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.
One of the artificial lightweight aggregates with a wide range of applications is Lightweight Expanded Clay Aggregate. Clay is utilized in the production of light aggregates. Using leftover clay from significant infrastructure development projects to manufacture lightweight aggregates has a favorable environmental impact. This research examines the expanded clay aggregate production process and the impact of processing parameters on its physical and mechanical qualities. It also looks at secondary components that can be used to improve the qualities of concrete with expanded clay aggregates. The effect of the quantity of expanded clay aggregate on the fresh, hardened, and durability qualities of concrete is also studied.
... Show MoreMefenamic acid was esterified with starchwith[1:1] Molar ratio, as drug substituted with natural polymer, to prolongthe period of hydrolysis of drug polymer with other advantages. The new prodrug starch was characterized by FT-IR and UV-Visible and 1H-NMR spectroscopies. The physical properties were studied and controlled drug release was studied in different pH values at 37oC. The stability of drug was carried out by measuring the absorbance of mefenamic starch which hydrolyzed in HCl solution of pH 1.1 (artificial gastric fluid) and phosphate buffer of pH 7.4 (simulating intestinal fluid SIF) at 37oC for several days. The thermal analysis such as DSC was studied.
Physicians are infrequently selected to serve in the yearlong role of Jefferson Science Fellow (JSF) as senior science advisor for the US Department of State or the United States Agency for International Development. The authors discuss the role of a JSF in promoting “science diplomacy” from the perspective of one alumnus, who sites examples of ongoing, long-term collaborative projects including one focusing on medical education reform in Iraq that would not have been possible without the JSF program. More than 3 decades of political and social unrest, terrorism, the internal displacement of millions of Iraqi citizens, the arrival of Syrian refugees, international sanctions, and the effect of fluctuating oil prices that fund education i
... Show MoreOne of the management accounting tools is responsible accounting. In this system, the organisation is divided into responsibility centres that help to connect an individual performance responsible to perform through a combined system of reports according to the implementation of the mechanism of exception tools which gives assistance in planning. The exploitation of the organisation's available resources is achieved through the application of responsible accounting. Also, the best exploitation will lead to the provision of low-cost products through the disposal of all types of waste or loss during the cost centres. By providing products at a lower cost and satisfying the wishes of the needs of customers, the result reflects the competitive
... Show MoreIn this study, the behavior of square helical piles models (5×5) mm2 embedded in expansive soil bed overlaying a layer of sandy soil was investigated. The sand layer 200mm thickness was compacted into four sub layers in a steel container with diameter 400mm in size. Sandy soil layer was compacted into two relative densities 40% and 80%. The bed of ثءحties 40% and 80%.The bed of o00mm in size.Sandy soil layer was compacted into two relative densities 40% and 80%.The bed of oexpansive soil 300mm thickness was compacted into six sub layers on sandy soil layer. Model tests are performed with helical pile length 350mm, 400mm and 450mm and with helix diameter 15mm and 20mm. Also, one helix and double helix were
... Show MoreThe study aims to identify the neurological perfectionism of talented girls with disabilities and do a case study for one of these girls. The sample of the study consisted of (11) female students at the university level, 5 females with disability and (6) normal female-students. The sample also included (19) secondary school female students in Tabuk region, including 10 students with visual disability and (9) normal students. The case study was limited to one case of mentally superior girls (talented) with kinetic disability. The researcher adopted the descriptive methodology (case study), he used neurological perfectionism scale, Salah Mekhemar interview, Stanford interfacial intelligence scale fifth picture, case study form. The re
... Show MoreIn light of what constitutes the cultural factor from a great importance in the context of the incorporation of an active and participant civil society in the process of democracy- building and the achievement of political development, this article tries to look at the concept of the political culture and the civil society with the stand on the nature of existing relationship between them in its theoretical part, then the move to dissection of the civil society crisis in Algeria under the prevalent cultural values for understanding the relationship between the two variables in its empirical part, as a step towards the detection on the pivoting of democratic values in activating the political participation and attainment the democratic co
... Show MoreTheatrical art, from (Plato) to (Heidegger), passing through (Husserl) and (Husserl) has propagated the parallel relations between the overlapping formal patterns in the world of hypotheses crowded with diaspora and scattering, leading to the manifestations of implicit meaning in the intellectual and aesthetic discourse, through the deconstructive pattern that restructures The aesthetic image according to the aesthetic data to be employed, so the effectiveness of the deconstructive system had an important role in authorizing the Ghanaian logic and continuity on which the Western meta meaning was based, and the artistic scene was subjected to it in line with literature and art to be able to pay attention to the achievement and clarify it
... Show MoreBackground: Insulin resistance is present in 50% or more of patients with primary hypothyroidism. Metformin can decrease TSH levels in these patients by a complex matter, this can be of great help in clinical practice.
Objective: This study was designed to evaluate the effect of metformin in reducing TSH levels in patients with primary hypothyroidism.
Methods: Hundred patients with primary hypothyroidism, 82 females, 18 males were included in this study, everyone was followed up for two months after adding metformin 850 mg twice daily in addition to thyroxin.
Results: 36 patients (36%) have a normal baseline TSH and no change after 2 months, 64 pa
... Show MoreReduction has been linked visually in art since man began making functional and aesthetic forms, and this beginning can be identified with cave paintings. Reduction is one of the clearest indications of intellectual presence in aesthetic experience. Modernism was greatly supported by the great transformations that the intellectual movement witnessed in the world in general and in Europe in particular. There, and their transfer of European artistic experiences, and the reflection of this influence in their aesthetic sculptures, and for this reason the researchers find that the study of the aesthetic references of the reductive forms in the Iraqi sculptural experience represents a great importance in the study of the history of contemporar
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