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.
In this paper, a Modified Weighted Low Energy Adaptive Clustering Hierarchy (MW-LEACH) protocol is implemented to improve the Quality of Service (QoS) in Wireless Sensor Network (WSN) with mobile sink node. The Quality of Service is measured in terms of Throughput Ratio (TR), Packet Loss Ratio (PLR) and Energy Consumption (EC). The protocol is implemented based on Python simulation. Simulation Results showed that the proposed protocol provides better Quality of Service in comparison with Weighted Low Energy Cluster Hierarchy (W-LEACH) protocol by 63%.
Students in the twenty-first century need to find innovative ways to satisfy and respond to these learning requirements since they live in a visible world that is continuously surrounded by visual, technological stimuli. This is especially true of higher education. In order promote advancements in sustainable awareness, the project aims to include visual understanding in education (VUE) in higher education communication skills. An interview has been employed as a tool to accomplish the study's goal. The idea of Visual Understanding in Education (VUE) is one of the many novel or modern ways that has produced remarkable outcomes in a wide range of specialized sectors. Teachers may spread lessons of responsibility and consciousness by being aw
... Show MoreBetween the 1980s and 1990s, the HURIER model was developed by Brownell and consist of six interrelated components, which are represented in these acronyms (Hearing, Understanding, Remembering, Interpreting, Evaluating, and Responding). This model can be considered as a framework of the behavioral approach which can be used to improve students’ listening performance and to foster a positive attitude toward listening. Many learners find it challenging to improve their listening skills when learning a second or foreign language because it requires the integration of both listening and speaking. Consequently, enhancing this skill will help students improve other language skills, including reading, speaking, and writing. The HURI
... Show MorePraise be to God, and may blessings and peace be upon the Messenger of God, his family and companions, and from his family and after ...
It is the right of every nation to be proud of its heritage, science and civilization among the nations, taking pride in the efforts of its construction and the keenness of its scholars and dedication to serve their nation and their history, and from the great sciences that boast and honor our great nation and distinguish it over others the science of attribution and the preservation of the novel over generations and ages. The novel is preserved from the plagiarism of the nullified, the excess of the deceitful and the liars, and the science of isnad from religion as the scholars said, and without the
Adopting a policy of attracting investments in all countries, whether developing or developed prevailed, especially after the global crisis, and this trend is imposed by considerations of political and development (urban, economic, and social) can be formulated as a rational policy to solve many problems related to patterns of urban growth, economic, social, and including the problem of housing. As the reality of the housing sector in Iraq will require the allocation of substantial resources to promote it by the research problem is the lack of financial resources and the inability of investments to meet the various requirements including the requirements of economic sectors, particularly in the field of housing, infrastructure an
... Show MoreMeans the current research study in the direction iconic structures plates Ottoman calligraphers , as they took turn in this area and because it excelled in the form of a strong incentive and motivation to seek calligraphers in this direction so as to simulate the skill of the artist and parallel to the side of his creativity as well.And iconography , RECEIVED of objective vision and aesthetic and semantic in the output of compositions written according to the specific significance and this has a clear impact on the propensity to develop technical and aesthetic and expressive in the output of the structure of synthetic iconography is limited by rules or building in the form of public panel linear . And that all forms , whether animal , h
... Show More<p>There is an Increasing demand for the education in the field of E-learning specially the higher education, and to keep contiuity between the user and the course director in any place and time. This research presents a proposed and simulation multimedia network design for distance learning utilizing ATM technique. The propsed framework determines the principle of ATM technology and shows how multimedia can be integrated within E- learning conteext. The first part of this research presents a theoretical design for the Electricity Department, university of technology. The purpose is to illustrate the usage of the ATM and Multimedia in distance learning process. In addition, this research composes two entities: Software entity
... Show More
The Islamic religion approach Rabbani urges and seeks to bring happiness to people, as Allah says: ((We sent thee not all people glad tidings and a warner, but most people do not know)) Spa: State 28
Islam looks at the concept of educational values through positive behavior derived emerging through formal and informal education. The Islamic approach works on the basis of a systematic and clear rule in the form of an integrated system includes multiple areas. As the lead actor role as the desired position.
Although
Abstract
The research aims to verify the dimensions of tax justice that exist in Iraq, and to determine their impact on tax compliance. Through a revised model of tax justice based on the literature of tax justice according to the classification of the studies of (Saad, 2009), (Wenzel, 2002), by using a questionnaire as an experimental measurement tool designed to be in line with perceptions of tax justice in Iraq. To define the dimensions of tax justice (the independent variable) with eight dimensions (Distributive justice, Exchange justice, Vertical justice, Horizontal justice, Retributive justice,
... Show MoreIn general, researchers and statisticians in particular have been usually used non-parametric regression models when the parametric methods failed to fulfillment their aim to analyze the models precisely. In this case the parametic methods are useless so they turn to non-parametric methods for its easiness in programming. Non-parametric methods can also used to assume the parametric regression model for subsequent use. Moreover, as an advantage of using non-parametric methods is to solve the problem of Multi-Colinearity between explanatory variables combined with nonlinear data. This problem can be solved by using kernel ridge regression which depend o
... Show More