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 process of evaluating data (age and the gender structure) is one of the important factors that help any country to draw plans and programs for the future. Discussed the errors in population data for the census of Iraqi population of 1997. targeted correct and revised to serve the purposes of planning. which will be smoothing the population databy using nonparametric regression estimator (Nadaraya-Watson estimator) This estimator depends on bandwidth (h) which can be calculate it by two ways of using Bayesian method, the first when observations distribution is Lognormal Kernel and the second is when observations distribution is Normal Kernel
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This study is prospective in nature, It consider
110 patients with vertigo who were assessed
between April and December 2010 at E.N.T out
patient department of otolarygiology, in Al
Diwania teaching hospital, in Diwania city,
Iraq. The study is designed to assess the
incidence of vestibular and non vestibular
vertigo and their association with
tinnitus,hearing loss,migraine in Young adult
and elderly.All patients were assessed by
questionary method and by pure tone
Audiometry.
Results: the incidence of vestibular vertigo was
69.1% while non vestibular vertigo is 30.9 %,
vestibular vertigo was inversely related to the
age while non vestibular vertigo directly related
to the age
The percen
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
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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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Mixed convection heat transfer to air inside an enclosure is investigated experimentally. The bottom wall of the enclosure is maintained at higher temperature than that of the top wall which keeps in oscillation motion, whereas the left and right walls are well insulated. The differential temperature of the bottom and top walls changed several times in order to accurately characterize the temperature distribution over a considerable range of Richardson number. Adjustable aspect ratio box was built as a test rig to determine the effects of Richardson number and aspect ratio on the flow behavior of the air inside the enclosure. The flow fields and the average Nusselt number profiles were presented in this wo
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The study aims to identify the impact of competency-based training in its dimensions (skills, cognitive abilities, attitudes, and attitudes) in improving the performance of employees (achievement, strategic thinking and problem solving) in Jordanian university hospitals.
The study based on analytical descriptive method. The study population consisted of the Jordanian University Hospitals, the University Hospital of Jordan and the King Abdullah Hospital, as applied study case. The sample of the study consists of all upper and middle administrative employees of these hospitals; questionnaire distributed all of them and the number of valid questionnaires for analysis were 182 questionnaire.
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Industrial product is one of the things of daily use and direct interaction with the user, so the ranges of its association to the user, took a varied and multiple aspects. The user today sees the products as things have specifications related directly to the psychology of the user, so he can reflects his values, principles and ideas on the composition of the total structure of the product, making them a means by which manifested the internal entity's of the user took an external materiality. And then counting the products being things excite positive feelings among different user was a natural result given the complexity of the relationship between the user and the industrial product. So pleasure is one important effects that result fro
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: The Aluminium (Al) material emerged as a plasmonic material in the wavelength ranges from the ultraviolet to the visible bands in different on-chip plasmonic applications. In this paper, we demonstrate the effect of using Al on the electromagnetic (EM) field distribution of a compact hybrid plasmonic waveguide (HPW) acting as a polarization rotator. We compare the performance of Al with other familiar metals that are widely used as plasmonic materials, which are Silver (Ag) and Gold (Au). Furthermore, we study the effect of reducing the geometrical dimensions of the used materials on the EM field distributions inside the HPW and, consequently, on the efficiency of the polarization rotation. We perform the study based o
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