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.
Business organizations strive to reach organizational excellence, in instruction to maintain their position in the market, so the research started from the problem of the weakness of the senior leaders in the two companies investigated in the management and sustainability of work, as well as their inability to face challenges that could affect the work of the two companies in the future, especially the lack of organizational of the future and the prediction of those events, so the two companies seek to explore and invest opportunities to achieve organizational excellence. The research aims to know the role of Ambidexterity leadership behaviors in organizational excellence in my company .and create ideas that will achieve organizati
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Abstract:
In the name of God , most Gracious , most merciful
The Holy Quran conciders the celestial book which consults
languages with its accents , and consults the people with their circumstances
and it takes care of all worships.
We find that Holy Quran consults atheist human and afaithless one ,
therefore , it aspect the orabion of God to human “s heart as a results , it is
one of an incapacitation of Holly Quran in This research.
WE try to taik about special vocables which relate to hearts of
unfaithful hummance , so we mentio these vocables in a guidance hierarchy
table in the end of this research.
The study of the " Speech act " in grammatical codes reveals great efforts in the study of the elements of linguistic communication contained in their efforts, and is part of the study of the linguistics of heritage, and the research has been designed to identify the verbal act in the blog of Ibn al-Khabaz (guiding the shine) by studying its sections comprehensively; To the spirit of grammatical discourse as well as the combination of the concept of the semantic act already verbal according to Searle, and its response in the form of indirect verbal acts more than direct acts, as well as the pure formulas of the opinions of the violators in the speech of Ibn al-Khabaz other than the proven verbal formulas Approval and approval, the class
... Show MoreObjectives: To study the prevalence of rs1799964 (-1031 T/C) and rs361525 (- 238 G/A) SNPs and their effect on the disease activity, severity, and cytokines production in newly diagnosed Iraqi rheumatoid arthritis patients. Patients and Methods: sixty-three patients were diagnosed by a specialist physician while attending the rheumatology unit and twenty control participated. The inflammatory markers were measured and PCR amplification and sequencing were performed to demonstrate TNF-α SNPs. Results: Regarding (-1031 C/T) SNP, the TT genotype and allele C were significantly present in the controls, and the CT genotype was distributed significantly in the patients. The TT genotype was mostly distributed in the mild-moder
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The interleukin-1 family has multifaceted roles in men٫s reproductive syste. Out of these is interleukin-1 receptor antagonist (IL-1RN) which exists in men gonads, and in case of infection and inflammatory process, its activity is increased. The current study aims to verify a possible linkage of Variable Number Tandem Repeat (VNTR) polymorphism of the IL-1RN gene with human men infertility. The study groups enrolled included 100 infertile men and 100 fertile and healthy men. Their seminal fluids were subjected to analysis. Also peripheral blood samples were collected for the assessment or detection of polymorphic Variable Number Tandem Repeats (VNTR) polymorphism of interleukin-1 receptor antagonist gene (IL-1RN). Two a
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Abstract:
Thanks for people's God who brought the great book, prays and peace for
his prophet "Mohammad" the master of missioners to all people.
Allah created human being in it's best way and give him a soul thus ,
he will be a human with faith that has movement and life and the centre of his
soul is the sense which differentiate human from other animals. This
sensation generated from different senses that made the soul.
God had given him a protected heart, talkative tounge and clear seeing
to understand with consideration, so he will prevent himself of falling in wrong
by thinking and situation that he will pass by.
The significance and probability of sensation had talken our attention in
Qur'an . Hence
Abstract
This study aims to identify the social and psychological abuse towards elderly people by others, to identify the difference of social and psychological abuse towards elderly by others according to the variable of gender (male and female). Additionally, to identify the difference of social and psychological abuse towards elderly by determining the one who is responsible of abusing (son, daughter, spouse, etc.). To achieve this aim, the researcher designed a scale to identify the social and psychological abuse towards elderly by others. The results showed that this sample exposed to psychological abuse by different sides due to lacking of powers. Besides, the result showed that there are no signifi
... Show MoreAbstract:
The issues related to foreign trade is a broad field for discussions and captures the interest of economists for their contribution to the process of economic development in the economies of the countries, especially developing ones. The imports of goods and services in foreign trade constitute an important part of the local by which the economy gets goods and services that the economy cannot produce because of the incompetent base of production. Further, the demand function of imports occupied a good deal of the attention of researchers in the field of international economics for which agricultural imports constitute an important part. The reason for the interest in the subject is due to its im
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One of the most important features of American foreign activity during the second half of the 19th century was the encouragement of sending Protestant missionary missions to all countries around the world. The mission of these missions was facilitated by the weakened state of the Ottoman Empire, the increasing influence of European countries, and their interference in its internal affairs. Despite the Ottoman efforts to counter the activities of these missions, the American missionary missions adopted a well-planned strategy that suited the conditions of the region, aimed at achieving their goals through direct and indirect methods, including intervention in the field of education. These missions gave great importance to educational aspects
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