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 thirties and the early forties and the at end of the World War II of the last century
witnessed several attempts carried out by the Public Health Directorate and by the Iraqi
Ministry of Foreign Affairs to persuade the Rockefeller Foundation to fund Iraq with its
health program which is carried out in several regions in the world to promote the health and
social situations since Iraq during that period in history was badly in need to such plans and
programs because of this lack of financial and technical possibilities necessary for the
advancement of health and social dire situation.
The details of these attempts are deposited in the documents of the diplomatic mail
records of the United States of America , an
Machine learning models have recently provided great promise in diagnosis of several ophthalmic disorders, including keratoconus (KCN). Keratoconus, a noninflammatory ectatic corneal disorder characterized by progressive cornea thinning, is challenging to detect as signs may be subtle. Several machine learning models have been proposed to detect KCN, however most of the models are supervised and thus require large well-annotated data. This paper proposes a new unsupervised model to detect KCN, based on adapted flower pollination algorithm (FPA) and the k-means algorithm. We will evaluate the proposed models using corneal data collected from 5430 eyes at different stages of KCN severity (1520 healthy, 331 KCN1, 1319 KCN2, 1699 KCN3 a
... Show MoreThe development of wireless sensor networks (WSNs) in the underwater environment leads to underwater WSN (UWSN). It has severe impact over the research field due to its extensive and real-time applications. However effective execution of underwater WSNs undergoes several problems. The main concern in the UWSN is sensor nodes’ energy depletion issue. Energy saving and maintaining quality of service (QoS) becomes highly essential for UWASN because of necessity of QoS application and confined sensor nodes (SNs). To overcome this problem, numerous prevailing methods like adaptive data forwarding techniques, QoS-based congestion control approaches, and various methods have been devised with maximum throughput and minimum network lifesp
... Show MoreRegression testing being expensive, requires optimization notion. Typically, the optimization of test cases results in selecting a reduced set or subset of test cases or prioritizing the test cases to detect potential faults at an earlier phase. Many former studies revealed the heuristic-dependent mechanism to attain optimality while reducing or prioritizing test cases. Nevertheless, those studies were deprived of systematic procedures to manage tied test cases issue. Moreover, evolutionary algorithms such as the genetic process often help in depleting test cases, together with a concurrent decrease in computational runtime. However, when examining the fault detection capacity along with other parameters, is required, the method falls sh
... Show MoreJava is a high-level , third generation programming language were introduced Javaoptics Open Source Physics (OSP) as a new simulation for design one of the most important interference optical coating called antireflection coating. It is recent developments in deign thin-film coatings. (OSP) shows multiple beam interferences from a parallel dielectric thin film and the evolution of reflection factors. It is simple to use and efficiently also can serve educational purposes. The obtained results have been compared with needle method