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
The added value of internal audit greatly contributes to adding value to the institution, but most departments of economic units in Iraq neglected the role of internal audit and the added value that can be achieved by those institutions, since the term added value of internal audit is a relatively vague term from the premise that what cannot be measured is difficult Determine it, and perhaps descriptive standards for it is the extent of compliance with international auditing standards (IIA).
The research aims to study the procedures and results of auditing to verify that they have given an added value to the audit with a positive impact, develop its aspects and research, identify deficiencies for the audi
... Show MoreDiscretionary Punishment, Public Regulation, Interest
Abstract
The study aims to reveal the level of inclusion of citizenship values in the English language textbooks (We Can) series for elementary education in the Kingdom of Saudi Arabia. To achieve this objective, the "content analysis" methodology was used. A content analysis card was designed to include (6) main areas of citizenship values, it consisted of (28) sub-indicators of citizenship values that were supposed to be included in the English language textbook series (We Can) for elementary education. The study sample consisted of all the English language textbooks (We Can) series for elementary education, which consisted of (6) textbooks, two for each class. The results of the study indicated that there is a
... Show MoreThe research aims to identify the level of psychological burnout among the professors of Sana’a University in light of the armed conflicts in Yemen. The research sample consisted of (104) faculty members. A descriptive-analytical approach was adopted. The results of the research showed that university professors suffer from psychological burnout at a very high level in the overall score of the scale. There were no statistically significant differences in terms of gender, academic degree, teaching experience, marital status, number of family members, or salary. In light of the results, the researcher presented a number of relevant recommendations and suggestions.
Abstract
The current research problem includes a variety of research motivations to serve the private health sector, which is witnessing a great competition from internal and external environments. In this regard, private medical clinics are increasingly seeking to attract and retain customers through the quality of their service offerings represented by health services. Innovative and effective marketing methods to improve performance and stay in competition, by relying on the physical evidence of the product as a component of the marketing mix of services and its role in particular in packaging and supporting the health service with concrete evidence that affects the customer an
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(4)
(3)
Background: The highest concentrations of
blood glucose during the day are usually found
postprandialy. Postprandial hyperglycemia (PPH)
is likely to promote or aggravate fasting
hyperglycemia. Evidence in recent years suggests
that PPH may play an important role in functional
& structural disturbances in different body organs
particularly the cardiovascular system.
Objective: To evaluate the effect of (PPH) as a
risk factor for coronary Heart disease in Type 2
diabetic patients.
Methods: Sixty-three type2 diabetic patients
were included in this study. All have controlled
fasting blood glucose, with HbA1c correlation.
They were all followed for five months period
(from May to October 2008)
A simple reverse-phase high performance liquid chromatographic method for the simultaneous analysis (separation and quantification) of furosemide (FURO), carbamazepine (CARB), diazepam (DIAZ) and carvedilol (CARV) has been developed and validated. The method was carried out on a NUCLEODUR® 100-5 C18ec column (250 x 4.6 mm, i. d.5μm), with a mobile phase comprising of acetonitrile: deionized water (50: 50 v/v, pH adjusted to 3.6 ±0.05 with acetic acid) at a flow rate 1.5 mL.min-1 and the quantification was achieved at 226 nm. The retention times of FURO, CARB, DIAZ and CARV were found to be 1.90 min, 2.79 min, 5.39 min and 9.56 min respectively. The method was validated in terms of linearity, accuracy, precision, limit of detection and li
... Show MoreEFFECT OF SPRAYING IRON AND ZINC CONCENTRATIONS IN GRAIN AND LEAF CONTENT FOR TWO VARIETIES OF WHEAT CROP
The main purpose of the research is to diagnose the importance of the role that strategic memory plays with its three variables (content, structure, and processes) in helping the human resource department to use the COSO model with its five components (culture and governance, strategy and objectives, performance, communications and information, and feedback) in auditing activities and tasks Her own. As the research problem emphasized the existence of a lack of cognitive perception, of the importance of strategic memory, and the investment of its components in the rationalization of the application of the COSO model. and therefore it can be emphasized that the importance of the research is to provide treatments for problems relate
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