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 Research dealt with the role of the target costs in reducing the cost of products in the General Company for soft drinks. One the modern approaches reduce costs and thus increase the ability and continuity to compete in the market. Where the problem of research in identifying the shortcomings in the traditional method used in the company sample research. Which led to a weak control of the cost and the researcher relied on data and costs of the company. The research recommended that the target cost of the company should be applied to the research sample. Training the employees. In addition, preparing training courses for them. He stressed the need to address obstacles that prevent the existence of an effective cost system. Including t
... Show MoreDespite the importance of sustainable development and its dimensions in developing performance and supporting competitive advantage in economic units, there is a gap and lack of coordination between Combined Assurance providers (management, internal audit, external audit) to report on sustainable development, and the research aims to propose a model for the Combined Assurance report to achieve development sustainable development in the Iraqi economic units, especially the Baghdad Municipality, enables assurance providers to coordinate efforts that lead to the achievement of Combined Assurance, The research found the proposed model for the Combined Assurance report in achieving sustainable development in the Iraqi economic units, es
... Show MoreThe rubber ropes exercises affected muscle groups, which in turn affects the corners of the conditions of the body before and over the barrier where affected the time passed. To change the angle of the approaching and payment impact on passing each times the barrier 1-5. That passed over the barrier 1and gate 5 impacts on the nature of the achievement, where time has become less. Find the values of cruise missiles and other phases and stages of pitch angle other categories which it enshrines stood as compelling rejection men's 110m hurdles. Find the value of the instant messaging distances between different barriers and stages. Studies by adding rubber sling barriers race categories, measurement of kinematic variables. Emphasis on the devel
... Show MoreEach organization has values and objectives, tangible and intangible properties of its products. The reflection of properties on the brand constitutes the identity of the brand that contributes to building the customer's convictions about the products or services provided by any organization and its brand in a positive or negative way. This is reflected in purchasing behavior, which may push forward the progress towards marketing goals or deviation from them. Therefore, the current research came to identify the brand identity, its types and the factors affecting them and how they affect to achieve each of the marketing goals. At a time when
... Show MoreThe research aimed to shed light on the impact of international Accounting Standard No (21) on tax obstacles represented by (tax evasion, double taxation) The financial statements of a group of banks operating in the private sector were relied upon to know the impact of the standard on tax obstacles, as well as knowing the amount of amounts, The researcher relied on the method of financial analysis of that data, which was obtained from the website of the Securities Commission, and conducted personal interviews with a number of university professors, chartered accountants, financial experts, banks, and the General Authority for Taxes to benefit from their
... Show MoreThat internal control is particularly important in improvingperformance and tax reform، they play an important role in the regularity ofwork and development and the anti corruption and activating the decisionsand tax legislation، as contained in the organizational plan and the means،procedures and components designed from which to ensure a policy andimplementation plans The research aims to review the reality of the internalcontrol in the General Commission for Taxes and stand on the deficiencies init, with the strengthening of the role of internal control in the GeneralAuthority for taxes based on the laws and regulations and by using modernmeans to work as well as developing the performance of employees in thebody، including helpin
... Show MoreIt has been an increase concern of scientific and professional accounting sides on disclosure especially after appearance of business firms and accounting development with its relationship to financial statements which are considered to be outputs of the activity results. The preparing of financial statements and auditing of those accounts according to normal principles and standards of accounting on both local and international levels. Accounting disclosure can be seen an importance through discover all fundamental and necessary information for proper supply. Therefore, the research will highlight on public companies commitment in Iraq for basis and standards which have taken disclosure in financial data. The conceptual frame of t
... Show MoreABSTRACT
The current research aims at highlighting the role of engagement of a sample of employees who works in some of the Iraqi private banks in terms of their interaction , commitment and enthusiasm and the positive impact they own regarding their job and devote their efforts to achieve the core purpose which is customer loyalty. The problem was expressed through a number of intellectual and practical questions.
In order to achieve the aim of the research the quantitative analytical method was used depending on a questionnaire as a basic tool to collect research data and the qualitative survey method depending on semi-structured interviews which were distrib
... Show MoreWater has a great self-generating capacity that can neutralize the polluting interventions carried out by humans. However, if human activities continue this uncontrolled and unsustainable exploitation of this resource, this regenerating capacity shall fail and it will be jeopardized definitively. Shatt Al-Arab River in South of Iraq. It has an active role in providing water for irrigation, industry, domestic use and a commercial gateway to Iraq. in the last five years Shatt Al-Arab suffered from a rise in pollutants due to the severe decline in sewage networks, irregular networks and pesticide products, as well as the outputs of factories and companies that find their way to water sou