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.
Using the traditional methods in teaching Islamic subject have neglected student's role and focus mainly toward teacher. Thus, the role of student in teaching process would take a negative side: following these methods cannot achieve the educational objectives of Islamic subject. Teachers who give Islamic subject do not have a full knowledge of the appropriate techniques in teaching. They lack the scientific background that qualify them for teaching. The weakness of knowledge that face Islamic teachers have arisen over different stages of education which showed their lacking in the provision of intonation and interpretation of the Quran as well as the utterance of Prophet Mohammed Hadiths. It takes time to train teachers to do a
... Show MoreIn 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%.
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I started writing the research because of the linguistic and rhetorical methods in the Holy Quran.
This Sura included in all its verses the plural form such as the word planets graves and seas except the word sky was singular as the name of a genus, and this Sura showed the horrors of the Day of Judgment at the world level Included another science is the science of the interview and also came in the repetition and deletion and other linguistic and rhetorical things and concluded this Sura that the goal of breaking the sky and scattering planets and scatter graves is the human himself.
The Koran is a miracle immortal and science is still drawn from him each according to his specialty.
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The current research aims to diagnose the extent of interest in knowledge sharing and its role in achieving organizational excellence at the level of the Iraqi environment Primary data through descriptive statistics (arithmetic mean, standard deviation, coefficient of variation, percentages, frequencies) and hypothesis testing using appropriate statistical methods for inferential statistical analysis (Pearson correlation coefficient, simple linear regression, multiple regression, path analysis) and checking the quality of the data from During (normal distribution, confirmatory factor analysis, structural modeling method, and exploratory factor analysis), after collecting data from (358) observations from the company’s leaders, as
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A lack of adequate building maintenance is a significant obstacle faced by governmental hospitals. This paper evaluates factors that negatively impact building-maintenance practices in Iraq. A literature review was conducted to identify factors affecting maintenance. A list of 42 factors affecting hospital-buildings was collected from previous studies and tested using a structured questionnaire distributed to hospital-maintenance experts. During the data analysis, 76 valid questionnaires were used. Based on the respondents’ ratings, the relative-importance index (RII) was used to determine the level of importance of each factor. From the results, it was concluded that twelve factors affect maintenance practices in hospital buildin
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Automation is one of the key systems in modern agriculture, providing potential solutions to the challenges related to the growing world population, demographic shifts, and economic situation. The present article aims to highlight the importance of precision agriculture (PA) and smart agriculture (SA) in increasing agricultural production and the importance of environmental protection in increasing production and reducing traditional production. For this purpose, different types of automation systems in the field of agricultural operations are discussed, as well as smart agriculture technologies including the Internet of Things (IoT), artificial intelligence (AI), machine learning (ML), big data analysis, in addition to agricultural robots,
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The ethyl acetate synthesis via heterogeneous reactive distillation is studied experimentally using ethanol and acetic acid. Three types of cation exchanging resins were used as catalysts: Zerolit 225, Zerolit 226 and Ambylite 400. Experiments were carried out in two units of the same dimensions. Each unit consisted of three sections: rectifying, reactive and stripping sections of heights (60+25+20) cm respectively and 2.5cm column diameter. The first unit (column-A-) was a fractionation type and the second unit (column-B-) was packed column. The packing type was hollow glass cylinders with 10 mm height, and 4, 5 mm inner and outer diameter respectively.
The experiment
... Show MoreBitcoin is a decentralized blockchain-based cryptocurrency that has taken the world by storm. Since its introduction in 2009, it has grown tremendously in terms of popularity and market cap. The idea of having a decentralized public ledger while maintaining anonymity and security attracted the attention of developers and customers alike. Special nodes in the bitcoin network, called miners, are responsible for making the network secure by using a concept called proof-of-work. A certain degree of anonymity is also maintained as no personally identifiable information of a person, like name, address, etc., is linked to the bitcoin wallet. In terms of bitcoin, a user is anonymous if different interactions of the user cannot be linked to
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The process of risk assessment in the build-operate transfer (BOT) project is very important to identify and analyze the risks in order to make the appropriate decision to respond to them. In this paper, AHP Technique was used to make the appropriate decision regarding response to the most prominent risks that were generated in BOT projects, which includes a comparison between the criteria for each risk as well as the available alternatives and by mathematical methods using matrices to reach an appropriate decision to respond to each risk.Ten common risks in BOT contracts are adopted for analysis in this paper, which is grouped into six main risk headings.The procedures followed in this paper are the questionnaire method
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