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: BACKGROUND: Infantile haemangioma one of the most common tumour of new borns , a safe and effective treatment options are under ongoing research . OBJECTIVE: The authors show the effectiveness and safety of low dose propranolol as a method for infantile haemangioma treatment . METHOD: In this study twenty- four patients with infantile haemangioma in different anatomical locations were treated with oral propranolol and the result were assessed in a retrospective analysis of the results patients were kept on 0.25 mg/kg/day for one month , then on 0.5mg/kg/day in 2 divided doses for another one month , in the third month the dose will be increased to 1 mg/kg/day in 2 divided doses , then the propranolol were given in a maintenance do
... Show More
(2)
Pun concept the design discourse for the cover of magazines the researcher chose the German magazine Der Spiegel as a model for that, as the research problem was manifested by the following question: What are the representations of puns in the covers of the German magazine (Der Spiegel)? The researcher has identified four chapters for this study as follows: The first chapter is devoted to research procedures, and the theoretical framework, which is like the second chapter, included the literature related to the topic of research according to the two interlocutors. A review of the concept of pun in the field of typographic design and the functions that puns achieve in that field, leading to the third chapter, which included the analysis
... Show More
The concept of environmental debt, which has several dimensions, emerged in the nineties. One of these dimensions is spatial, referring to the debts that southern countries sustain due to the extraction of natural resources and environmental damage inflicted upon northern countries. Another dimension, the temporal dimension, concerns the environmental debts that current generations owe to their predecessors. That means past generations are culpable for overuse of natural resources and mismanagement. The debt issue is complex, despite many mechanisms to resolve it. Most important are the recently introduced environmental bonds, an important step forward in the field of sustainable financing of environmental debts.
(29)
(14)
Cleaning is one of the services provided by the state and its ad hoc institutions. Every developed country is clean due to the good planning and attention given to the staff of all municipalities and service institutions. Beside, the attention paid to this sector is considered one of the windows to maintain the states’ aesthetics. If janirtos stop disposing of all the discarded wastes, the result will be having big piles of waste, affecting accordingly the health and safety of its citizens and the aesthetics of the areas. The janitors and those responsible for them are tha staff that the state must take care of because of their importance to the state in general and to the province in particular. The importance of the research
... Show More
The term discourse is one of the terms that have attracted the attention of learners because it is indicative of the speech that is directly related to the addressee and the addressee through a common message between them. In the story of the study and the importance of research can be a widespread method, and then the choice of this story the story of Joseph (peace be upon him) in particular did not come The research presented in the introduction and the preamble and three topics, dealt with the definition of discourse, and the role of discourse in modern Quranic and linguistic studies, and in the first section dealt with the definition of the style of command language, terminology and command formu
... Show MoreAfter the issuance of agrarian reform first law of 1958 events social economic
accelerating out of sync with political events on the application of the agrarian reform law
issued a government executive branch law number (74) in May 1959 was the introduction of
the ministry of Agrarian reform and the development of a new system of the ministry of
agrarian reform and its department to determine structural ministry the new work started
department of the ministry ptt.
The subject of the research seeks to indicate the level of influence of emotional intelligence in the empowerment of workers in the Ministry of Industry and Minerals General Company for Food Products. The research problem is illustrated by knowing all of the following:
- The level of the relationship between emotional intelligence in promoting the empowerment of employees of the Ministry of Industry and Minerals.
- The impact of emotional intelligence on the empowerment of workers in the ministry.
- Recognize the interest of the management of the Ministry of Industry and Minerals in emotional intelligence and the
A sensitive, accurate, and affordable colorimetric method was developed for assaying prednisolone (PRZ) in various medicinal forms. The procedure involves the oxidation of PRZ by ferric ions, followed by complexation of the resulting ferrous ions with ferricyanide to produce a greenish-blue product. Common complexation conditions were thoroughly investigated. The mole ratio of FeCl₃·6H₂O to K₃Fe(CN)₆ was 8:1. The proposed mechanism of complexation was suggested and considered. Various parameters were optimized, including the reduction of the colorimetric reaction temperature to 50°C and the duration of heating and analysis to 20-30 minutes. The calibration curve was linear over the range of 1-60 µg/mL. The limit of detection (LOD
... Show More