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
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This study seeks to address the impact of marketing knowledge dimensions (product, price, promotion, distribution) on the organizational performance in relation to a number of variables which are (efficiency, effectiveness, market share, customer satisfaction), and seeks to reveal the role of marketing knowledge in organizational performance.
In order to achieve the objective of the study the researcher has adopted a hypothetical model that reflects the logical relationships between the variables of the study. In order to reveal the nature of these relationships, several hypotheses have been presented as tentative solutions and this study seeks to verify the validity of these hypotheses.
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The administration on the basis of the activities designed to evaluate the performance of activities in terms of cost, time and quality by identifying activities that add value and those that are no add value and enables the administration of making up their own continuous improvement in production, through lower costs and reduce the time and improve the quality and reduce the incidence of spoilage and waste, y based search Ally premise that (the continuous improvement of the adoption of management style on the basis of the activities helps management in decision-making wise to reduce costs) to prove the hypothesis has sought research to achieve its goal of Alkadivh and Alkoppelan &nb
... Show MoreThe researches to discover useful ways to represent the agents and agent-based
systems are continuous. Unified Modeling Language (UML) is a visual modeling language
used for software and non software modeling systems. The aim of this paper is: using UML
class diagram to design treasury pharmaceuticals agent and explain its internal action. The
diagram explains the movement of the agent among other nodes to achieve user's requests
(external) after it takes them. The paper shows that it is easy to model the practical systems by
using agent UML when they are used in a complex environment.
Pilot-scale dead end microfiltration membranes were carried out to determine the feasibility of the process for treating the oily wastewater which discharge from some Iraqi factories such as power station of south of Baghdad and the general company of petrochemical industries. Polypropylene membranes (cylindrical shape) with different pore diameters (1 and 5 micron) were used to conduct the study on micromembrane process. The variables studied are oil concentration (100 – 1000 ppm), feed flow rate (20 – 40 l/h), operating temperature (31 – 50°C) and time (0 – 3 h). It was found that the flux increases with increasing feed flow rate, temperature and pore size of membrane, and decreases with increasing oil concentration and operating
... Show MoreA numerical method (F.E.)was derived for incompressible viscoelastic materials, the aging and
environmental phenomena especially the temperature effect was considered in this method. A
treatment of incompressibility was made for all permissible values of poisons ratio. A
mechanical model represents the incompressible viscoelastic materials and so the properties can
be derived using the Laplace transformations technique .A comparison was made with the other
methods interested with viscoelastic materials by applying the method on a cylinder of viscoelastic material surrounding by a steel casing and subjected to a constant internal pressure, as well as a comparison with another viscoelastic method and for Asphalt Concrete pro