Pressure ulcer (now called Pressure injury) happens when the bony prominence like the sacrum exposes to pressure for a long period and also can cause soft tissue injury. In order to prevent and cure pressure-induced wounds, continuous and attentive repositioning is necessary. Wound management begins with the identification and aggressive management of the modifiable factors, such as positioning, incontinence, spasticity, diet, devices, and medical comorbidity, which contribute to pressure injury formation. Initial interventions include washing, cleaning, and maintaining the surfaces of the wound. In certain cases, it may be sufficient to debride the non-viable or contaminated tissue; however, operational care in more severe cases or to encourage patient satisfaction may be necessary. Our patient is a 50-year-old overweighted man, nonsmoker, and confined to a wheelchair presented with a 20*20*8 stages 4 ulcers in the sacral area after multiple failed bedside debridement. When we use the fasciocutaneous we should consider the depth of the wound and fill dead space. Here we the local situation in Palestine as those patients are usually neglected and their management is restricted to bedside debridement, with no experience in flap reconstruction operations which would dramatically improve patients’ lives. We believe that further awareness is demanded for such procedures.
Warfarin dosing is challenging due to a multitude of factors affecting its pharmacokinetics (PK) and pharmacodynamics (PD). A novel personalised dosing algorithm predicated on a warfarin PK/PD model and incorporating CYP2C9 and VKORC1 genotype information has been developed for children. The present prospective, observational study aimed to compare the model with conventional weight-based dosing. The study involved two groups of children post-cardiac surgery: Group 1 were warfarin naïve, in whom loading and maintenance doses were estimated using the model over a 6-month duration and compared to historical case-matched controls. Group 2 were already established on maintenance therapy a
In this work gold nanoparticles (AuNPs), were prepared. Chemical method (Seed-Growth) was used to prepare it, then doping AuNPs with porous silicon (PS), used silicon wafer p-type to produce (PS) the processes doping achieved by electrochemical etching, the solution etching consist of HF, ethanol and AuNPs suspension, the result UV-visible absorption for AuNPs suspension showed the single peak located at ~(530 – 521) nm that related to SPR, the single peak is confirmed that the NPs present in the suspension is spherical shape and non-aggregated. X-ray diffraction analysis indicated growth AuNPs with PS. compare the PS layer without AuNPs and with AuNPs doped for electrical properties and sensitivity properties we found AuNPs:PS is more
... Show MoreWith a great diversity in the curriculum contemporary monetary and visions, and development that hit the graphic design field, it has become imperative for the workers in the contemporary design research and investigation in accordance with the intellectual treatises and methods of modern criticism, because the work design requires the designer and recipient both know the mechanics of tibographic text analysis in a heavy world of texts and images varied vocabulary and graphics, and designer on before anyone else manages the process of analysis to know what you offer others of shipments visual often of oriented intended from behind, what is meant, in the midst of this world, the curriculum Alsemiae directly overlap with such diverse offer
... Show MoreOver the last few years, the interior designer has been given the ability to access many innovative tools for new forms of unprecedented diversity and efficiency. Some design experts have described the new parametric procedures they are introducing to create new interior projects as a radical transformation that carries all the elements of a qualitative shift in interior design. The best of these parametric procedures is the technical capabilities offered by us to create new forms that are different from what has been discussed in everything that has been produced by designers and architects since modernity and even before it to the present time, which returns our design products through a series of computer programs that perform the pro
... Show MoreInternational law has proven that it is an evolving and flexible law over the years, and despite that, this development takes a very long time, as the concept of peremptory norms took 83 years to crystallize and have concrete and impactful applications, and within this development another modern concept emerged, which is the obligations Erga Omnes in the Barcelona Traction case 1970. We have concluded that these two concepts fall under a broader concept, which is peremptory norms, and this concept represents the common supreme interests of the international community, and consists of rules that transcend all other rules in international law, and it is not permissible to derogate or deviate from them. On the other hand, it bears the oblig
... Show MoreMineral filler is one of important materials and affecting on properties and quality of asphalt mixtures .There are different types of mineral filler depended on cost and quality , the matter encourages us to achieve this study to evaluate hydrated lime filler effects on properties of asphalt mixes related with strength and durability. Conventional asphaltic concrete mixtures with Portland cement and soft sandstone fillers and mixtures modified with hydrated lime were evaluated for their fundamental engineering properties as defined by Marshall properties , index of retained strength , indirect tensile strength , permanent deformation characteristics , and fatigue resistance .A typical dense graded mixture employed in construction
... Show MoreConstruction projects are characterized as projects with multi phases and activities, complex, unique, and have many different parties and stakeholders. Risks could appear at one or more of the construction project stages and may affect the achievement of project objectives. Therefore, one of the key elements in the planning phase of any project is the risk management process (RMP). This study attempts to understand the terminology of risk in general, risk management, and response to risk in particular. This study is mainly a review of thirty-eight studies that have been published between 1997 and 2020 that demonstrate the importance of the crucial phase of risk response from the risk management process and its impact on
... Show MoreI started writing the research because of the linguistic and rhetorical methods in the Holy Quran.
This Sura included in all its verses the plural form such as the word planets graves and seas except the word sky was singular as the name of a genus, and this Sura showed the horrors of the Day of Judgment at the world level Included another science is the science of the interview and also came in the repetition and deletion and other linguistic and rhetorical things and concluded this Sura that the goal of breaking the sky and scattering planets and scatter graves is the human himself.
The Koran is a miracle immortal and science is still drawn from him each according to his specialty.