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
Academic writing is a key skill for success in academic life, particularly for graduate students of a foreign language. The importance of writing to academic culture, practice, and knowledge building has led to a great deal of research in many fields, including rhetoric and composition, linguistics, applied linguistics, and English for Academic Purposes (EAP). Often, studies and research investigating academic writing are motivated by the need to inform the learning of writing to native and non-native English-speaking students, through both descriptions of professional academic writing as well as through comparisons of novice writer (native and non-native Englishspeaking) and expert production. However, while learning about academic writing
... Show MoreThe research aims to achieve proof of convergence between optimal costs and standard costs in calculating costs for the economic unit, support efforts aimed at adopting optimal costs in cost accounts and accounting thought in general, and achieve benefit from the theory of convergence between optimal costs and standard costs in the field of achieving actual costs in The economic unit in order to reduce and converge, and this came to address the possibility of adopting the concept of optimal costs in the production costs calculations for the purposes of rationalizing administrative decisions, and rationalizing the preparation of financial statements within management accounting.
The research concluded that
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Background: The isthmus is a difficult area in the root canal complex to manage. The research aimed to evaluate the efficiency of three different obturation techniques (lateral condensation, EandQ (thermoplasticized gutta percha system) and Soft Core (thermoplasticized core carrier gutta percha system)) to obturate the isthmus area of roots prepared by two different instrumentation techniques (rotary ProTaper universal and ProTaper Next systems). Material and method: Sixty freshly extracted teeth were randomly divided into two main groups (A and B) of 30 teeth each. Group A was prepared by rotary ProTaper Universal whereas group B was prepared by ProTaper Next system. Each main group was then randomly subdivided into three subgroups of 10 t
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Background: Prolonged use of low-dose estrogen ''20 micrograms or less" Combined oral contraceptive pill (that have estrogen and progesterone steroid hormone) had an effect on bone turnover .Bone mineral density is used in clinical medicine as an indirect indicator of osteoporosis and fracture risk. The aim of the study: The aim of this study was to investigate the effect of low dose oral contraceptive pill on the cortical thickness (in millimeter) and bone mineral density at the mandibular cortex of mental and gonial regions in Hounsfield unit(HU) using spiral computed tomography. Material and method: This prospective study was conducted on computed tomographic image of 100 women aged between (20-40) years .The collected sample includes
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The research synthesis variables of competitive advantage and the mechanism achieved by focusing on knowledge abilities and strategic of the administrative leadership, and governments and the developed countries took the racing frantically and my destiny to invest more money and resources to development of wealth and human knowledge is so choice investment winner always and who Aaikhyee never, because God Almighty give humans the abilities of all other creatures and that these abilities varying from person to person, there is the problem of search provoking questions about the essence of what it's about research and both sides theoretical and field, the objective of this research
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In this paper, compared eight methods for generating the initial value and the impact of these methods to estimate the parameter of a autoregressive model, as was the use of three of the most popular methods to estimate the model and the most commonly used by researchers MLL method, Barg method and the least squares method and that using the method of simulation model first order autoregressive through the design of a number of simulation experiments and the different sizes of the samples.
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