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.
Organizations adopt a number of procedures and instructions in their field of activities in order to aid their resources development and energies to serve their entrepreneurial orientations. This calls for preparing a range of mechanisms to mitigate the strictness and complexity of procedures. The ambiguity and severe complexity of procedures means acknowledging the loss in energy and this in turn impedes the hopes while in the same time weakens the enthusiasm in these organizations and an impedes the possibility to achieve continues innovation, thereby losing opportunities to the level of surrender to the risks and assuming them to be unconquered obstacles.
There
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This study presents a mathematical model describing the interaction of gut bacteria in the participation of probiotics and antibiotics, assuming that some good bacteria become harmful through mutations due to antibiotic exposure. The qualitative analysis exposes twelve equilibrium points, such as a good-bacteria equilibrium, a bad-bacteria equilibrium, and a coexisting endemic equilibrium in which both bacteria exist while being exposed to antibiotics. The theory of the Sotomayor theorem is applied to study the local bifurcation around all possible equilibrium points. It’s noticed that the transcritical and saddle-node bifurcation could occur near some of the system’s equilibrium points, while pitchfork bifurcation cannot be accrued at
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Abstract
The aim of the research is to identify the role of ethical leadership in achieving comprehensive quality standards in public education schools in the Al-Ardha governorate. To achieve this goal, the descriptive approach was used, the researcher developed a questionnaire consisting of (35) items, divided into two sections: the first one is related to ethical leadership includes (17) items, and the second section relates to total quality management includes (18) items. The research sample consisted of (405) teachers from the stages of public education. The results showed that the level of ethical leadership practice (ethical personal characteristics, ethical administrative features, teamwork, and human rela
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The purpose of this research is measuring relationship level and impact between Organizational Factors and their Dimensions (Leadership, Organizational Structure, Organizational Culture), and Talent Management Strategies (Talent Recruitment,Talent performance management, Talent Development, Talent Retention ). it was relied on the Questionnaire form as a basic instrument in collecting the Data by using (Likert) instrument ,which was distributed on the research Sample which number was (100) individual included (Managers of schools, assistants (scientific and Administration ) and teachers in Four schools of Talents in Iraq (Baghdad , AL-Nagaf , AL-Basra, Mesan). All fo
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The worsening of environmental problems has led to them being addressed by many entities, the most important of which are the top regulators. Federal Board of supreme audit Office is one of the most important regulators in Iraq. The problem of the research was the fundamental question of the extent to which the Federal Financial Supervisory Office was committed to implementing and exercising environmental control over the audited ones. The refore, the research was based on the main objective of questioning the role of the Federal Financial Supervisory Office in the exercise of environmental control and the compliance of those under its control, by identifying the antosai standards for environmental control, particularly the stand
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For Spanish learners who are not immersed in everyday contexts, such as students of Spanish as a foreign language, interaction with native speakers is an enriching experience that allows them to contrast their knowledge in a meaningful way. For its part, understanding the cognitive and grammatical functions of the so-called verbs of change plays an essential role in the development of everyday conversation,including the management of aspects such as dialectal variations.In relation to this important function, the central theme of our proposal is verbs of change. The latter have been the research base of several linguists who highlight, amidst their complex functioning in Spanish, positive communicative bases. By observing these perspecti
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