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.
Zainab M. Al-Bahrani Department of Oral Diagnosis, College of Dentistry, University of Baghdad, Baghdad, Iraq.Corresponding author: Zainab M. Al-Bahra...
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 MoreThe present study aimed to shed light on the urine HSP70 concentration of patients with urinary bladder carcinoma UBC and control subjects as new urinary biomarker. The second aim was to associate this protein concentration with UBC stage and grade in patients with UBC. A direct ELISA was used to quantify urine HSP concentrations in 58 patients with urinary bladder carcinoma UBC with different grades (G) and stages (T) all malignant of them was transitional cell carcinoma (TCC) type , 15 from patients with urinary Bladder disorders other than cancer UBD and 15 healthy subjects(control) . Urine concentrations of HSP70 were elevated in patients with UBC compared to those without UBC (healthy and UBD, P< 0.5). There was a high signifi
... Show More
Pinter's play One for the Road (1984) is considered one of his important plays because
it focuses on political issues, which he has not presented overtly before. Generally speaking,
Pinter's early plays describe man's existential fear of an unnamed danger which might be
represented by an intruder who invades the characters' solitude , threatens their peace, and
brings their hidden fears to the surface. Pinter began to write political plays as a result of his
political attitudes and his involvement in political activities over the last three decades.
Pinter's One for the Road deals with the oppressive and authoritarian operations of
state power. This play and Pinter's political plays which followed it, like Mountain
Background: Pregnancy is considered a major risk factor for development and progression of periodontal disease. There are hormonal changes in both estrogen and progesterone hormones in addition to bacterial effect and poor oral hygiene that will enhance development of periodontal disease in pregnant women. Materials and methods: Seventy subjects were enrolled in the study, the subjects with an age range (20-35) years old without any history of systemic disease. The subjects were divided into 20 non-pregnant women they represent the control group (G I), 30 pregnant women with gingivitis (GII) and 20 pregnant women with periodontitis (GIII).All periodontal parameters (plaque index, gingival index, bleeding on probing, probing pocket depth an
... Show MoreThe authentic traditional architecture proved that it is very convenient to the environmental and social regulations where it appeared and lasted for hundred of years.
This traditional architecture got the intelligence in providing thermal comfort for their occupants by the intelligent usage of the building materials and the intelligent planning and designs which took in consideration the climatic condition and the aerodynamics of the whole city as one ecological system starting from the cold breeze passing through its narrow streets till it enters the dwelling units and glides out through the wind catchers.
This architecture had been neglected and replaced by modern imported architecture which had collap
... Show MoreFundamentals Concept in Metorology an Introductory Survey - ISBNiraq.org
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 t
... Show More