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 organizations, represented by its Management, are working hard in various ways to identify the environmental disturbances that occur in their environment and to investigate and follow up the movement of these disturbances and to respond to them through the decisions they make in an attempt to keep pace with the work and sustainability of their activities, including those decisions, marketing decisions taken by the environmental disturbulence in the market of the organization, the inability of these organizations to read the indicators of these disturbulence correctly displays their marketing effectiveness to vibration and decline in the negative.The current research is based on a fundamental problem that envi
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The study aims to investigate the degree of student teachers at Sultan Qaboos University acquired skills in teaching Arabic via a virtual micro-teaching lab, as well as to reveal the difficulties they faced and their development proposals. To do this, the researchers developed a questionnaire divided into four dimensions: planning, implementation, evaluation, and
ethical values for the teaching profession, in addition to two open-ended questions to identify difficulties and suggestions. It was administered to (30) student teachers. The results revealed that the average degree of student-teacher acquisition of skills was high in its four dimensions. It ranged between (39.2) to (82.2), while the overall average was (56.2).
... Show MoreThe implicit is the narrative technique used to give indirect hidden messages. To read between the lines means to understand the implicit meaning that is not directly indicated. This technique is expressed in two forms: the hypothesis and the implications of linguistic and non-linguistic rules. Nathalie Sarraute’s "Pour un oui ou pour un non" states this narrative method through her character’s verbal and non-verbal dialogue. The present paper discusses the implicit method and shows the reason behind which the author uses it in her play "Pour un oui ou pour un non".
Résumé
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The research aims to show the effect of some short-term debt instruments (central treasury transfers, cash credit granted to the government by commercial banks) on the production of the wheat crop in Iraq, through its effect on money supply during the period (1990-2018), As the study includes two models according to the statistical program (Eviews9), the first model included measuring the effect of short-term debt instruments on money supply, and the second measuring the extent of the money supply's impact on Wheat crop production, as the results of the standard analysis showed that the short-term debt instruments used in the model were Significant effect on wheat crop production indirectly through its effect on money supply, As
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The a i m of the present study is to shed some light on the
imm u nol ogica l effect of so lub l e protei ns extracted from Proteu mirabilis th rough em ployi ng t he level of the en zy mati c activity of Superoxide Dismutase,SOD.
The olublc proteins·Sp I and Sp2,were extracted by usi ng th e lysosyme enzyme .The rabbits were divided into three groups ,the fir t one was injected w
... Show MoreThis research began by explaining its variables and dimensions especially the digital gap, which the authors explained it elaborately beginning with the concept, the reasons blind its emergence of its measurement, and how to treat it. The authors supposed the potentiality of relying on enforcing knowledge in general and the groups suffer from this gap in particular, especially the targeted knowledge to treat its subject.
As enforcing knowledge usually depends on some strategies or choices of organizational orientation among them is learning and training from one side, and communication, as an indicating factor for organizational effectiveness as the authors refer from the other side.
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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.
