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.
This research tackles the play of Synge "Rider to the Sea" to find out whether the
theories of Leech (1983) and Brown and Levinson (1987) can be applied or not to this study.
The model of Leech (1983) consists of seven principles and for Brown and Levinson
(1987),it consists of two principles of politeness where one of them is positive and the other is
negative politeness.
It is hypothesed that:
1. There is a relation between the two theories.
2. Synge deals with these theories in such a way to depict his characters.
3. It is also hypothesed that every character deals with these principles in such a way to show
the events of the play.
The study concludes that there is a relation between the two theories in d
R. Vasuki [1] proved fixed point theorems for expansive mappings in Menger spaces. R. Gujetiya and et al [2] presented an extension of the main result of Vasuki, for four expansive mappings in Menger space. In this article, an important lemma is given to prove that the iteration sequence is Cauchy under suitable condition in Menger probabilistic G-metric space (shortly, MPGM-space). And then, used to obtain three common fixed point theorems for expansive type mappings.
<p>In this paper, we prove there exists a coupled fixed point for a set- valued contraction mapping defined on X× X , where X is incomplete ordered G-metric. Also, we prove the existence of a unique fixed point for single valued mapping with respect to implicit condition defined on a complete G- metric.</p>
Praise be to Allah, Lord of the Worlds, and prayers and peace be upon the prophet as a mercy to the worlds and on his family and companions. The phenomenon of suicide is one of the most expanding social phenomena in the world, where many groups of society of different ages try to put an end to their lives, especially young men and girls. The numbers always remain on the rise, and there is no doubt that the one who does this matter, that he has reasons that made him resort to suicide, and despite that, whatever those reasons. However, this is not a justification for the assault on the soul that God has forbidden to infringe on or lead them to perdition, or to what harms them. Modern psychology has tried to explain this phenomenon and try to
... Show MorePraise be to God, who has seen uniting the wonders of manufactures, and pronounced Pthamidh oddity Alambdoat, and swam his creation in different languages, Glory is not equal to one in the earth and the heavens, praise Him, and I bear witness that there is no god but Allah alone with no partner certificate towering branches, and I bear witness that Muhammad is His slave and Messenger sent swage Arab government balance, and clearest statement, and the highest residence and Ohllagha words, and Oovaha Zmama, he pointed the way and advised the creation, and the month of Islam, breaking idols, and showed provisions, uncle Balanaam, God separated blessings and peace upon our Prophet Muhammad and the God of the good and virtuous and his compani
... Show MoreThe study includes collection of data about cholera disease from six health centers from nine locations with 2500km2 and a population of 750000individual. The average of infection for six centers during the 2000-2003 was recorded. There were 3007 cases of diarrhea diagnosed as cholera caused by Vibrio cholerae. The percentage of male infection was 14. 7% while for female were 13. 2%. The percentage of infection for children (less than one year) was 6.1%, it while for the age (1-5 years) was 6.9%and for the ages more than 5 years was 14.5%.The total percentage of the patients stayed in hospital was 7.7%(4.2%for male and 3.4%for female). The bacteria was isolated and identified from 7cases in the Central Laboratory for Health in Baghdad. In
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Through the study of social work and social policy ( problems of marginalization and empowerment opportunities ) and taken a theoretically descriptive and analytical and highliyhed the role of social work in social policy its achieved only through community intraction and paamong all parties and according to social policies include of material resources and haman and integrated in to the planning and development framework with the aim of providing social services for allsegments of society and become the study in social work that include the introducation / and five chapters each chapter in cludes several detectives and each complements the other .
1 – The absence of social development projects on social policy .
2 – social pol
This study deals with the thems of "in-betweeness" in the modern Afro-American Drama, drawing upon the accumulated literature of the colonial and postcolonial studies. In-betweeness appears in these studies under the canopy of the terms mimicry, hybridity and liminality which refer to a transformative, in-between state of being. It also refers to themutual relations holdingbetween man and his cultural space.
This concept is fitting the Afro-American playwright Amiri Baraka's plays and his violent, revolutionary theatre. In his play Dutchman (1964), Clay, the protagonist, is a good example of the two-ness or in-betweeness. He finds difficulty choosing between the ethnocentric white culture and the black culture.He allows
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