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.
A single-blind randomized controlled clinical trial in patients with deep caries and symptoms of reversible pulpitis compared outcomes from a self-limiting excavation protocol using chemomechanical Carisolv gel/operating microscope (self-limiting) versus selective removal to leathery dentin using rotary burs (control). This was followed by pulp protection with mineral trioxide aggregate (MTA) and restoration with glass ionomer cement and resin composite, all in a single visit. The pulp sensibility and periapical health of teeth were assessed after 12 mo, in addition to the differences in bacterial tissue concentration postexcavation. Apical radiolucencies were assessed using cone beam computed tomography/periapical radiographs (CBC
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A finite element is a study that is capable of predicting crack initiation and simulating crack propagation of human bone. The material model is implemented in MATLAB finite element package, which allows extension to any geometry and any load configuration. The fracture mechanics parameters for transverse and longitudinal crack propagation in human bone are analyzed. A fracture toughness as well as stress and strain contour are generated and thoroughly evaluated. Discussion is given on how this knowledge needs to be extended to allow prediction of whole bone fracture from external loading to aid the design of protective systems.
Background: Bone augmentation techniques are commonly employed in medical fields. This biomaterial system must be readily available, easily applicable by minimally-invasive technique and able to release an osteoinductive growth factor. Such a system will be able to engineer new bone formation locally at the site of injection. Hyaluronic acid has osteogenic potential that can be exploited not only for repairing bone defects but also for providing transplantable bone for the reconstruction of a variety of bone defects. The aims of this study were to evaluate the effects of Hyaluronic acid gel on bone healing by immunohistochemical estimation of transforming growth factor -beta 3 in experimental and control groups. Materials and methods: Thirt
... Show MoreBackground/purpose: Dental implantology involves different treatments that have been used in conjunction with dental implant surgery to increase implant stability and bone regeneration process. Photobiomodulation( PBM) can be one of these techniques. The objective of this study was to evaluate the bone density around implants. Materials and methods: in this study, 10 individuals had 20 implants inserted in the posterior of their mandibles. each patient received two implants the left side served as the control whereas the right side served as the study group with a diode laser (same patients). measurements were made for each implant. Measurements were obtained using cone-
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Background: Simultaneous and staged guided bone regeneration (GBR) is one of the several surgical techniques that have been developed in the past two decades to regenerate bone and thus to allow implant placement in compromised sites (fenestration and dehiscence). It is a surgical procedure that consists of the placement of a cell-occlusive physical barrier between the connective tissue and the alveolar bone defect. The treatment concept advocates that regeneration of osseous defects is predictably attainable via the application of occlusive membranes, which mechanically exclude non-osteogenic cell populations from the surrounding soft tissues, thereby allowing osteogenic cell populations originating from the parent bone to inhabi
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The aim of this research is to determine the most important and main factors that lead to Preeclampsia. It is also about finding suitable solutions to eradicate these factors and avoid them in order to prevent getting Preeclampsia. To achieve this, a case study sample of (40) patients from Medical City - Oncology Teaching Hospital was used to collect data by a questionnaire which contained (17) reasons to be investigated. The statistical package (SPSS) was used to compare the results of the data analysis through two methods (Radial Bases Function Network) and (Factorial Analysis). Important results were obtained, the two methods determined the same factors that could represent the direct reason which causes Preecla
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Background : It has been suggested that pretreatment with a statin agent prior to
myocardial infarction limits myocardial
creatine kinase release, and thus may act to
limit myocardial infarct size in humans.
Objective : To examine the effect of very
early statin initiation for acute myocardial
infarction (AMI), to the extent of
myonecrosis as manifested by peak serum
creatine kinase levels.
Methods : Patients with AMI admitted to AlKindy teaching hospital cardiac care unit
from 1st February 2007 to 28th February
2008, who fulfilled the inclusion criteria
cited in the present study, were randomly
assigned into two study groups. The statin
group patients have received a single oral
dose of 40 mg
Background: Breast Cancer is the most common malignancy among the Iraqi population; the majority of cases are still diagnosed at advanced stages with poor prospects of cure. Early detection through promoting public awareness is one of the promising tools in its control. Objectives: To evaluate the baseline needs for breast cancer awareness in Iraq through exploring level of knowledge, beliefs and behavior towards the disease and highlighting barriers to screening among a sample of Iraqi women complaining of breast cancer. Methodology: Two-hundred samples were enrolled in this study; gathered from the National
Background: Radioactive iodine-131 therapy is highly effective in treating patients with hyperthyroidism. An ablative dose is preferred by a number of endocrinologists, and, a fixed dose protocol seems to be better than a calculated dose in real practice.
Objective: To check for hypothyroidism in hyperthyroid patients one year after RAI therapy, comparing between the results of high ablative versus usual dosages of RAI-131.
Methods: This study included 174 hyperthyroid patients, 101 males and 73 females, divided into 2 groups, the first consisted of 162 patients given a usual fixed dose of RAI while the second consisted of 12 patients given a high fixed ablati
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