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.
If 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
... Show More
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 MoreThe 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
... Show More
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 MoreThe 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
... Show More
Testing the current research and effect correlation between Transformational leadership variable manufacturing and variable administrative creativity, as it represented the research problem the extent of the role of transformational leadership in achieving administrative creativity in the office of the Iraqi Ministry of Education, it has been used questionnaire as a tool for data collection, as is the distribution (32) for the sample of the research, which was selected intentional and as director general and assistant general manager and director and deputy director and head of the Division, and represented the premise of the major search existence of liaison and the impact of significantly between transformational leadership and achieve
... Show MoreThe world faces, in the last years of the last century and the beginning
of the current century i.e. the 21st century, a great expansion and a large
openness on new worlds in studies differ in their development, detection of
thinking methods and practice of mental processes.
The recent studies have proved an increase in the scientific
achievement among students through the presence of new techniques one of
which is Landa Organizing and Exploring Model concerning Physiology that
deals with various body organs.
This research aims at identifying the effectiveness of Landa Model on
the achievement of the Technical Medicine Institute students in Physiology so
as to be sure of the following nil hypothesis: there i
The capital banking foundation stone upon which the bank in the practice of business activities, the more capital a good financial adequacy of the increased bank's ability to grant credit and expand the various activities and provide a safety element for depositors and other sources of funding to achieve profits and increase the trading volume of the shares, causing the rise the rate of return for the shares of banks and have the Central Bank as head of the banking system by issuing instructions capital increase banking, according to the requirements of economic development and increase gross domestic product by supporting investment projects that are financed through banks, the research aims to show the extent of the banks commitment to
... Show MoreBACKGROUND: Acute coronary syndrome (ACS) is the clinical manifestation of acutely diminished coronary arterial blood supply. The rate of increase of intraventricular pressure during isovolumetric contraction (left ventricular dP/dt) represents the rate of change of pressure during ejection. OBJECTIVE: The aim of this study is to evaluate the usefulness of the rate of increase of intraventricular pressure during isovolumetric contraction (dP/dt) in assessment of left ventricular function in patients with acute coronary syndrome and its relation to certain clinical and echocardiographic features. PATIENTS AND METHODS: The study is a cross sectional study including 50 patients with an established diagnosis of acute coronary syndrome. The
... Show MoreThis research was carried out to evaluate the activity of crude juice of Olive on some cytogenetic parameters in mice like chromosomal aberration (CAs) and micronuclei formation(MN). The results showed that there was no significant difference between the crude juice (green and black)in CAs(3.77,4.10)and MN(0.25,0.25) in comparison with negative control (3.39,0.22)respectively. The interaction effect between the crude before and after treatment with mutagen MMC showed that the crude is one of the vital inhibitors of the mutagen by its ability in reducing the percentages of both the CAs and MN in bone marrow cells in mice.