Background: The first and second choice for vascular access in patients with end stage renal disease (ESRD) is radio cephalic and brachio cephalic arteriovenous fistula (AVF).In patients with failed previous AVF e or poorly visualized or impalpable cephalic veins, the basilic vein can be mobilized and superficialized to create an AVF with the brachial artery.Objective: The aim of this study is to report our experience at the Vascular Surgery Department/ Surgical Specialty Hospital in brachio-basilic (BB) vascular access for hemodialysis.Methods: From January 2006 to December 2009, 31 patients with ESRD whose cephalic veins were thrombosed or impalpable or had previous unsuccessful vascular access procedures were referred to the Vascular Surgery Department/Surgical Specialty Hospital for creation of vascular access. Brachio - basilic mobilization AVF was offered to them. There were 20 females and 11 males. Their ages ranged from 12 to 70 years with a mean of 40. following a careful clinical assessment of the patients, particularly their upper limb superficial veins, Doppler study of both subclavian veins was done to all patients; those with a vein stenosis exceeding 40% were excluded from the study. All patients had mobilization of basilic vein under general anesthesia via a hooky racket incision on medial aspect of upper arm extending from the axilla to the antecubital fossa. The vein is tunneled subcutaneously and anastomosed end to side to brachial artery. The postoperative condition was monitored looking for any complication. The follow up period lasted for 6 months.Results: nineteen patients (61.3%) had left-sided operations. All fistulae except one functioned well primarily (a success rate of 96.8%). One patient had primary thrombosis of the fistula while another patient developed an aneurysm of the AVF 4 months after the operation. The remainder had a smooth non-complicated postoperative course. All fistulae matured and were ready for cannulation in 6 weeks and remained functioning during the 6 months of follow up.Conclusion:: Brachio-basilic AV fistula with anterior basilica vein mobilization is an acceptable option for dialysis with good success rate and fewer complications
Genome sequencing has significantly improved the understanding of HIV and AIDS through accurate data on viral transmission, evolution and anti-therapeutic processes. Deep learning algorithms, like the Fined-Tuned Gradient Descent Fused Multi-Kernal Convolutional Neural Network (FGD-MCNN), can predict strain behaviour and evaluate complex patterns. Using genotypic-phenotypic data obtained from the Stanford University HIV Drug Resistance Database, the FGD-MCNN created three files covering various antiretroviral medications for HIV predictions and drug resistance. These files include PIs, NRTIs and NNRTIs. FGD-MCNNs classify genetic sequences as vulnerable or resistant to antiretroviral drugs by analyzing chromosomal information and id
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A geographic information system (GIS) is a very effective management and analysis tool. Geographic locations rely on data. The use of artificial neural networks (ANNs) for the interpretation of natural resource data has been shown to be beneficial. Back-propagation neural networks are one of the most widespread and prevalent designs. The combination of geographic information systems with artificial neural networks provides a method for decreasing the cost of landscape change studies by shortening the time required to evaluate data. Numerous designs and kinds of ANNs have been created; the majority of them are PC-based service domains. Using the ArcGIS Network Analyst add-on, you can locate service regions around any network
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The current study is concerned with the analysis of spatial and temporal to death the elderly population in the city of Baghdad and at the level of administrative units Minor (districts and the areas) depending on the general population census of the province of Baghdad, data for 1997 and data from the Ministry of Health Department of Health and Vital Statistics for 2013.
The study showed differing age and quality of mortality rates at the level of administrative units of the study area, and notes the high mortality rates of elderly people of all age groups in 2013 compared to 1997, and this is due to security conditions after the USA occupation, and the accompanying conditions have affected the increase in mortality rates.
The tensions and crises and the psychological pressure as well as the rapid changes and great development which is taking place in the present time. And witnessing community of wars and conflicts that give rise to future concern among members of the community in general and students in particular, as it included the current research a number of chapters, the First chapter contains the research problem, the important goal, then set researcher terminology that has defined and contained in the title of research in the form (concern the future, artistic expression, middle school). The Second chapter included three sections, the first included the nature of adolescence and traits, characteristics and pr
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This research aims to present a proposed model for disclosure and documentation when performing the audit according to the joint audit method by using the questions and principles of the collective intelligence system, which leads to improving and enhancing the efficiency of the joint audit, and thus enhancing the confidence of the parties concerned in the outputs of the audit process. As the research problem can be formulated through the following question: “Does the proposed model for disclosure of the role of the collective intelligence system contribute to improving joint auditing?”
The proposed model is designed for the disclosure of joint auditing and the role
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Markov chains are an application of stochastic models in operation research, helping the analysis and optimization of processes with random events and transitions. The method that will be deployed to obtain the transient solution to a Markov chain problem is an important part of this process. The present paper introduces a novel Ordinary Differential Equation (ODE) approach to solve the Markov chain problem. The probability distribution of a continuous-time Markov chain with an infinitesimal generator at a given time is considered, which is a resulting solution of the Chapman-Kolmogorov differential equation. This study presents a one-step second-derivative method with better accuracy in solving the first-order Initial Value Problem
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