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.
Death is undoubtedly the theme of Don DeLillo’s White Noise. Murray Siskind, a College-on-the-Hill professor who is obsessed with the exploration and reinterpretation of American popular culture, talks about the Tibetan Book of the Dead, and the German mentor of Jack Gladney has been using the Egyptian Book of the Dead, translated into German. The core episode of the story is the Airborne Toxic Event, the associate of Heinrich (Jack’s teenage son), Orestes Mercator, dreams of becoming one of the great figures in the Guinness Book by challenging and confronting death by enclosing himself in a glass pen jam-packed with poisonous snakes, and Heinrich challenges an imprisoned mass murderer in a chess game. The scholarly expertise of Jack c
... Show MoreThe research aim at identifying the time of motor response to auditory and visual stimuli as well as identifying the accuracy of blocking and finding the relationship between motor repose time and blocking accuracy. The community was (7) primer soccer league of 2019 – 2020 and the subjects were (24) volleyball players from Al Jaish and Al Shorta clubs ten players from Al Shorta club performed the pilot study. The researchers used the descriptive method and the data was collected and treated using SPSS. The results showed a significant relationship between response time and blocking accuracy. The researchers recommended concentrating on applying scientific principles for developing time of motor response in a manner suitable for bl
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The different crises and financial collapses place in many companies, particularly in developed countries as a result of administrative and financial corruption return aspects of the task to the role of the company and the external auditor, both in their emphasis on honesty and fairness of financial statements and the Provisions of accounting information and on the contrary to the truth, you may have to the loss of the rights of stakeholders, particularly existing investors, and the loss of confidence of prospective investors in the accounting information contained in the financial statements of these companies, which led to a crisis of confidence and credibility in the profession of accounting and auditing where the wonder of ma
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The need for Dewatering is very important in construction workshops field and sometimes it needs to pay more attention as a result of its impacts on causing additional settlement of nearby pile foundations. Dewatering construction may become a costly topic if ignored during project planning and designing .In this paper a simplified procedure maybe adopted to calculate the foundation settlement induced by using dewatering system which is required to lower the water table level to reach a dry condition during construction. Synthesized case study adopted at a specified location in Baghdad city and analysis are computed for two types of piles both of them are submerged with water. Results shows the effect of dewatering on pile foundatio
... Show MoreMany studies of the relationship between COVID-19 and different factors have been conducted since the beginning of the corona pandemic. The relationship between COVID-19 and different biomarkers including ABO blood groups, D-dimer, Ferritin and CRP, was examined. Six hundred (600) patients, were included in this trial among them, 324 (56%) females and the rest 276 (46%) were males. The frequencies of blood types A, B, AB, and O were 25.33, 38.00, 31.33, and 5.33%, respectively, in the case group. Association analysis between the ABO blood group and D-dimer, Ferritin and CRP of COVID-19 patients indicated that there was a statistically significant difference for Ferritin (P≤0.01), but no-significant differences for both D-dimer and CRP.
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Teaching techniques are the vehicles, which are used by teachers to help pupils learn and gain experiences and create positive classroom activities, as much as these techniques are varied, they lead to successful and fruitful learning in the foreign language. They help teachers achieve their objectives (Asowrth, 1985: 124).
The English language teacher's work is an active and purposeful one when he can plan carefully and frequently make the necessary changes in the contents and methods of teaching programme to fit the interest and needs of pupils. It seems that the majority of primary English teachers' interests does not go far in planning their work, and do not understand which o
... Show MoreThis study was conducted in 2018, at Technical College of Applied Sciences, Sulaimani Polytechnic University, and Kurdistan Region-Iraq. The aim of the study was to determinate nutritional compositions and some elemental contents in marketable white button mushroom (Agaricus bisporus) that is collected in local markets of Kurdistan Region-Iraq. Five different samples (A: Penjwen product fresh, B: Sulaimani product fresh, C: American caned, D: Valencia Netherlandcaned and E: Erbil product fresh) were collected to be observed. The elements were analyzed by Atomic Absorption Spectrometry methods, and their chemical compassions were determined, too. The collected data were analyzed by One Way ANOVA. The highest fat, protein, fiber and dry matte
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