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 present paper aims at evaluating the vailability quality and future horizons of potable water in the city of Shatra as a model. This is done in accordance with certain subjective and objective factors alongside the classification map of Shatra as a residential area. This system follows geographical studies specialized in urban construction. The problem of the present paper as well as the data approaching that problem have been chosen from the records of 2018. The researcher offered (919) questionnaire forms to be answered by a sample of dwellers in that area. Besides, the researcher also followed lab analysis of water samples collected from districts in the city of Shatra. GIS technology was also used to arrive at the real water shar
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Background Psoriasis is one of the most prevalent chronic inflammatory skin conditions; its prevalence ranges from 1 to 3%. Tumor necrosis factor-alpha (TNF-α), a cytokine that enhances inflammation, is overexpressed in synovium and skin plaques in psoriasis. TNF-α plays a critical role in the pathogenesis of psoriasis. IL-10 is the most crucial cytokine for reducing excessive immune responses and decreasing pro-inflammatory reactions in all autoimmune disorders. Objective To evaluate the effect of Apremilast on ILـ10, TNFـα, and BMI in obese psoriatic patients. Methods Thirty patients included in this investigative study to measure the concentrations of TNFـα, ILـ10 and BMI, before and after receiving Apremilast. TNFـα and
... Show MoreThe present study aims to identify the most and the least common teaching practices among faculty members in Northern Border University according to brain-based learning theory, as well as to identify the effect of sex, qualifications, faculty type, and years of experiences in teaching practices. The study sample consisted of (199) participants divided into 100 males and 99 females. The study results revealed that the most teaching practice among the study sample was ‘I am trying to create an Environment of encouragement and support within the classroom which found to be (4.4623). As for the least teaching practice was ‘I use a natural musical sounds to create student's mood to learn’ found to be (2.2965). The study results also in
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The contractual imbalance is perceived today by the majority of the doctrine as being one of the pitfalls to the execution of the contracts. As a result, most legislations grant judges the power to intervene to restore it. Granting the judge the power to complete the contract raises the question of the extent to which the judge can obtain such power. Is it an absolute authority that is not limited? If so, is it a broad discretion in which the judge operates in his conscience, or is it a power of limited scope by specific legal texts and conventions? This is what we will try to answer in this research.
Alice Walker (1944) ranks among the greatest American writers of the twentieth century. Through her novels Meridian and the color Purple, Alice outlines many issues concerning the effect of authoritarian thinking upon its often innocent victims, and the possibility of meaningful, productive resistance. Walker's texts aim at giving a voice to those who have no voice especially those poor, rural black women who are robbed of power and the right to make decisions about their own lives by a range of forces standing against them. These texts also aim at clarifying how Walker's female protagonists, Meridian and Celia try to free themselves from oppression, misery , fear and underestimation
... Show MoreNew membrane electrodes for determination of ciprofloxacin hydrochloride were prepared depending on ciprofloxacin hydrochloride - phosphotungstic acid (CFH-PT) as an active material and these electrodes were made with three plasticizers: Di-octylphenylphosphonate(DOPH), Di-butyl phosphate (DBP)Tri-n-butyl phosphate(TBP), in PVC matrix. One of the ciprofloxacin electrodes was gave Nernstian slope equal to 57.21 mV/ decade for DOPH membrane with concentration range from 1.5×10-5 to1.0×10-1 M, and detection limit equal to 1.5×10-6 M .Lifetime was 93 days. Non- Nernstian responses equal to 39.40 and 30.70 mV/ decade for membranes DBP, TBP, respectively. These electrodes were gave concentration range from 1.0× 10-5 to 1.0×10-2 and from 4.0
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KE Sharquie, AA Noaimi, MN Almallah, Journal of Cosmetics, Dermatological Sciences and Applications, 2014 - Cited by 2