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
This research discussed and analyzed the formulation of a strategy to manage tax compliance risks, as an applied research in the General commission for Taxes. The questionnaire was used as a research tool to identify the factors that stimulate or retard the research sample from being compliant. The K-means clustering method was also used to enable the classification of the research sample's views into four behaviors, some of these views pose tax-compliance risks. The research concluded that risk management is a continuous process and that all departments of the General commission for Taxes are responsible for its implementation to enable them to deal with the behavior of the taxpayer towards tax compliance. And it recommended
... Show MoreThe responsibility of the Central Bank through the implementation of its monetary policy to maintain the integrity and stability of the financial system and the economic system, because any shock, whether internal or external, may endanger the financial system and instability, so the research sheds light on the effectiveness of monetary policy in maintaining financial stability, The most important conclusion is that there is an increase in capital, which gives banks the possibility to face the risks to which they are exposed, as well as a rise in the total bad debts, which weakens its financial position, which constitutes a decline in the financial stability of these banks.
Chilled ceilings systems offer potential for overall capital savings. The main aim of the present research is to investigate the thermal performance of the indirect contact closed circuit cooling tower, ICCCCT used with chilled ceiling, to gain a deeper knowledge in this important field of engineering which has been traditionally used in various industrial & HVAC systems. To achieve this study, experimental work were implemented for the ICCCCT use with chilled ceiling. In this study the thermal performances of closed wet cooling tower use with chilled ceiling is experimentally and theoretically investigated. Different experimental tests were conducted by varying the controlling parameters to investigate their effects
... Show MoreMany isolated rural communities are located in regions where there is an abundant and reliable supply of solar energy, but where the distance to the nearest power station is many tens or even hundreds of kilometre. It is therefore mainly in these areas that rural electrification is now being provided by PV generators. since Stand-Alone PV generator can offer the most cost-effective and reliable option for providing power needed in remote places. Accordingly these isolated rural canters are fitted with PV for lighting, a refrigerator, a television and socket to supply kitchen appliances
This paper attempts to shed light on the most influential factors in the importance of religious buildings were destroyed because of the recent war due to the control of terrorist gangs of ISIS over the city of Mosul, and to prioritize their reconstruction and their role in reviving the historical center of Mosul.
The research’s problem emerged in the lack of knowledge about the identifying the most influential factors in the importance of religious buildings and utilizing them to prioritize their reconstruction. This study aims to analyze the factors influencing the importance of religious buildings using the Expert Choice software through the Analytic Hierarchy Process (AHP) to reach an analysis of their weights and propose p
... Show MoreThe paper aims to measure the impact of monetary policy on price stability , by testing the causal relationship between the money supply, inflation rate and the exchange rate , In order to prove that the inflation is a monetary phenomenon in the Iraqi economy , and that the exchange rate is controlled in the money supply , the money supply as an endogenous variable continued we found by using the standard tests to the existence of a single co-integration between the money supply and the rate of inflation and the money supply and the parallel exchange rate, This confirms the existence of a long-term relationship between the variables , It also confirmed the results of the vector error correctio
... Show MoreIn general, the importance of cluster analysis is that one can evaluate elements by clustering multiple homogeneous data; the main objective of this analysis is to collect the elements of a single, homogeneous group into different divisions, depending on many variables. This method of analysis is used to reduce data, generate hypotheses and test them, as well as predict and match models. The research aims to evaluate the fuzzy cluster analysis, which is a special case of cluster analysis, as well as to compare the two methods—classical and fuzzy cluster analysis. The research topic has been allocated to the government and private hospitals. The sampling for this research was comprised of 288 patients being treated in 10 hospitals. As t
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Background: The oral cavity is a complex environment, both structurally and functionally, the hard and soft tissues are in close a proximity. Oral tissues subjected to wear throughout the life, that threatened the vitality of the pulp or increase the sensitivity of dentinal tubules. One of the common dental problems is loss of enamel or cementum, which stimulate the nerve ending in or near the pulp and manifested as pain sensation. Aim of the study: This study had done to evaluate the effects of 980nm diode Laser in diameters reduction of exposed dentinal tubules analyze the results and morphological changes of irradiated dentine surface by FE-SEM (field emission scann
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