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 liability limit liability limit and reinsurance re factors insurance are important in influencing the achievement of company's competitive goals and achieve success and excellence in the market and because the limit of liability and reinsurance aimed to increase output with the stability of inputs leading to increased insurance business and increase profits. The study was based on two variables presidents interact with each other to form the intellectual and philosophical framework has two ( the limit of liability and reinsurance ) . The study was launched from a problem expressed by a number of targeted questions answered from the elucidation of theoretical philosophy and intellectual goals of these variables and highlight the impor
... Show MoreIntroduction: Elite football performance hinges on rapid tactical decision-making under physical and cognitive strain. While peripheral fatigue’s effects on motor output are well documented, the neurophysiological markers of mental fatigue and their impact on in-game decision making remain underexplored. Objective: To determine how EEG-derived central fatigue indices—frontal theta power and the theta/alpha ratio—relate to tactical decision accuracy and speed in elite football players. Methodology: Twenty male national-level footballers (age 22.4 ± 2.1 years; ≥ 5 years’ experience) completed the Yo-Yo Intermittent Recovery Test Level 1 while wearing an 8-channel dry-electrode frontal EEG headset. Frontal theta
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The study aimed to analyze the effect of meteorological factors (rainfall rate and temperature) on the change in land use in the marshes of the Al‐Majar Al‐Kabir region in southern Iraq. Satellite images from Landsat 7 for 2012 and Landsat 8 for 2022 were used to monitor changes in the land coverings, the images taken from the Enhanced Thematic Mapper Plus (ETM+) and Operational Land Imager (OLI) sensors of the Landsat satellite. Geometric correction was used to convert images into a format with precise geographic coordinates using ArcMap 10.5. The maximum likelihood classification method was used to examine satellite image data using a supervised approach, and the data were analyzed statistically. We obtained clear images of the area,
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The drive of this exploration is to investigate the mucoadhesive assets of A. indica (Azadirachta indica) fruit mucilage by incorporating it into mucoadhesive microspheres with Acyclovir (AVR) as a model drug. The study was performed to check the impact of the mucilage proportion on particle size and swelling index. Nine batches of AVR mucoadhesive microspheres were made with varying proportions of Polyacrylic acid 934P and A. indica fruit mucilage (AIFM). A central composite design with design expert software to check the impact of dependent variables (A. indica mucilage and Polyacrylic acid 934 P levels) on particle size and swelling index as a response. As part of congeniality studies, the batches w
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The theater can be considered a media that the effectiveness of its tools and the perceptions it produces cannot be abandoned according to patterns or aesthetic artistic trends, and at the same time it carries a large amount of information that can be worked on activating it with conscious directions within the elements of the theatrical performance, and these can be counted The study is an attempt to trace the functioning of the communication and media elements in the structure of the theatrical performance, as the study included: An introduction that defines the research problem and its importance, which crystallized around the following question: Does the media communication through theatrical presentation form its desired effectivene
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Background: Oral squamous cell carcinoma is the most prevalent malignant neoplasm of the oral cavity which results from accumulated genetic and epigenetic alterations. It is not always inexorable and may be reversible if early intervention in the process can occur to prevent further genetic mutation and disease progression. The FHIT gene is a tumor suppressor gene located in FRA3B region which is the most active common fragile site, where DNA damage leading to aberrant transcripts and translocations frequently occur. The WWOX is a tumor suppressor gene that plays a central role in tumor suppression through transcriptional repression and apoptosis, with its apoptotic function the more prominent of the two. This study aimed to evaluate and co
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