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
This research attempt to explain the essential aspects of one important model in management of Bank risks , that is (stress testing) , which increase the concentrate on it resulting the negative affects of Global financial crisis that it accuar in 2008 to study the application possibilities in iraqian banks to enhancing the safety and financial soundness Becuase the classical tools in Risk management don’t give clear image on Banks ability in facing risks, hence the Basel committee on Banking supervision focusing in agreement of Basel 2,3 on stress testing when it doing the internal capital adequacy assessment process (ICAAP) .
To achieving the reseach obje
... Show Moreيهدف البحث الى أعداد بعض تمرينات الاساسية لسلاح الشيش بأستخدام المرايا في تطوير قدرة مستوى تعلم الطالبات في المبارزة ومعرفة الفروق بين المجموعتين التجريبي والضابطة بتأثير استخدام المرايا في مستوى اداء بعض مهارات سلاح الشيش لطالبات المرحلة الثالثة , وقد أستخدمت الباحثتان المنهج التجريبي على عينة من طالبات المرحلة الثالثة , وقد بلغ عددهم (45) طالبة , وقد خرجت الباحثتين بعدة أستنتاجات وهي:- - أن المنهاج التعليمي
... Show MoreThis research aims at answering many questions raised by the research problem concerning the view of the organizations under consideration for the concept of smart leadership and its most important dimensions, as well as the view of crisis management and its concept and most important methods through research objectives that define and clarify the smart leadership with its dimensions and methods of crisis management.
For the purpose of reaching the results of the research and testing the assumptions about the relationship between smart leadership and methods of crisis management, the researcher adopted a questionnaire, designed especially to be a criterion for the research, as the main tool for data coll
... Show MoreThe research problem stems from a chief question: “What is the nature of the responsibility that «Al-Sabah Al-Jadeed» and «Al-Mada» Newspapers have undertaken in promoting the values of citizenship and national belonging in the society? The research aims to achieve a number of goals, including: Determining the most prominent themes that were emphasized in the opinion articles in these two newspapers within the framework of the responsibility of promoting the values of citizenship and national belonging in society, and revealing the most prominent topics that were discussed in opinion articles in the two sample newspapers regarding the promotion of the mentioned values. This research is a desc
... Show MoreWomen's rights in social studies and national textbooks in the secondary stage in the light of the international charters of women's rights and the cultural specificity of the Saudi society Abstract The current study focuses on exploring women rights that required to be involved in social studies and national textbooks in the secondary stage in the light of international conventions on women's rights and cultural specificity of the Saudi society, as well as to reveal the teachers and educational supervisors' estimation about the degree of importance of those components included in the books, and then build a matrix of the range and sequence of women's rights in the books of social studies and national in the secondary stage. The study us
... Show MoreThis paper deals with the subject of demarcating as appropriate scientific techniques to rationalize consumption and to control segments of the society for the technical conduct of its handling of the product depending on the mix of elements (product and the volume of demand, Price, promotion and distribution), but inverse manner designed to adjust the working condition of balance between supply and demand and to ensure that rates continue in the marketing process properly, and therefore the research aims to shed light on some of the practices that reflect the Demarketing techniques, As well as the statement of the reality of attitudes towards the practice of those techniques through a sample survey of officials in Baghdad company for so
... Show MoreThe study aimed to identify the degree of availability of design Thinking Indicators in The content of the Arabic Language Curricula at the secondary stage in the Syrian Arab Republic; to achieve the goal of the study. The researcher used the Descriptive Approach based on the analysis method according to the Cognitive Theory. The study tools consist of a list of Design Thinking Indicators and a Content Analysis Tool. The researcher completed the Validity and Reliability procedures for the tools. After applying them, the results of the study resulted in the following: Greater Interest than other sub-skills. The results also showed a Divergence of care for the sub-skills and the Difference in their recurrence rate, and the Omission of some
... Show MoreThe upbringing of Yehuda Amichai and the conditions he lived in had a great influence on his deep sense of pain, which made him think of death and suicide. Especially after the Nazis came to power in Germany, and his emigration with his family. Amichai searched for love throughout his life, and his failure was one of the most important factors affecting his psyche, which is A deep influence that made him live in harsh and painful pains that broke him, and prevented her from achieving his ambitions in life.Dramatic texts are characterized by repetition in writing and presentation. It is a textual discourse that has two advantages, first, that it can be read as a literary text like all other literary texts, and second, that it can be consider
... Show MoreThe success of any institution must be based on means to protect its resources and assets from the waste, loss, misuse and the availability of accurate and reliable data by accounting reports to increase its operational efficiency, namely, that the internal control system is considered as a safety valve for top management in any economic unit. The problem is represented by the need for an efficient system, so to ensure its success, there must exist external parties which monitor and evaluate the performance because of its importance by following clear criteria. So, the research problem came to address performance evaluation indicators which are set by the Federal Board of Supreme Audit (FBSA) and identify the extent of its contribution t
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