Infection at the site of vascular anastomosis is a serious complication of vascular surgery and is associated with a high limb loss and mortality rate. The classical method of management is ligation of the injured artery, adequate wound debridement and restoration of circulation. The latter is achieved by either in situ or extra-anatomic bypass. If the distal circulation is not maintained, subsequent amputation is most likely.
Objectives: In this study we tried to assess the efficacy of extra-anatomic synthetic bypass grafts in the treatment of vascular infection in the groin to save the limb and avoid the inevitable amputation.
Methods: Between January 2006 and December 2007, ten male patients aged twenty to thirty five years (mean=27.3years), with previous vascular surgery (reversed saphenous vein grafting) for sub-inguinal penetrating injuries complicated with infection and bleeding were admitted and managed surgically in the Department of Thoracic and Vascular Surgery, Surgical Specialties Hospital, Medical City Teaching Complex, Baghdad. These patients were studied retrospectively regarding their demographic and clinical features as well as details of the operative procedures and surgical outcome.
All patients received emergency wound debridement, arterial ligation and extra-anatomic synthetic (PTFE) bypass grafts (External iliac or common femoral to distal superficial femoral or popliteal artery, six routed laterally and four routed medially in the thigh away from the original surgical field).
Results: Excellent results were obtained in nine patients who saved amputation while one patient ended with above knee amputation. No mortality recorded.
Conclusion: Extra-anatomic bypass is a useful approach in dealing with infected and disrupted vascular anastomosis and can be used in emergency as well as elective situations as mentioned in most literatures.
Inherited metabolic disorders (IMDs) are a diverse group of hereditary abnormalities that leads to a defect in metabolic pathway. Its diagnosis has been transformed by the innovations of molecular genetics and computational biology. Conventionally, diagnosis of IMDs is dependent on clinical findings and biochemical tests. Yet, these methods are limited due to a heterogeneity of such disorders and a large number of genes involved. The main objective of this review is to highlight the role of next-generation sequencing (NGS), including targeted gene panels, whole-exome sequencing (WES), and whole-genome sequencing (WGS), in the diagnosis of IMDs and providing reliable information in identifying genetic causes, and to explore the integrated an
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The research seeks to identify the role of the International Assurance Standard (3402) in the auditor's procedures, as the importance of the research stems from providing assurance services for control tools through reports that are prepared according to this standard, which contribute to strengthening audit procedures through a proposed assurance program. Many conclusions were reached, the most important of which The assurance operations are considered among the operations with a special assignme
... Show MoreTransgenic plants offer advantages for the manufacture of recombinant proteins with terminal
mannose residues on their glycan chains. So plants are chosen as source of pharmaceutical products and for
the development of alternative expression systems to produce recombinant lysosomal enzymes. In the
present study the sequence of the natural cDNA encoding for the human lysosomal enzyme
glucocerebrosidase (GCD) was modified to enhance its expression in soybean plants. The glucocerebrosidase
gene signal peptide was substituted with that signal peptide for the Arabidopsis thaliana basic endochitinase
gene to support the co-translational translocation into the endoplasmic reticulum (ER), and the storage
vacuol
Background: one of the complications of power bleaching is surface roughness of enamel which increases the possibility of post bleaching teeth discoloration. The aim of the present study is to evaluate the effect of toothpaste containing nano hydroxyapatite, NovaMin and kin sense fluoride on surface roughness of human tooth enamel after laser bleaching with 35% hydrogen peroxide bleaching gel. Materials and Methods: Twenty human enamel incisors were cleaned and their labial surface polished up to #1200, then categorized into four equal groups; first group kept without bleaching as a control group, while the remaining three experimental groups were bleached with 35% hydrogen peroxide, and each group treated with a restore paste containing o
... Show MoreThe need for detection and investigation of the causes of pollution of the marshes and submit a statistical study evaluated accurately and submitted to the competent authorities and to achieve this goal was used to analyze the factorial analysis and then obtained the results from this analysis from a sample selected from marsh water pollutants which they were: (Electrical Conductivity: EC, Power of Hydrogen: PH, Temperature: T, Turbidity: TU, Total Dissolved Solids: TDS, Dissolved Oxygen: DO). The size of sample (44) sites has been withdrawn and examined in the laboratories of the Iraqi Ministry of Environment. By illustrating SPSS program) the results had been obtained. The most important recommendation was to increase the pumping of addit
... Show MoreThe audience is one of the important practical elements in the theatrical show and its importance is not confined to its static activity as a receiver element only, rather it went beyond that issue as an effective and influential element in the proceedings of the show and the process of meaning construction, that it gains an active role in the construction and production of the connotation that influences and is influenced by the actor, where the communication channels are open between the two sides, consequently a kind of watching and joint interaction happens between them. Thus, it has become necessary for the actor to create a suitable environment for the onlookers in order for it to be an essential part of the show system. The
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Rationale, aims and objectives: A review of studies published over the last six years gives update about this hot topic. In the middle of COVID-19 pandemic, this study findings can help understand how population may perceive vaccinations. The objectives of this study were to review the literature covering the perceptions about influenza vaccines and to determine factors influencing the acceptance of vaccination using Health Belief Model (HBM). Methods: A comprehensive literature search was performed utilizing PubMed and Google Scholar databases. Three keywords were used: Influenza vaccine, perceptions, and Middle East. Empirical studies that dealt with people/ HCW perceptions of influenza vaccine in the Middle East and writt
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In globalization, the world became open area to competition for the attractive of investment, and the abilities of each country to win the confidence of investors depend upon the preparation to optimize circumstances. The competitiveness is an essential means of expanding the capacity of developed to coexist in an international environment characterized by globalization. While competition describes the market structure, the behavior of investors and business, competitiveness is interested in the evaluation of business performance or countries and compare them in the conditions of competition available in these markets. Regarding Malaysia, which is depend on FDI-Export- Led Growth strategy, it has taking on diffe
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In this work, an estimation of the key rate of measurement-device-independent quantum key distribution (MDI-QKD) protocol in free space was performed. The examined free space links included satellite-earth downlink, uplink and intersatellite link. Various attenuation effects were considered such as diffraction, atmosphere, turbulence and the efficiency of the detection system. Two cases were tested: asymptotic case with infinite number of decoy states and one-decoy state case. The estimated key rate showed the possibility of applying MDI-QKD in earth-satellite and intersatellite links, offering longer single link distance to be covered.
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