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
The current study aims to identify the predictability of burnout in perceived self-competence among mothers of students with disabilities in the Sultanate of Oman. The study sample consists of (484) respondents who were mothers of students with disabilities. The researcher developed a burnout Scale which consists of (19) items and a perceived self-competence Scale which consists of (20) items. A correlation descriptive design was used. The results showed that the level of burnout was low (Mean= 2.30), while the level of burnout was high (Mean= 3.87). Regarding the correlation coefficient, the results showed that there was a significant negative correlation between burnout and perceived self-competence. A
... Show MoreThe paper deals with the study of the sciences of the Qur’an according to the interpreter, Ayatollah Sayyid Mahmoud al-Talaqani, a religious jihadist figure from Iran. He is the author of the exegesis (Ishraq from Al-Quran), which consists of six parts, which he wrote inside the prisons of the Shah and in exile. Mr. Al-Talaqani agreed with some of the commentators in his positions on the sciences of the Qur’an, and some of them disagreed with others.
The research aims at introducing the principles of six sigma and if it had any effect of the dimensions of six sigma to improve the performance of the dentists and the availability of an appropriate environment in the center Specialist respondent to the application of six sigma principles and how to adopt Specialized Center under the dimensions of the six sigma and if there informed enough with the management methodology six sigma, and if you can adopt six sigma as one of the entrances to reduce medical errors. So Search creating six sigma five dimensions and are (the commitment and support of senior management, the focus on the patient, continuous improvement, training and civil, and infrastructure) as a variable int
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One hundred isolates of Pseudomonas aeruginosa were obtained from patients admitted to Baghdad hospitals, Iraq during the period between May 2018 until July 2018. These isolates were distributed as 15 isolates from blood, 25 isolates from urinary tract infections, 10 isolates from sputum, 12 isolates from wounds, 15 isolates from ear infections, 15 isolates from bronchial wash of patients suffering from respiratory tract infections in addition to 8 isolates from cystic fibrosis patients. The isolates were initially identified by culturing on MacConkey agar, blood agar and P. aeruginosa agar then diagnosed by performing some morphological and biochemical tests. The second diagnosis was done by API 20E system followed by Vitek 2 compact syste
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Collapsing building structures during recent earthquakes, especially in Northern and Eastern Kurdistan, including the 2003 earthquake in Cewlig; the 2011 earthquake in Van; and the 2017 earthquake near Halabja province, has raised several concerns about the safety of pre-seismic code buildings and emergency facilities in Erbil city. The seismic vulnerability assessment of the hospital buildings as emergency facilities is one of the necessities which have a critical role in the recovery period following earthquakes. This research aims to study in detail and to extend the present knowledge about the seismic vulnerability of the Rizgary public hospital building in Erbil city, which was constructed before releasing the seism
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Modern societies tend to live in an electronic way. Indeed, many citizens and business owners are currently working in an electronic way because the use of information technology systems reduces the number of steps in the routine required to carry out work, and converts manual jobs to automatic, and helps improve the way of serving citizens by providing access to information in a service manner. The e-government can also automate responses to requests for licenses or information, in order to save time and energy for employees in order to provide better services to those reviewers who call directly or attend by themselves to accomplish some exceptional work. Therefore, to raise awareness its services, it is necessary to use various public re
... Show MoreThis paper aims at the fact that most organizations today suffer from a waste of time, effort, and cost, and they have difficulty in achieving the best performance situations and compete strongly. The researcher distributed 108 questionnaires as a statistical analyzable sample society where the sample intentionally consists of general managers, department head, and division head. The questionnaire was formulated according to the Likert scale. The use of personal interviews and observations are additional tools for data collection and a number of statistical methods is used for data analysis such as simple regression and correlation coefficient (Pearson). One of the most prominent conclusions is that the company has adequate and c
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Praise be to Allaah.
My research has included the following: The field of application of semantics when fundamentalists are the book and the Sunnah. Imam Ibn Hajar agreed with the majority of fundamentalists that what is meant from the year (one word denotes one side on two things onwards), and agreed that the significance of the year specific to the rest of its members is not a definite and definite formulas of the public has the singular known as (the) Astragharism, and the plural known as ( The nationality stating that dumping, pluralism is defined as (add), and nakra, if it occurs in the context of the condition, denial and prohibition, the names of the condition, the connected names, and the word (all - all). And the year in whic
The current study aimed to reveal the moral values available in the Arabic language textbook (Al-Mu’nes) for grades eleven and twelve for post-basic education in the Sultanate of Oman. The researcher adopted the descriptive approach using the sentence as measuring unit in the analysis process. The five fields of moral values and their subcategories values represented the categories of the analysis. Iterations of values and the percentages of iteration were calculated in those textbooks. Moreover and the analysis and stability of the process were confirmed.
After referring to previous studies, it was possible to de
... Show MoreThe study aimed at recognizing the availability of the cultural intelligence dimensions in social studies book at the high school in the kingdom of Saudi Arabia (curricula system- joint program). The study used the descriptive approach and content analysis method. As tools of the study, the study adopted a list of cultural list of indicators and dimensions that suits the secondary stage social curricula. It further adopted a content analysis form designed to analyze the social studies book in the secondary school in the kingdom of Saudi Arabia. The study has reached several results, the most significant results were: There is a difference in including the cultural intelligence dimensions in social studies book at high school in the kingd
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