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
Decision-making in Operations Research is the main point in various studies in our real-life applications. However, these different studies focus on this topic. One drawback some of their studies are restricted and have not addressed the nature of values in terms of imprecise data (ID). This paper thus deals with two contributions. First, decreasing the total costs by classifying subsets of costs. Second, improving the optimality solution by the Hungarian assignment approach. This newly proposed method is called fuzzy sub-Triangular form (FS-TF) under ID. The results obtained are exquisite as compared with previous methods including, robust ranking technique, arithmetic operations, magnitude ranking method and centroid ranking method. This
... Show MoreIn this research, optical communication coding systems are designed and constructed by utilizing Frequency Shift Code (FSC) technique. Calculations of the system quality represented by signal to noise ratio (S/N), Bit Error Rate (BER),and Power budget are done. In FSC system, the data of Nonreturn- to–zero (NRZ ) with bit rate at 190 kb/s was entered into FSC encoder circuit in transmitter unit. This data modulates the laser source HFCT-5205 with wavelength at 1310 nm by Intensity Modulation (IM) method, then this data is transferred through Single Mode (SM) optical fiber. The recovery of the NRZ is achieved using decoder circuit in receiver unit. The calculations of BER and S/N for FSC system a
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The heat exchanger is a device used to transfer heat energy between two fluids, hot and cold. In this work, an output feedback adaptive sliding mode controller is designed to control the temperature of the outlet cold water for plate heat exchanger. The measurement of the outlet cold temperature is the only information required. Hence, a sliding mode differentiator was designed to estimate the time derivative of outlet hot water temperature, which it is needed for constructing a sliding variable. The discontinuous gain value of the sliding mode controller is adapted according to a certain adaptation law. Two constraints which imposed on the volumetric flow rate of outlet cold (control input) were considered within the rules of the proposed
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The design of reinforced concrete spread foundations mainly depends on soil bearing capacity, loading value, and column size. So for each design case, tiresome calculations and time consumption are needed. In this paper, generalized design charts are presented and plotted according to derivations based on the ACI 318 M-2019 Code. These charts could be used directly by the structural designers to estimate the column size, foundation thickness, and dimensions as well as the foundation reinforcement under a certain given concentric load assuming a uniformly distributed contact pressure underneath the foundation. Of noteworthy, these charts are oriented to deal with square isolated footings with a square concentric column, covering reasonable r
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The psychological burnout is considered one of dangerous phenomenon’s which appeared in the 70s of the 20th century and suffered by most of the society classes. It is a term which the wide uses and various meaning like emotional, mental, and physical exhaustion and chronic weak exhaustion. The presented research aims t identify the psychological burnout as for the Kindergarten teacher and the differences significance according to the variations (Kindergarten type: private or govern mental). The research sample contains 400 female teachers divided to 170 governmental Kindergarten teachers and 230 private Kindergarten teachers. The researcher prepared a measurement method to measure the psychological burnout for those teachers after
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