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.
Results showed high efficiency of the predator Chrysoperla carnea (Stephens) to attack and consume nymphal instars and adults of cabbage aphid, Brevicoryne brassicae (L.).The total average of the nymphal instars consumed by the larval stage of predator were 308.67, 285.9, 198.77, 154.7 for 1st ,2nd ,3rd ,4th nymphal instars respectively .While it was 110,107.9 for apterae and alatae respectively . Also, predation efficiency increases with the progress of the larval instars up to the third (last) which was the most voracious .The 1st instar nymph consumed by the larvae of the predator were 47,80,181.67 nymphs ,with predation rate of 14.71% , 23.75% and 50.13% for 1st ,2nd and 3rd larval instars
Semiotics has been through wide experiences in various human sciences, especially in the fields of poetry, novel and myths. But its interest in the theatre and drama was much less and unique despite the richness of the theatrical connection as it is a probable field for the semiotic investigation which may require the semiotic approach in dealing with the theatrical and dramatic show during the two processes of: structural construction and deconstruction starting from a set of overlapping and interconnected texts inside the show, which can be limited in the text, then it would be difficult to semiotically cover all these complex and tricky texts. The theatre in its structural and aesthetic construction is c
... Show MoreTo avoid the negative effects due to inflexibility of the domestic production inresponse to the increase in government consumption expenditure leads to more imports to meet the increase in domestic demand resulting from the increase in government consumption expenditure. Since the Iraqi economy economy yield unilateral depends on oil revenues to finance spending, and the fact government consumer spending is a progressive high flexibility the increase in overall revenues, while being a regressive flexibility is very low in the event of reduced public revenues, and therefore lead to a deficit in the current account position. And that caused the deficit for imbalance are the disruption of the
... Show MoreThis research aims at the possibility of rationalizing business organizations according to the strategic planning directions which have been developed to deal with many problems faced by business organizations, including the General Company for Automobile and Machinery Trade which was chosen as a research society, and several research problems were diagnosed, including an increase in the numbers of employees who constitute hidden unemployment, lack of work in the system of job specialization, and the organizational structure which is the non-application of the company to a modern administrative model. The importance of the research is that the company being investigated is a pioneer in its field of work and seeks to achieve custo
... Show MoreMixed ligand of Co and Ni (II) complexes were prepared from [5-(p-nitrophenyl)-4/-phenyl-1,2,4-triazole-3-dithiocarbamato hydrazide](TRZ.DTC) as primary ligand and 2,2'-bipyridyl (bipy) as a co-ligand with metal salts. These complexes were analytically and spectroscopically characterized in solid state by elemental analyses, flame atomic absorption, magnetic susceptibility and molar conductance measurements, as well as by UV–Vis and FTIR spectroscopy. Infrared, ultra violet spectra reveal a bidentate coordination of the two ligands with metal ions 1:1:1 mole ratio. Room temperature magnetic moments and solid reflectance spectra data indicate paramagnetic complexes with five-coordinate square pyramidal geometry for nickel (II) comple
... Show MoreThermal energy storage is an important component in energy units to decrease the gap between energy supply and demand. Free convection and the locations of the tubes carrying the heat-transfer fluid (HTF) have a significant influence on both the energy discharging potential and the buoyancy effect during the solidification mode. In the present study, the impact of the tube position was examined during the discharging process. Liquid-fraction evolution and energy removal rate with thermo-fluid contour profiles were used to examine the performance of the unit. Heat exchanger tubes are proposed with different numbers and positions in the unit for various cases including uniform and non-uniform tubes distribution. The results show that
... Show MoreThe research Aim is to provide support to small enterprises by providing tools that enable measurement and test their performance and identifying weaknesses and work on them is determined by the problem of searching using traditional assessment methods for small projects with only financial performance measurement standards that do not provide a complete picture of the performance of these projects so use the balanced scorecard the four pillars (financial, customer, learning and growth, and internal processes) and identify deviations and work on them through the use of the outputs of the programme (probe), PROmoting Business Excellence-PROBE), which It is a model of performance evaluation, with which you can deve
... Show MoreHuman behavior is one of the topics that has captured the attention of researchers throughout the ages, and motivation is one of the manifestations of this behavior, which indicates the extent of interest in a particular topic and their unwillingness to rush towards a particular topic. The topic of motivation is one of the important topics of interest to the teacher and coach in the field of sports. The aim of this research was identifying the level of motivation for junior students, and the differences in the dimensions of motivation for junior students in squash lessons. We used the descriptive survey method, and the research sample was chosen randomly. Only male of the junior students in the College of Phys
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The serum protein test includes measurement of the level of total protein(albumin, globulin). Fetuin-A is a blood protein made in liver. It can inhibit insulin receptor, enhance insulin sensitivity and make the individuals more likely to develop type 2 diabetes, then disorder in lipid profile (Total cholesterol(TC), low density lipoprotein cholesterol (LDL-c), high density lipoprotein cholesterol (HDL-c), Triglyceride(TG) and very low density lipoprotein cholesterol (VLDL-c) . To evaluate Fetuin-A, total protein, albumin, globulin, HbAlc and lipid profile in 200 adult and elderly Iraqi patients with type 2 Diabetes Mellitus were taken and compare them with 200 subjects as a healthy control. The laboratory analysis(for patients and
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