Pelvic support osteotomy by Ilizarov’s concept: Is it a valuable option in managing neglected hip problems in adolescents and young adults?

For evaluating pelvic support osteotomy as a salvage procedure in managing neglected hip problems in adolescents and young adults, PSO was performed for 20 hips in 20 patients (5 men and 15 women). The mean age was 21.5 years. The etiology was neglected developmental dysplasia of the hip in 9 patients, post-septic hip sequelae in 9 patients, and paralytic dislocation due to poliomyelitis in 2 patients. All patients were treated by two osteotomies: a proximal femoral osteotomy to support the pelvis and correct the flexion and rotational deformities of the hip and a distal varization and lengthening osteotomy. Final clinical evaluation was done 6 months after frame removal. The mean external fixation time was 6.4. Lengthening and mechanical axis parallelism was achieved in all patients. At the final follow-up and according to a predesigned scoring system, there were 7(35%) excellent results, 6(30%) good results, 7(35%) fair results, and no poor results. Hip reconstruction by Ilizarov’s concept can be technically demanding and involving lengthy period wearing the frame but found to be a valuable salvage procedure for numerous neglected hip problems particularly in young patients

Genetic distance and heterogenecity between quasispecies is a critical predictor to IFN response in Egyptian patients with HCV genotype-4

BACKGROUND: HCV is one of the major health problems in Egypt, where it is highly prevalent. Genotype 4 is the most common genotype of HCV and its response to treatment is still a controversy. METHODS: HCV genotype 4 quasispecies diversity within the 5' untranslated region (5'UTR) was studied in a series of 22 native Egyptian patients with chronic hepatitis C virus with no previous treatment who satisfied all NIH criteria for combined treatment of pegylated IFN and ribavirine and was correlated with the outcome of treatment. The study also included 7 control patients with no antiviral treatment. HCV sequencing was done using the TRUGENE HCV 5-NC genotyping kit. RESULTS: At the 48(th )week of treatment, 15 patients (68%) showed virological response. Whereas HCV-RNA was still detected in 7 patients (32%) in this period; of those, 6 experienced a partial virological response followed by viral breakthrough during treatment. Only one patient did not show any virological or chemical response. The four females included in this study were all responders. There was a significant correlation between the response rate and lower fibrosis (p = 0.026) as well as the total number of mutation spots (including all the insertions, deletions, transitions and transversions) (p = 0.007, p = 0.035). CONCLUSION: Patients who responded to interferon treatment had statistically significant less number in both transitions (p = 0.007) and the genetic distances between the quasispecies (p = 0.035). So, viral genetic complexity and variability may play a role in the response to IFN treatment. The consensus alignment of all three groups revealed no characteristic pattern among the three groups. However, the G to A transitions at 160 was observed among non responders who need further study to confirm this observation

Management of hepatitis C virus genotype 4: recommendations of an international expert panel.

HCV has been classified into no fewer than six major genotypes and a series of subtypes. Each HCV genotype is unique with respect to its nucleotide sequence, geographic distribution, and response to therapy. Genotypes 1, 2, and 3 are common throughout North America and Europe. HCV genotype 4 (HCV-4) is common in the Middle East and in Africa, where it is responsible for more than 80% of HCV infections. It has recently spread to several European countries. HCV-4 is considered a major cause of chronic hepatitis, cirrhosis, hepatocellular carcinoma, and liver transplantation in these regions. Although HCV-4 is the cause of approximately 20% of the 170 million cases of chronic hepatitis C in the world, it has not been the subject of widespread research. Therefore, this document, drafted by a panel of international experts, aimed to review current knowledge on the epidemiology, natural history, clinical, histological features, and treatment of HCV-4 infections

Proposed formula for design of deep beams with shear openings

This research presents an analytical study to verify the experimental study of new models for reinforcing deep beams with different shear openings, in addition to proposing a formula for calculating the shear capacity of such beams.The results of the analytical study demonstrated the efficiency of the proposed nonlinear finite element (NLFE) model by close matching the carrying capacity of the tested beams and their comparative analyzed by the ABAQUS program. The analytical program included representing a 14-specimens study with two different concrete strength and three different sizes of shear openings.The comparison revealed the accuracy of the analytical model in the representation of solid deep beams and deep beams with shear openings; including predicting the fracture load, the behavior of these beams, in addition to the crack pattern and stresses of the proposed reinforcement configurations.Using both of ABAQUS program and specifications of the ACI 318-14 (ACI Committee 318, 2014), a parametric study was developed to investigate the relationship between shear strength of deep beams with different sizes of shear openings and shear opening ratio to the total area of shear zone.Based on this parametric study, a dimensionless equation for calculating the shear strength of deep beams was obtained, which can be utilized in the design of such beams having same shear span-to-depth ratio and opening maximum size of 0.15 relative to shear zone. Keywords: Solid deep beams, Deep beams with shear openings, Proposed shear reinforcement, Finite element modeling, Predicting shear strength of deep beams with shear opening

Conceptual Drawings as Explorative Tools: Tracing the Evolution of the Extended and Nuclear Family Houses in Kuwait

This paper examines the evolution of the layout and occupancy of family houses in Kuwait, using conceptual drawings as a tool to study, describe and understand their transformations. Through the analysis of the political and social development of the country, this research will describe the main architectural facets of a group of case studies related to three different phases: the pre-oil period, the post-oil period and the current contemporary stage of evolution. Particular attention is given to the dynamics that have influenced the relationships between social changes and the houses’ layouts, including specific design traditions developed in each period. The goal of this investigation is to propose a logical sequence of drawings and graphic analyses valuable to illustrate and verify the persistence of a cultural continuity, which has survived substantial socio-economic transformations that occurred during the past century. This cultural continuity runs from the urban layouts to the basic units and represents a significant level of awareness to be used in every future planning action