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.
Deception is defined as a linguistic and non-linguistic behavior that is used in interaction in order to make the addressees believe what is believed to be false or lack evidence. McCornack (1992) classifies deception into four manipulative strategies (i.e., fabrication, distortion, equivocation and concealment), other scholars argue that deception encompasses the strategies of “fabrication (outright lying), equivocation (being vague and ambiguous), or concealment (with holding relevant information) Thus, the present study investigates the deception strategies and motives that are used by Johnny Depp and Amber Heard during their defamation trials. Qualitative and quantitative methods are employed when analyzing the data in question. Th
... Show MoreBackground: Dialysis is in common use to treat patients
with end stage renal failure .However longstanding dialysis
harboring some cellular changes in various body fluids.
This study was conducted in order to detect these changes
in urine.
Objective: The study was conducted to detect cellular
changes in urine of patients with longstanding dialysis.
Method: Fifty-three urine samples were examined
cytologically obtained from patients with longstanding
dialysis during 6 months period. Freshly voided midstream
urine samples were taken . Samples were centrifuged and 2
to 3 drops of sediments were smeared on 2 glass slides and
fixed in 95% ethyl alcohol then stained with Hand E stain
to be evaluated.
R
The current research aims to identify the occupational stresses of doctors who are working in governmental hospitals according to the variables of gender and career ranking. The researcher adopted a scale to measure the occupational stress of (1088) doctors (561 males and 527 females) working in governmental hospitals. The results have shown that doctors have a high level of professional stress, but there is no significant difference between doctors in terms of gender. However, there were significant differences in favor of novice residents.
The notion of presupposition has been tackled by many linguists. They have found that the term ―presupposition” is being used in two different senses in the literature: semantic and pragmatic. As for semantic sense, Geurts (1999) has isolated some constrictions as sources of presupposition by making lists of presupposition triggers. Concerning the pragmatic sense Kennan (1971:89) uses the term pragmatic presupposition to refer to a class of pragmatic inferences which are, in fact, the relation between a speaker and the appropriateness of a sentence in the context. In spite of the fact that there are many researches that have been done in the field of presupposition but few of them in the field of short stories up to the researcher's kno
... Show MoreThe research aims to identify the educational values prevailing in the small kinetic games for the children of Riyadh, and to categorize the educational values of the kinetic games small children Riyadh. The research analyzed the content of a number of small kinetic games that included studied physical education at the two pre-kindergarten and stipulated by the Platform for kindergartens, which is being applied. The content analysis was used by analysts agreement with themselves over time (21) days. The agreement between the external researcher and analyst. The researcher used the Cooper to extract equation lab agreement between the researcher and the outside analyst, has reached agreement on determining factor idea and label values (0.8
... Show MoreThis study aims to examine how the lives of blacks are reduced and eliminated in Brother (2017) by David Chariandy. Black Lives Matter is a hash tag that appears after the killing of Trayvon Martin (17 years old African American) in 2012 by the savage hands of George Zimmerman (white person). This hash-tag has become a social movement that calls for equality in order to stop the violence against black people because their live is as valuable as white’s. The movement comes into being to highlight the “hypocritical democracy in service to the white males whose freedom are openly depended upon the oppression of blacks” (Lebron, 2017, P. 1). Those who have started this movement try to redeem a state and its arbitrary actions again
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Abstract
What the research come to:
1- The presentation of the image of the proud person in this
mortal life appeared in several styles such as (conversation)
arousing the insert once and convincing in other time,
(confirmation) in all its types، (argument) scolding with the
gradual progress of time of the discourse .Interview and
parallelism are two of these styles with the presences of the
repetition style especially in the topics that has a reference to
the theme of (pride) being implied not directly stated. The
Koran discourse varied in its reference to the theme of pride
according to the context which is mentioned directly
(eighteen times) which formed one third of the number of
The implementation of decentralization in Iraq was asymmetrical, leading to different forms and paces of implementation. Comparing four cases of Basra, Kirkuk, Nineveh, and Sulaymaniyah indicate that these cases differ in their political stability and autonomy in a way that led to a different forms of decentralization. This paper argues that the higher the level of political autonomy from the federal government, the more efficient the governance model, and the more efficient the governance model, the more legitimate the system (trust), and the more legitimate a system, the more accountable elected officials. Therefore, it recommends reforming the institutional setup of decentralization by having districts, instead of provinces, as the bu
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