A vascular 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. Patients & Methods: We retrospectively reviewed 37 patients (44 hips) with osteonecrosis of the femoral head between May 2007, and March 2011, divided into two groups. Group A include 17 patients (22 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 (22 hips) in 20 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% (19 of 22 hips), which is higher than group B 63% (14 of 22 hips) with core decompression alone. Conclusion: These procedures (core decompression and autogenous cancellous bone graft) effectively reduce donor site morbidity and may defer joint arthroplasty in selected patients & it is more effective than core decompression alone in treating early stages of femoral head osteonecrosis.
In the last few years, there have been a lot of changes in the economy, society, and the environment. This has led to much competition between companies, directly and indirectly affecting production and marketing processes. Most companies are trying to cut production and manufacturing costs by using modern cost techniques such as product life cycle costing and Continuous Improvement (Kaizen) technology, in the method of measuring production costs or service costs, and the need for internal control to keep an eye on how these technologies are being used and how well they work. And to find out the effect of internal control on the implementation of costing techniques in Iraqi companies, 64 questionnaires were given to people who work in the i
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Some may think that the games, especially the folk games, are just a means of entertainment and fun and children may resort to them to alleviate the tension they are experiencing at home or school, but the truth is that they carry values and meanings that can be invested in education because they contribute to the development of the personality of the child and enhance self- confidence. The objective of the research is to learn how to use folk games to develop children's acting and performance skills in the kindergartens.
The research included a theoretical introduction of three sections: the first section: education through play. The second section: the folk tale and the development of imagination and the
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The purpose of this research highlight the achievement of the effectiveness of small and medium enterprises dimensions and conformable to analyze the relationship between business strategies and human resources management strategies , and launched search of a dilemma thought provoking fundamental questions revolve around the search is the lack of appropriate strategies in these enterprises to help them continuity and permanence in business and markets , as these enterprises lack the human resources management strategies appropriate , as well as business strategies that make them withstand the changes in the market environment is changing and volatile . It was to
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This study was conducted to describe a protocol for the callus establishing culture of Lavandula angustifolia plant and estimating their content of volatile oil. The quantity of volatile oil callus tissues was compared with that of leaves production. Callus was induced from leaf explants on Murashige and Skoog medium (MS) supplemented with Naphthalene acetic acid (NAA) and Benzyl adenine (BA) in different concentrations. Maximum callus fresh weight was obtained in the combination of 10 mg/L BA and 3 mg/L NAA which reached 18 g after four weeks. The results of this work showed that the quantity of volatile oil from the highest fresh weight callus was 6 ml compared with quantity of 18g of leaves which gave 0.5 ml. Volatile o
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The article discusses political discourse as a communicative space of modern politics in the context of the anthropocentric paradigm. The following components of the political discourse have been outlined: the character of the subject and that of the addressee, genres of oral and written speech, the opposition of monologue and dialogue, the functions, the amount of information among the genres, the aim of speech.
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Women with diabetes in pregnancy (type 1, type 2 and gestational) are at increased risk for adverse pregnancy outcomes which also include infant development of congenital heart disease and even fetal death. Adequate glycemic control before and during pregnancy is crucial to improve outcome
Three hundred and fifty five patients with hepatitis were investigated in this study all cases gave negative result with HBs Ag , IgM-anti HCV , IgM-anti HEV, IgM-anti HDV and anti-HIV tests . The frequency of IgM-anti HAV was 113 and the percentage was 32 % in all ages but when these patients divided into five groups dependent on ages. The highest percentage of IgM-anti HAV was (45%) in age <10 and the percentage declined with age increase till to 9% in age >41 year.
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This research focuses on detecting the financial corruption cases in Iraq in light of adoption the strategic audit, the paper deals with the problem of the proliferation corruption cases particularly financial in Iraq and dramatically in the presence of audit and control devices as well as inspection and integrity devices, which indicates the existence of deficiencies and weaknesses in those devices in the implementation of audit and control functions in order to detect the corruption cases in the economic units in Iraq.
Stems objective of this research through the provision of approach of strategic audit concepts and indicate the extent importance of adopting of strategic audit as a means to detect the f
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