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.
Blogs have emerged as a powerful technology tool for English as a Foreign Language (EFL) classrooms. This literature review aims to provide an overview of the use of blogs as learning tools in EFL classrooms. The study examines the benefits and challenges of using blogs for language learning and the different types of blogs that can be used for language learning. It provides suggestions for teachers interested in using blogs as learning tools in their EFL classrooms. The findings suggest that blogs are a valuable and effective tool for language learning, particularly in promoting collaboration, communication, and motivation.
Otitis media with effusion (OME) is the long-term deposition of mucus in the middle ear cleft. It is the leading cause of childhood hearing loss and a common childhood infection. It can impair communication and life quality. OME's direct and indirect costs are also crucial. Improving OME care is crucial. This study examines intranasal mometasone's efficacy in treating otitis media with effusion. A clinical trial study was conducted during a period from January 2021 to June 2022. It included 80 patients suffering from otitis media with effusion bilaterally (160 ears) who had an intact tympanic membrane and tympanometry type B. These patients were included only if they had a hearing change or loss noted by the parents or by the patien
... Show MoreBackground: Oxidative stress may contribute to the etiology of hypertension in humans. Oxidative stress is an imbalance between reactive oxygen species (ROS) and antioxidant defense mechanisms, causing damage to biological macromolecules and dysregulation of normal metabolism and physiology. Amlodipine as an antihypertensive agent is a long-acting calcium channel blocker that dilates blood vessels and improves blood flow. The aim of this study was to assess the oxidative stress in hypertensive patients on Amlodipine treatment through the assessment of salivary Malondialdehyde (MDA) and superoxide dismutase (SOD) as a marker of oxidative stress.
Mat
... Show MoreThe working of the some designer was recognize by the Production and introduction of the design which have special stemp and style determind by the experience and the Knowledge ability for the Designer which change the ordinaries shape to the develops shaps bening ideas and new meanings un known to the viewen make the design at high level of creative and the designer acquest experiennce and new skill in his way for the designs and the art march-out which clearly demonstrate on all the graphical work so the high research conserned on the knowledge and detect about the methods constructing of the ability and expernence for the graphic designer become it is decisive worker in effective or net effective the designers work and any consist whi
... Show MoreDoubts arise about the originality of a document when noticing a change in its writing style. This evidence to plagiarism has made the intrinsic approach for detecting plagiarism uncover the plagiarized passages through the analysis of the writing style for the suspicious document where a reference corpus to compare with is absent. The proposed work aims at discovering the deviations in document writing style through applying several steps: Firstly, the entire document is segmented into disjointed segments wherein each corresponds to a paragraph in the original document. For the entire document and for each segment, center vectors comprising average weight of their word are constructed. Second, the degree of cl
... Show MoreAbstract The relative pronoun in Hebrew language is an important pronoun use anciently and recently, it developed and it's usage and meanings differed so, it was not confined to the particle "אֲשֶׁר" as a relative pronoun, but beside it appeared other pronouns giving the relative meaning. Hence, the topic of this research was on this basis through studying the relative pronouns in old and modern Hebrew, the way of using them and their connection with preposition particles, as well as studying the relative clause.
substitution is considered a method of meaning enrichment and is a formal substitution for the letter or the word inside the text, and it is an expression substitution that is a replacement of an element of a text with a formal or graphic element, and a substitution of a latter form by a previous vocalization, thus it results in a cohesive expression. Replacement inside the text happens through the existing relation between the word or the letter and the form within the phenomenon that is based on enhancing the meaning in a way that delimits the context. There are many studies and researches written about replacement, especially in the textual linguistics that focused on the literary and linguistic texts. Hence, the researcher found that
... Show MoreA mathematical model is developed which predicates the performance of cylindrical ion exchange bed involving comparing of axial dispersion model for cation exchange column with different assumption, this model permits the performance to predicate the residence time within the bed with the variance, axial dispersion and Pecklet No. to indicated deviation from plug flow model.
Two type of systems are chosen for positive ions first with divalent ions (Ca+2) to exchange with resin of Na+1form used as application in water softener units and second with monovalent ions (Na+1) to exchange with resin of H+1 form used as application in deionize water units &n
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