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.
Abstract
The aim of the research to define the concept of moral intelligence and its dimensions and its relationship to some personal characteristics with the internal auditors and identify the importance of the employment of moral intelligence dimensions of (empathy, conscience, self- control, respect, kindness, tolerance, fairness) in the internal audit and the extent of support for the performance of the internal audit process in light of these dimensions. And that by answering the following question : Is there a role for moral intelligence of internal auditors in support the performance of internal audit process ? How are employ these dimensions i
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The researcher attempts to diagnose the level of the effect of strategic thinking skills (intuition, meditation, creativity) of the managers in the Ministry of Health in Iraq and some of its institutions in the formulation of human resources management: (selection, training, incentivence , performance appraisal (Recognizing the importance of the subjects studied, and because of the importance of the expected results of th
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The Research aims to determine role of The Intellectual capital in the performance of small and medium enterprises , to achieve this goal through a researcher from the theoretical literature and studies related to the construction of the scheme shows the hypothetical relationship between the variables, which was adopted by the independent variable intellectual capital, distributed four variable are:( human capital, structure capital ,customer capital, innovation capital) as well as four variable (the financial perspective, the customer perspective, process perspective ,the learning & growth perspective) The study were getting to many results as bellow :the intellectual capital in the small and intermediate p
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The objectives of this research are to determine and find out the reality of crops structure of greenhouses in association of Al-Watan in order to stand on the optimal use of economic resources available for the purpose of reaching a crop structure optimization of the farm that achieves maximize profit and gross and net farm incomes , using the method of linear programming to choose the farm optimal plan with the highest net income , as well as identifying production plans farm efficient with (income - deviation) optimal (E-A) of the Association and derived, which takes into account the margin risk wich derived from each plan using the model( MOTAD), as a model of models of linear programming alternative programming m
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This study aimed to identify the degree of use computers in administrative functions (planning, organization, controlling, and evaluation) among school leaders and assistants in public education schools in Sharoorah governorate ، as well as to identify obstacles of use computers in administrative functions from the perspective of school leaders and assistants male and female in public schools during the academic year 1439-1440, the study sample (66) school leaders and assistants, males (58), a and females (44), , and to answer the questions of the study, the researchers developed a questionnaire consisting of (60) items, has been verified sincerity and persistence, and data analysis was used frequencies, percentages an
... Show MoreIf the sovereignty of the state is reflected in the taxation of its citizens, this sovereignty can not be completed and completed only if it works on its part to collect its debts, whether voluntary or compulsory, and the debt of the debt arises from the will of the individual and the will of the state alone, The existing management of seizure and collection is based on an unequal relationship between the State and the debtor from which the obligation arises. Naturally, this relationship has obligations and rights on both parties. The researcher used a set of studies and previous research, books and other sources related to the subject of research. This was done through the theoretical and practical aspects, which focused on direct and i
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The subject of improving the performance of services provided by government institutions of the important topics at the present time because of their direct contact at the service of citizens and the increased importance of these units as a result of the diversity of activities performed by the so governments of the countries and their people made sure to pay attention to the good use of those allocated to those sectors of resources and spending in the service prescribed and manage the highest level of efficiency and effectiveness and monitor the proper management of the money used in those sectors and evaluate their performance through the Supreme Audit Institutions so that they can play their role oversight and contribute to th
... Show MoreBackground: Neonatal macrosomia is defined as a birth weight of more than 4000 g. Significant maternal and neonatal complications can result from the birth of macrosomic infants like hypoglycemia and birth injuries.Objectives: To determine the frequency of hypoglycemia in neonates with macrosomia in Amarah, IraqMethods: The study involved 146 macrosomic newborn neonates delivered in 2 maternity hospitals in Amarah, Iraq during a period from June 2011 to June 2014.Results: Hypoglycemia was observed in 16% of neonates affected by macrosomia. Maternal diabetes was the most common cause of fetal macrosomia (28%).Our results were compared with those from other parts of the world.Conclusion Macrosomia is associated with increase rate ofneonata
... Show MoreBackground: Primary Health care (PHC) is unanimous to be the cornerstone of a person-centered health system. While the adoption of a well-function, two-way, and organized referral system is the mainstay in the development of an efficient healthcare delivery system.
Objective: To Assess the practice & opinion of doctors in the hospitals toward the referral system. to determine the doctors in the hospital's commitment to referral system instructions and guidelines.
Subjects and Methods: A cross-sectional study with analytic elements was conducted in nine Iraqi governorates. Eight doctors from each health directorate, resulting in a tot
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In the present work, radon gas concentrations in different surface soil samples in Baghdad governorate were measured using RAD-7 detector. The results have been shown that, the Radon gas concentrations ranged between (41.67±1.78Bq/m3), to (185.67±4.22Bq/m3), a map showing the distribution of the concentration of radon in selected areas was defined to identify areas with high pollution level. The reason for the high concentration of radon is that these surface soil samples are taken from agricultural areas. It is also known that fertilizers contain uranium levels as well as areas bombed in wars in the country. It is worth noting that all radon concentrations in Baghdad governorate are below the recommended minimum of 200-300Bq/m3) (Inte
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