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
In their cross-sectional study, Al-Rubaye et al studied the extent of vitamin D (VD) deficiency/ insufficiency, factors affecting its degree, and the adverse outcomes of the altered VD status among a group of mothers and their neonates from Baghdad, Iraq. They found that 96.6% of the mothers had VD deficiency/ insufficiency compared to 86.4% in their neonates. Maternal VD levels and neonatal weights were significantly correlated with neonatal VD levels. We believe that the study results need to be revised. This is based two points listed in this letter to editor
Whereas conventional methods of teaching history do not meet the sometimes purpose has suggested some educators strategies modern help to improve the level of students in the education process through activating prior knowledge and employed in positions of current learning, and focus attention on the points and the outstanding elements of the content and practice techniques Calendar criticof ideas and meanings and mental and linguistic activities used to verify the extent of reaching understanding. &n
... Show MoreModern French novel has gained a distinctive status in the history of French literature during the first half of the twentieth century. This is due to many factors including the new literary descriptive objective style adopted by novelists like Alain Robbe – Grillet that has long been regarded as the outstanding writer of the nouveau roman, as well as its major spokesman, a representative writer and a leading theoretician of the new novel that has broken the classical rules of the one hero and evolved, through questioning the relationship of man and the world and reevaluating the limits of contemporary fiction , into creating a new form of narrative.
Résumé:
En vue de résu
... Show Moreמטרת המחקר הזה היא לבדוק את שלושה סיפורים קצרים מהקובץ הראשון של אהרון אפלפלד , שנחשב ההצהרה הרשמית על היותו סופר השואה הראשון בישראל , המשותף לשלושת הסיפורים הוא הנימה של הגיבורים היוצאים למסע פיזי ונפשי לגלות את אשר אירע להם , מגמתו של המחקר היא לבדוק את הצורה המיוחדת שבה אפיין אפלפלד את גיבוריו שמעידים על כך , כי השואה היא החוויה המרה והקשה בקרב היהודים והשלכותיה נשארה טמונה בקרבם גם אחרי המלחמה ואחרי שנים
... Show MoreThe research aims to identify the role of the dimensions of financial inclusion in achieving the competitive advantage by An exploratory research of the views of a sample of customers of the 20 Algerian commercial banks, And the relationship between its dimensions (Access dimension, Usage dimension, Quality) And competitive advantage. This research is based on the analytical descriptive approach. The questionnaire was adopted as a main tool in collecting data and information on the sample of 377.
The The research showed several results, the most important of which is a strong correlation between the dimensions of the three financial inclusion combined and the competitive advantage of the Algerian commercial banks, and explained t
... Show MoreThis research is drawn from a doctoral dissertation, studying the approach of Sheikh Abd al-Qadir al-Muhajir al-Sanandji al-Kurdi (1303 AH) on the issue of proving the existence of God Almighty.
Sheikh Abd al-Qadir al-Sanandji was one of the scholars well versed in mental sciences. He has many books, all of them in the sciences of speech and wisdom, and among his books is the book (Raising the Eyebrow in Explanation of Ithbat al-Wajib), which is still a manuscript that has not been printed.
Through this book, the researcher studied the evidence of Sheikh Abdul Qadir to prove the existence of God Almighty, and compared it with the evidence of philosophers and theologians.
At the beginning, he presented a study on the import
The present study is concerned with studying the effect of aquatic plant Hydrella vorticellata with the concentration of 10 and 20 gm/2 K gm soil on percentage and growth rate of germinating seeds of Hordeum vulgare and Vicia faba. More overs, the quantitative amount of NPK in both tested plants and Hydrella vorticellata, are estimated as an organic fertilizer. It has also been find the total number of root cells, the number of dividing cells, and stages of mitosis. The study reveales, that there are no significant differences between the concentration of hydrella used in germination percentage, growth rate, wet and dry weight. While there are differences in the plants containing NPK. The number of cells dividing stages and number of divid
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Recently, there has been a notable surge in interest surrounding entrepreneurial orientation and strategic entrepreneurship. These concepts are particularly relevant due to their modern characteristics that aid in adapting to the environment. They also play a crucial role in improving production, service, and technological processes to sustain value, minimize competition, and drive ongoing enhancements, ultimately leading to a position of leadership within public companies. Therefore, the primary focus of this research was to examine the influence of entrepreneurial orientation on achieving strategic entrepreneurship. This influence is further mediated by the presence Iraqi Ministry of Agric
... Show MoreBackground: evaluate the effects of three different intracoronal bleaching agents on the shear bond strengths (SBS) and failure site of stainless steel and monocrystalline (sapphire) orthodontic brackets bonded to endodontically treated teeth using light cured orthodontic adhesive in vitro. Materials and methods: Eighty extracted sound human upper first premolars were selected, endondontically treated and randomly divided equally (according to the type of the brackets used) into two main groups (n = 40 per group). Each main group were subdivided (according to the bleaching agent used) into four subgroups 10 teeth each; as following : control (un bleached) group, hydrogen peroxide group (Hp) 35%, carbamide peroxide group (CP) 37% group and s
... Show MoreThe study aimed to prepare a set of qualifying exercises to improve the muscular strength of the muscles surrounding the ankle joint by applying different resistances according to the nature of the movement of this joint, which is one of the second moving joints (flexion, extension and rotation of the right and left) in order to increase the efficiency of all muscles working on this joint according to those movements and identification On the impact of these exercises and assume that there will be statistical differences between the two tests of the research sample. The researcher used the semi-articulated experimental method with a pre- and post-test for one group. The injury was evaluated on the women's national team players durin
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