vascular necrosis depends mainly on early diagnosis which mainly based on clinical findings, x-ray finding & MRI.A variety of non vascularized bone grafting techniques have been proposed with varying degrees of success as treatment alternatives for osteonecrosis of the femoral head. The success of these procedures may be enhanced using ancillary growth and differentiation factors. Objectives: To treat non traumatic hip osteonecrosis by non vascularized bone graft versus core decompression. Type of the study: A retrospective study. Methods: We retrospectively reviewed 72 patients (88 hips) with osteonecrosis of the femoral head between May 2009, and March 2014,divided into two groups . Group A include 34 patients (44 hips) with osteonecrosis of the femoral head who had non vascularized bone grafting procedures done for them . Minimum follow-up was 12 months. We compared the outcomes in this cohort to similar hip number (44 hips) in 40 patients treated with core decompression only (group B). We used Phemister technique to make a window at the posterior aspect of greater trochanter to remove necrotic bone and packed the excavated area with autogenous cancellous bone graft taken from ipsilateral iliac crest or leave it without bone graft (decompression only). Results: We report the result of treatment for femoral head avascular necrosis depending on Ficat classification stage I, II, & III. The minimum follow up was 12 months (12m-36m). The success percentage of hips in our cohort of patients with non vascularized bone grafting group A are 86% (38 of 44 hips), which is higher than group B 63% (28 of 44 hips) with core decompression alone. Conclusions: These procedures core decompression and autogenous cancellous bone graft may defer joint arthroplasty in selected patients & it is more effective than core decompression alone in treating early stages of femoral head osteonecrosis.
Groupwise non-rigid image alignment is a difficult non-linear optimization problem involving many parameters and often large datasets. Previous methods have explored various metrics and optimization strategies. Good results have been previously achieved with simple metrics, requiring complex optimization, often with many unintuitive parameters that require careful tuning for each dataset. In this chapter, the problem is restructured to use a simpler, iterative optimization algorithm, with very few free parameters. The warps are refined using an iterative Levenberg-Marquardt minimization to the mean, based on updating the locations of a small number of points and incorporating a stiffness constraint. This optimization approach is eff
... Show MorePrednisolone (SAID) was conjugated with ibuprofen (NSAID) through an amino acid (glycine) as a spacer arm to synthesize the following compound:
Prednisolone – glycine – ibuprofen.
The method employed consists of converting the carboxylic acid function of (R,S) – ibuprofen – glycine to the highly reactive acid chloride and subsequent reaction with the C21 hydroxyl group of prednisolone. This reactive intermediate was found to react as well with the C17 tertiary hydroxyl group of the steroid to form three compounds and eight diastereomers. These results were confirmed by T.L.C, and the desired compound was separated by column chromatograph
... Show MoreThe temperature influence on the fluorescence lifetime, quantum yields and non-radiative rate parameter or coumarin 460 dye dissolved in methanol was investigated in the temperature range (160-300 k). A single photon counting technique was used or measuring the fluorescence decay curves. A noticeable decrease of the fluorescence lifetime with increasing the temperature was observed. The non-radiative activation energy of 10.57 K.J. mole-1 was measured by the help of Arrhenius plot.
This paper analyzes a piled-raft foundation on non-homogeneous soils with variable layer depth percentages. The present work aims to perform a three-dimensional finite element analysis of a piled-raft foundation subjected to vertical load using the PLAXIS 3D software. Parametric analysis was carried out to determine the effect of soil type and initial layer thickness. The parametric study showed that increasing the relative density from 30 % to 80 % of the upper sand layer and the thickness of the first layer has led to an increase in the ultimate load and a decrease in the settlement of piled raft foundations for the cases of sand over weak soil. In clay over weak soil, the ultimate load of the piled raft foundation w
... Show MorePurpose: In view of the trend toward using international financial reporting standards when generating financial statements, we looked at the interaction between audit services and non-audit services for auditors in the context of actuarial services for insurance firms. CPAs are authorized to work in banks and insurance businesses, but those with a practicing license obtained after earning a higher academic degree are not. Design/methodology/approach: A small number of auditing firms control the decisions issued by the Iraqi Accountants Association, monopolizing audit services in banks and insurance businesses. In the case of actuarial services used in reserve estimation, they are credited to an external party's account withou
... Show MoreFrom a group of 60 patients with dentoalveolar infections among which 10 were diabetic and 10 non-diabetic were elected as test group as well as 10 normal subjects as control group. Six Staphylococcus aureus and Streptococcus anginousus were diagnosed in the first and second group of the patients the immune status of the patients and control subject were tested by pathogen specific antibody titre, neotrophil NBT reduction phagocytosis and leukocyte inhibition LIF. Diabetic patients with dentoalveolar infection shows decreased specific antibody titers, subnormal neutrophil NBT phagocytic % as well as non significant LIF % in comparison non diabetic reveal high specific antibody titers against , high neutrophil NBT% and significant LIF% re
... Show MoreThe Behavioral Disorders of Primary School pupils the son of Alcohol and Non Alcoholic
This paper considers and proposes new estimators that depend on the sample and on prior information in the case that they either are equally or are not equally important in the model. The prior information is described as linear stochastic restrictions. We study the properties and the performances of these estimators compared to other common estimators using the mean squared error as a criterion for the goodness of fit. A numerical example and a simulation study are proposed to explain the performance of the estimators.
Knowledge of literature is an integral part of learning any spoken language. Learning literature expands the learner’s ability to understand the language studied. The field of literature is wide and cannot be limited to poems. It includes the etiquettes of a language and its environment, customs, and traditions etc. The Arabic language is among the languages with a centuries old history. It has achieved remarkable record accomplishments since the pre-Islamic era through to the present. This development is clear evidence of the great importance of literature in the revival of the Arabic language through different eras. As such, in Malaysia and other non-Arabic speaking countries, literature is taught in most schools, institutions and un
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