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 concept of sustainability is one of the modern concepts that influenced the quality of the urban plans for the cities, through the interest in the environmental and social aspects as well as the economic aspect and the need to balance to achieve sustainable development.
The research aims to identify the most prominent methods of sustainable urban land use planning and the strategies developed within these approaches to achieve sustainable development. The research started from the problem of a knowledge gap in adopting sustainable approaches and strategies when planning urban land uses for the holy city of Karbala.
In the theoretical aspect, the concepts of sustainable development, sustainable planning methodologies a
... Show MoreA study has been done to find the optimum separators pressures of separation stations. Stage separation of oil and gas is accomplished with a series of separators operating at sequentially reduced pressures. Liquid discharged from a higher pressure separator into the lower pressure separator. The set of working separators pressures which yield maximum recovery of liquid hydrocarbon from the well fluid is the optimum set of pressures which is the target of this work.
Computer model is used to find the optimum separators pressures. The model employs the Peng-Robinson equation of state for volatile oil. Application of this model shows good improvement of al
The rapid developmemt of information technology and its use in all fields has a bositive influence on all fields , and financial markets have a share of this development through the use of an electronic trading system to settle transactions and enhance transparency and disclosure in all activities of these markets and stimulate their performance .
It is worth nothing that these revolutions remove the necessity for nonstop connection with persons through the internet or phone networks , novel knowledge decreases the charges of structure original transaction system and reducing the fences of new participants entry .
The development in transportations expertise allows for quicker or
... Show MoreThe study aims to identify the effectiveness of employing microteaching in acquiring teaching skills of students teaching basic stage in Al-Aqsa University. The two researchers used the experimental method and a quota sample consisted of a group of (80) students who were distributed on the university two branches in Gaza and Khan younis and on males and females equally, and on four teaching courses counted (20) students for each. The study tool represented in an observation card ,and the results showed statistically significant differences between the level of all the skills of teaching and between the standard rate (75%) in favor of teaching skills, also showed statistically significant differences attributed to the variable of the univ
... Show MoreThe primary function of commercial banks is the process of converting liquid liabilities such as deposits to illiquid assets, (also known as a loan), liquid assets, (aka cash and cash equivalent) in a balanced manner between liquid and illiquid assets, that guaranteed the preservation of the rights of depositors and the bank and not by converting liquid liabilities into liquid assets in a very large percentage. This comes from its role as depository and intermediary institutions between supply and demand, therefore, we find that the high indicators of bank liquidity and solvency may reflect a misleading picture of the status of commercial banks, to some extent in terms of the strength of their balance sheets and
... Show MoreIn light of today's business world, who faces challenges and intense competition as a result of the rapid evolution of technical and informational, organizations had to respond to variables through the adoption of modern management techniques that reduce the effects of risks and activating the role of the internal control system in order to contribute to the early detection of risks and reduce the negative results expected .The research is to address the problem faced by organizations which still follow the traditional methods in the control activities, and the lack of knowledge of the management and their staff of the importance of the existence of risk management and internal control system takes into account these risks, and the limit
... 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 MoreThe 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
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