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
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Abstract:
The research concerned the study of the railway transport sector in selected countries that sought to raise the efficiency of the railway network and develop it, after realizing the importance of this vital sector, which is a link between it and the rest of the other economic sectors.
The research sought to explain the methods, methods and procedures adopted by these countries for the development of the railway sector, and to benefit from these experiments to improve the efficiency of the railway transport sector in Iraq.
The railway transport sector in Iraq suffers from the erosion of railway lines and mobile units such as locomotives, pas
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Evaporation is one of the major components of the hydrological cycle in the nature, thus its accurate estimation is so important in the planning and management of the irrigation practices and to assess water availability and requirements. The aim of this study is to investigate the ability of fuzzy inference system for estimating monthly pan evaporation form meteorological data. The study has been carried out depending on 261 monthly measurements of each of temperature (T), relative humidity (RH), and wind speed (W) which have been available in Emara meteorological station, southern Iraq. Three different fuzzy models comprising various combinations of monthly climatic variables (temperature, wind speed, and relative humidity) were developed
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This research develops a new method based on spectral indices and random forest classifier to detect paddy rice areas and then assess their distributions regarding to urban areas. The classification will be conducted on Landsat OLI images and Landsat OLI/Sentinel 1 SAR data. Consequently, developing a new spectral index by analyzing the relative importance of Landsat bands will be calculated by the random forest. The new spectral index has improved depending on the most three important bands, then two additional indices including the normalized difference vegetation index (NDVI), and standardized difference built-up index (NDBI) have been used to extract paddy rice fields from the data. Several experiments being
... Show MoreBackground: Pain is one of the most postoperative complications of surgical wound especially within first 24 hrs. leading to delay hospital discharge, stress gastritis and increasing blood pressure. As wound infiltration with long acting local anesthetic (bupivacaine) has been proved to be effective after orthopedic surgeries especially total hip and knee replacements.Objective: our study was designed to determine theeffectiveness of local infiltration of 0.5% of bupivacainebefore closure of surgical wounds in controllingpostoperative pain and improve patient’s outcome after totalhip and knee replacement surgeries in first 24hrspostoperative period.Methods: Twenty patients from class I (healthy patients) and class II (patients mild sys
... Show MoreThe Voluntary Obedience has great importance for the modern taxes systems and its management and this is meant the taxpayer whom in charge to pay of his taxes obligations voluntarily , he is very known of himself whereas he prepared his finishing accountings and present them as samples prepared by taxes management and settle the tax sum directly according to specified income , which has an impact to find end to tax evasion as result lead to increase the tax income and achieve the justice for the taxpayer and the state treasury
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