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.
Multilevel models are among the most important models widely used in the application and analysis of data that are characterized by the fact that observations take a hierarchical form, In our research we examined the multilevel logistic regression model (intercept random and slope random model) , here the importance of the research highlights that the usual regression models calculate the total variance of the model and its inability to read variance and variations between levels ,however in the case of multi-level regression models, the calculation of the total variance is inaccurate and therefore these models calculate the variations for each level of the model, Where the research aims to estimate the parameters of this m
... Show MoreThe technology and modern social communication medias have contributed to changing many of our concepts about education to a large extent; these technological advancements have created new challenges for the Instructor of course, but on the other hand it did provided him with expressive media, models and strategies that the old methods cannot fulfill, including the flipped classroom strategy, which is one of the modern technical solutions and in it's optimal use it can correct the weakness of the traditional education and can develop the communication skills as a whole among the students, in order to create a positive, active and interactive student.
The current research contained - four chapters: the first one included the methodolog
The study intends to explore the obstacles that encounter a program of rehabilitating released prisoners as perceived by prisoners themselves in tubas' province. To this end, the researcher used a questionnaire as an instrument which was applied on (150) prisoner had chosen randomly to collect the study data. The findings revealed no significant differences among obstacles the encounter program regarding to the following variables: age, detention period, and number of detention, additionally, the findings found that there is a variance of obstacles mean according to the prisoners themselves, rehabilitation program, and the facility of that program.
Strategic leadership is the main source to enable organizations of excellence in light of turbulent environment, it is also the capabilities of organizational renewal organization’s ability to anticipate changes that take place or possible occurrence.
As a result of the many changes that characterize the environment where they operate researched hospitals, many of them began looking for ways to help it achieve a lot of their own competitive advantages.
The subject of organizational renewal capabilities of subjects that are not obvious interest in the Arab environment in general and Iraq in particular, and longer. The problem of the research and field presence of deficiencies in
... Show MoreThe theater has live foundations that interact with all symbols and signs. It has never been far from these innovations and developments in the manner of dealing with those symbols and how and the extent of their effects on society through the world of technology because the theatrical performance contributes to its structure, a technique that is employed by designers in various technologies such as ( Music, lighting and sound effects engineer, as well as fashion designer, architecture, and modeling designer). The theater today also relied on various interactive techniques represented in the use of body language and a sign in order to communicate the meaning by forming movements, singing and dancing in order for the recipient to interact
... Show MorePolitical terminology differs from any other type of terminology not only in the presence of political terminology, but also in content, structure, functions and the recipient who perceives it. Taking this into account, it is inappropriate to consider the semantic difficulties of translating Russian-language political terms solely at the semantic level. In our opinion, it is inextricably linked with the lexical, syntactic and grammatical levels. If we combine all 4 levels, then the following translation techniques can be distinguished: lexical borrowing (transcription / transliteration, tracing); modulation; generalization / concretization; omission / addition; descriptive translation; conversion [Komissarov 2013]. One of the most
... Show MoreThis study is concerned with the topic of the constant and the variable within the artistic theatrical phenomenon and specifically the accompanying music for the movements, scenes and dramatized idea, which translates the Iraqi environments (the serious ones). The researcher, here, tries to determine those variables and constants as a methodological scientific study to serve the scientific and cultural institutions and contribute in settling them intellectually, and entering them in the academic environments that depend on studying the artistic associations between the theatrical science and musical science. We find that this study which addresses the topic (the constant and the variable in the theatrical show music for the department of
... Show MorePraise be to God, Lord of the Worlds, and prayers and peace be upon the Master of Messengers, and upon his family and companions
And whoever follows his guidance until the Day of Judgment. As for what follows: Islamic law commands Muslims to unite, reject disagreement, and not dispute, and to spread the spirit of tolerance and love among them. God Almighty said: “And hold fast to the rope of God all of you and do not become divided, and remember the favor of God upon you when you are enemies and He has joined your hearts.” So, by His grace, you became brothers (1), and He said: (And You will be like those who became divided and disagreed after the clear proofs had come to them. It is they - for them is a great punishment.) (2
... Show MoreThis title may have something strange or paradoxical; it is unusual or natural to look for violence in literature, or that literature is a tool for killing through the contribution of writers and poets in generating, feeding or advocating violence. The Zionist literature belongs to the 20th century, is almost the only literature among the etiquette of peoples, which professes racism and boasts of betraying its human role, and wants to be a vehicle for terrorism domination. It also tends to be a means in the hands of killers and adventurers. Writers of this Literature show that no solution to the Jewish problem is only by Zionist presence to replace the Palestinian presence and to build the state of "Israel" on the ruins of Pa
... Show MoreThis study aimed at recognizing the impact of empowerment of human resources strategy on enhancing the financial performance in working banks in Jordan, the axes of the strategy were: informative sharing, free and independence, working teams, and organizational power. To achieve the objective of the study, a questionnaire is designed and distributed on the sample of the study, which represented 60 employees of Banks. After analyzing the data by using SPSS, the study resulted that there is positive impact of empowerment of human resources strategy on enhancing the financial performance in working banks in Jordan. It suggested that the working banks in Jordan should establish database, and to create working teams.
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