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.
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A simple reverse-phase high performance liquid chromatographic method for the simultaneous analysis (separation and quantification) of furosemide (FURO), carbamazepine (CARB), diazepam (DIAZ) and carvedilol (CARV) has been developed and validated. The method was carried out on a NUCLEODUR® 100-5 C18ec column (250 x 4.6 mm, i. d.5μm), with a mobile phase comprising of acetonitrile: deionized water (50: 50 v/v, pH adjusted to 3.6 ±0.05 with acetic acid) at a flow rate 1.5 mL.min-1 and the quantification was achieved at 226 nm. The retention times of FURO, CARB, DIAZ and CARV were found to be 1.90 min, 2.79 min, 5.39 min and 9.56 min respectively. The method was validated in terms of linearity, accuracy, precision, limit of detection and li
... Show MoreIn light of increasing demand for energy consumption due to life complexity and its requirements, which reflected on architecture in type and size, Environmental challenges have emerged in the need to reduce emissions and power consumption within the construction sector. Which urged designers to improve the environmental performance of buildings by adopting new design approaches, Invest digital technology to facilitate design decision-making, in short time, effort and cost. Which doesn’t stop at the limits of acceptable efficiency, but extends to the level of (the highest performance), which doesn’t provide by traditional approaches that adopted by researchers and local institutions in their studies and architectural practices, limit
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This study aims to identify the issue of observing media publishing and its importance for public relations in the management of special events; and its role in building the positive image of the target audience through communication messages that illustrate the political, economic and diplomatic importance of the Arab Summit. As such Summit is one of the conferences that Iraq sought to secure the requirements of its convening to re-activate its political and diplomatic role in the Arab Ocean, especially after the circumstances and crises that Iraq went through.
The convening of the Arab Summit under the auspices of Iraq was a qualitative transition, during which Iraq sought to achieve some gains b
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The present study aims to present a proposed realistic and comprehensive cyber strategy for the Communications Directorate for the next five years (2022-2026) based on the extent of application and documentation of cybersecurity measures in the Directorate and the scientific bases formulating the strategy. The present study is significant in that it provides an accurate diagnosis of the capabilities of the cyber directorate in terms of strengths and weaknesses in its internal environment and the opportunities and threats that surround it in the external environment, based on the results of the assessment of the reality of cybersecurity according to the global Cybersecurity index, which provides a strong basis for building its strategic dire
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The solidification process in a multi-tube latent heat energy system is affected by the natural convection and the arrangement of heat exchanger tubes, which changes the buoyancy effect as well. In the current work, the effect of the arrangement of the tubes in a multi-tube heat exchanger was examined during the solidification process with the focus on the natural convection effects inside the phase change material (PCM). The behavior of the system was numerically analyzed using liquid fraction and energy released, as well as temperature, velocity and streamline profiles for different studied cases. The arrangement of the tubes, considering seven pipes in the symmetrical condition, are assumed at different positions in the system, i
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This paper presents a point multiplication processor over the binary field GF (2233) with internal registers integrated within the point-addition architecture to enhance the Performance Index (PI) of scalar multiplication. The proposed design uses one of two types of finite field multipliers, either the Montgomery multiplier or the interleaved multiplier supported by the additional layer of internal registers. Lopez Dahab coordinates are used for the computation of point multiplication on Koblitz Curve (K-233bit). In contrast, the metric used for comparison of the implementations of the design on different types of FPGA platforms is the Performance Index.
The first approach attains a performance index
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