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.
The theatre is one of the main pillars of the human aesthetic thinking as it contains logical explanations for the public human life aspects outside time and environment. When we find that the directive philosophical thinking moving away from the stylistic constants and the virtual laws in taboos that control the accomplishment in terms of the traditional shapes, the employment and the theatrical reception. Some directors moved in post-modernism concepts in a perceptive that liberates thought from its natural context in thinking into an innovative perceptive. The aesthetic images are the basic premise in the prohibition of the philosophical thinking interpretation in order to move the directive thinking and this movement depends on the v
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An experimental and numerical investigation of the effect of using two types of nanofluids with suspending of (Al2O3 and CuO) nanoparticles in deionized water with a volume fraction of (0.1% vol.), in addition to use three types of fin plate configurations of (smooth, perforated, and dimple plate) to study the heat transfer enhancement characteristics of commercial fin plate heat sink for cooling computer processing unit. All experimental tests under simulated conditions by using heat flux heater element with input power range of (5, 16, 35, 70, and 100 W). The experimental parameters calculated are such as water and nanofluid as coolant with Reynolds number of (7000, 8000, 9400 and 11300); the air
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A finite element is a study that is capable of predicting crack initiation and simulating crack propagation of human bone. The material model is implemented in MATLAB finite element package, which allows extension to any geometry and any load configuration. The fracture mechanics parameters for transverse and longitudinal crack propagation in human bone are analyzed. A fracture toughness as well as stress and strain contour are generated and thoroughly evaluated. Discussion is given on how this knowledge needs to be extended to allow prediction of whole bone fracture from external loading to aid the design of protective systems.
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In the Rumaila oilfields in southern Iraq, the Zubair Formation was deposited in a shallow environment as three main facies, delta plain, backshore, and delta front depositional conditions indicating a transition from delta front and delta plain to a highstand level due to the finning upward mode. The facies of the Zubair clasts show well-sorted quartz arenite sandstone, poorly sorted quartz arenite sandstone, clayey sandstone that has not been properly sorted, sandy shale, and shale lithofacies. The minor lithofacies were identified using well-logging methods (gamma ray, spontaneous potential and sonic logs) and petrography. The Zubair clasts are of transition environment that appears to be transported from freshwater and deposited
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The purpose of this research is to identify the effect of the use of project-based learning in the development of intensive reading skills at middle school students. The experimental design was chosen from one group to suit the nature of the research and its objectives. The research group consisted of 35 students. For the purpose of the research, the following materials and tools were prepared: (List of intensive reading skills, intensive reading skills test, teacher's guide, student book). The results of the study showed that there were statistically significant differences at (0.05) in favor of the post-test performance of intensive reading skills. The statistical analysis also showed that the project-based learning approach has a high
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The second most commonly diagnosed cancer is colorectal cancer (CRC) is in female. The levels of progranulin, obestatin and liver enzymes including ALT, AST and ALP were measured in forty five sera in female patients suffering from CRC before chemotherapy initiation treatment as G1, G2 after first chemotherapy cycle and G3 after second chemotherapy cycle compared with thirty female as a healthy control G4. Results showed a high significant increased in progranulin concentration and a high significant decrease in obestatin in G2 than other groups. The correlation between progranulin and ALP was a significant negative (-ve) relation while obestatin with AST gave a significant positive (+ve) correlation in G. The results also showed non signif
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This study was performd on 50 serum specimens of patients with type 2 diabetes, in addition, 50 normal specimens were investigated as control group. The activity rate of LAP in patients (560.46 10.504) I.U/L and activity rate of LAP in healthy(10.58 4.39)I.U/L.The results of the study reveal that Leucine aminopeptidase (LAP) activity of type 2 diabetes patient s serum shows a high signifiacant increase (p < 0.001) compare to healthy subjects. Addition preparation leucine amide as substrate of LAP, identification melting point and spectra by FTIR. K