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 : Bifurcational coronary lesions are
frequent and amounts to almost one fifth of routine
practice concerning up to 15 – 20 % of cases .
Revascularization by percutaneous coronary
intervention ( PCI ), of bifurcational lesion has
become easier by stenting yet it remains a frequent
challenge.
OBJECTIVE : To evaluate the success and hospital
complications of two most frequent technique of stent
deployment in bifurcational PCI.
METHODS : We prospectively analysed the data of
140 consecutive patients with bifurcational PCI at
Ibn_Al-Bitar Hospital for cardiac surgery for the
period from July 2008 to July 2009 .
Depending on whether the side branch was stented or
not, the patient has fa
In this work, a novel technique to obtain an accurate solutions to nonlinear form by multi-step combination with Laplace-variational approach (MSLVIM) is introduced. Compared with the traditional approach for variational it overcome all difficulties and enable to provide us more an accurate solutions with extended of the convergence region as well as covering to larger intervals which providing us a continuous representation of approximate analytic solution and it give more better information of the solution over the whole time interval. This technique is more easier for obtaining the general Lagrange multiplier with reduces the time and calculations. It converges rapidly to exact formula with simply computable terms wit
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The problem of Bi-level programming is to reduce or maximize the function of the target by having another target function within the constraints. This problem has received a great deal of attention in the programming community due to the proliferation of applications and the use of evolutionary algorithms in addressing this kind of problem. Two non-linear bi-level programming methods are used in this paper. The goal is to achieve the optimal solution through the simulation method using the Monte Carlo method using different small and large sample sizes. The research reached the Branch Bound algorithm was preferred in solving the problem of non-linear two-level programming this is because the results were better.
The monetary policy is a vital method used in implementing monetary stability through: the management of income and adjustment of the price (monetary targets) in order to promote stability and growth of real output (non-cash goals); the tool of interest rate and direct investment guides or movement towards the desired destination; and supervisory instruments of monetary policy in both quantitative and qualitative. The latter is very important as a standard compass to investigate the purposes of the movement monetary policy in the economy. The public and businesses were given monetary policy signals by those tools. In fiscal policy, there are specific techniques to follow to do the spending and collection of revenue. This is done in order to
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In this study, biodiesel was prepared from chicken fat via a transesterification reaction using Mussel shells as a catalyst. Pretreatment of chicken fat was carried out using non‐catalytic esterification to reduce the free fatty acid content from 36.28 to 0.96 mg KOH/g oil using an ethanol/ fat mole ratio equal to 115:1. In the transesterification reaction, the studied variables were methanol: oil mole ratio in the range of (6:1 ‐ 30:1), catalyst loading in the range of (9‐15) wt%, reaction temperature (55‐75 °C), and reaction time (1‐7) h. The heterogeneous alkaline catalyst was greenly synthesized from waste mussel shells throughout a calcin
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Background: Appreciation of the crucial role of risk factors in the development of coronary artery disease (CAD) is one of the most significant advances in the understanding of this important disease. Extensive epidemiological research has established cigarette smoking, diabetes, hyperlipidemia, and hypertension as independent risk factors for CADObjective: To determine the prevalence of the 4 conventional risk factors(cigarette smoking, diabetes, hyperlipidemia, and hypertension) among patients with CAD and to determine the correlation of Thrombolysis in Myocardial Infarction (TIMI) risk score with the extent of coronary artery disease (CAD) in patients with unstable angina /non ST elevation myocardial infarction (UA/NSTEMI).Methods: We
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The purpose of our study was to develop Dabigatran Etexilate loaded nanostructured lipid carriers (DE-NLCs) using Glyceryl monostearate and Oleic acid as lipid matrix, and to estimate the potential of the developed delivery system to improve oral absorption of low bioavailability drug, different Oleic acid ratios effect on particle size, zeta potential, entrapment efficiency and loading capacity were studied, the optimized DE-NLCs shows a particle size within the nanorange, the zeta potential (ZP) was 33.81±0.73mV with drug entrapment efficiency (EE%) of 92.42±2.31% and a loading capacity (DL%) of 7.69±0.17%. about 92% of drug was released in 24hr in a controlled manner, the ex-vivo intestinal p
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In this study, biodiesel was prepared from chicken fat via a transesterification reaction using Mussel shells as a catalyst. Pretreatment of chicken fat was carried out using non‐catalytic esterification to reduce the free fatty acid content from 36.28 to 0.96 mg KOH/g oil using an ethanol/ fat mole ratio equal to 115:1. In the transesterification reaction, the studied variables were methanol: oil mole ratio in the range of (6:1 ‐ 30:1), catalyst loading in the range of (9‐15) wt%, reaction temperature (55‐75 °C), and reaction time (1‐7) h. The heterogeneous alkaline catalyst was greenly synthesized from waste mussel shells throughout a calcin
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In this paper, simulation study of the frequency shift of photonic bandgaps due to refractive index scaling using liquids filled hollow-core photonic crystal fibers is presented. Different liquids (distilled water, n-hexane, methanol, ethanol and acetone) are used to fill the cladding of 2 types of hollow core photonic crystal fibers (HC19-1060, HC7-1060). These liquids are used to change the effective index scaling and index contrast of the cladding. The effect of increasing temperature of the liquid (20-100 0C for water and 20-70 0C for other liquids ) infiltrated hollow core fiber on the bandgap width and transmission properties has been computed. The maximum photonic bandgap width at 0.0243 has appeared with filling HC7-1060 PCF with
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