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.
Background: Melanin pigmentation of the gingiva appears in all ethnicities. Excessive pigmentation is an esthetic concern that has increased awareness about depigmentation procedures. This epidemiological study aims to find the correlation between skin color and gingival pigmentation in Sulaimani Governorate, Kurdistan/Iraq.
Subjects and Methods: A total of 820 apparently healthy and non-smokers, including 338 males and 482 females with healthy gingiva, aged between (18-40 years old) were enrolled in this study. Clinical examination on the participants’ gingivae was performed to assess color, and the distribution of pigmentations. Afterward the of participants skin color were
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The Contemporary Business Environment is Surrounded by many quick and continues variable and changes which has an effect on the economic units. These variables and changes like the high competition which need many tools to help them to continue and achieve The critical success. So to achieve this they have many competitive strategies like cost leadership strategy, differentiation strategy and focus strategy.
Budget is regarded one of main tools to execute objectives polices and programs of the economic units, beside show how the economic units had execute the available economic resources.
Activity based on budgeting is regarded one of the modern technique in the m
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This research aims at shedding light on the concept of insurance awareness and clarifying its role on marketing insurance services of a sample of (100) employees in the National Company for Insurance. Questionnaire is used as a main instrument for collecting data and information from the sample. Their answers were analyzed by using arithmetic means, standard deviation, centesimal weight, and the correlation coefficient ( , F, t) tests .The research reached several conclusions of which:1.The sample member's response to insurance awareness and marketing insurance services factors was in the medium level.2.There was a positive relationship of a moral sign between insurance awareness and marketing insurance services, that correlation coeffic
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Abstract:
Today, the financial and banking sector is witnessing a qualitative shift thanks to financial technology services, which provide their services to many individuals and companies in quick, easy and less expensive ways compared to traditional means. Financial technology is a new form of financial science that combines financial transactions and technological skills concerned with providing financial services and improving the work environment within Banking institutions, and financial technology provides many advantages such as lower transaction costs, instant payment, and saving more time and effort in conducting banking
... Show MoreBackground: Tear of MCL of the knee is a frequent problem among knee ligaments injuries.Injuries to the MCL are usually caused by contact on the outside of the knee and are accompanied by sharp pain on the inside of the knee. Contrary to most other knee ligaments the medial collateral ligament (MCL) has an excellent ability to heal, being fairly large and well vascularised structure. The vast majority of isolated medial ligament injuries heal without significant long-term problems
Objectives: is to compare between the early clinical examination, and assessment under general anesthesia (GA), and to find out the best methods to assess the MCL tear especially in suspected cases.
Type
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The importance of culture moot ( visual ) in the community , serves as the conceptual basis for the technical and aesthetic awareness , as all the fields of art represents a kind of social consciousness can not be separated from the practice of performance and awareness of it. That the link between what you do image that expresses the cognitive aspects and performance , and what is reflected on the receiver by turning the event into a set of symbols and meanings that have a correlation relationship to society , education, and other fields. Therefore must provide " material conditions and psychological " that helps the learner to interact effectively and with the active elements of the learning environment in the classroom and gain
The increasing Global Competitive and the continuous improvement in information technology has led the way to the development of the modern systems and using modern techniques. One of these techniques is benchmarking style and Total Quality Management all of them are used to improve the production process and target rid from the losts on the other side.
The Benchmarking style has become a very important for all the industrial systems and the serving systems as well. And an instrument to improve their performance specially those which are suffering from the highness of the costs or waste in time on the other side.
This study aims to depend on virtual Benchmarking style in the eval
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Suzanne Collins’ novel The Hunger Games suggests a new logic of victory and set a distinguished focus on the unique personality of her heroin which brings to the mind the permanent correlation between all moral values. The Hunger Games World seems to be much more like one big bowl as it links the past, present, and the future. An Intertextual reference is interwoven in the present research as it brings Golding’s Lord of the Flies to the surface, and it highlights certain similarities between the two texts. In which Ralph, Piggy and Simon in Golding’s Lord of the Flies are the incarnations of stable moral values and hope of surviving ethics and rules in a chaotic and turmoil world. The event
... Show MoreCurrent research aims to find out:
- Effect of using the active learning in the achievement of third grade intermediate students in mathematics.
- Effect of using of active learning in the tendency towards the study of mathematics for students of third grade intermediate.
In order to achieve the goals of the research, the researcher formulated the following two hypotheses null:
- There is no difference statistically significant at the level of significance (0.05) between two average of degrees to achievement
Provides the style of benchmarking the best possible use whenevaluating the performance and evaluation, as well as improved performance,due to its consistency with the principles of good evaluation of theperformance, an extension of the completion of several functions of the timeand cost less, thereby increasing the efficiency of the management of theinstitutions, especially institutions, the media, as it became public the future ofthe message sender to the same time Zaorosaúl new media is challenging thetraditional media of what distinguishes this new interactive media and mass ledto this transition . However, the media Aljdidhoosaúl traditional mediacontinue to coexist and reinforce each Menhmaalakhr, for his wealth offreedom of opin
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