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.
Perhaps going to watch movies in cinemas today has become different from what it was before. The cinematic film, the clarity of the image and the luster of its colors pulled the rug out from under the most important change that occurred in the structure of the contemporary cinematography, which is the sound. The surround sound environment that immerses viewers in the realism of sound that reaches them from all directions, and for this the researcher found it necessary to shed light on this topic because of its importance, so the research problem was represented in the following question: (How are modern sound systems used in the structure of contemporary feature films?) The theoretical framework included two topics: the first: the dialec
... Show MoreThe appearance of Mixed Mode Oscillations (MMOs) and chaotic spiking in a Light Emitting Diode (LED) with optoelectronic feedback theoretically and experimentally have been reported. The transition between periodic and chaotic mixed-mode states has been investigated by varying feedback strength. In incoherent semiconductor chaotically spiking attractors with optoelectronic feedback have been observed to be the result of canard phenomena in three-dimensional phase space (incomplete homoclinic scenarios).
Technologies of the theatre show elements get great transferring concerning the creative embodiment of its aesthetic elements including its raws, forms, parts and masses in an attempt to achieve the prin cipal expressive progress to embody the main theme of the idea and the intended subject .
This is within the criterion of supporting the way to deal with technologies (décor elements , lighting music tones vocal affects , fashion and makeup) that achieving the emagintional appropriate atmosbheres which the writer and the director of the theatre show aim to make it present and succeed by furming active participation tunches of the ability of the cinogra . phic – element dsigners in order to invlve the theatre space atmospheres in cl
Giving advice refers to an attempt by the speaker to express what the addressee should do in a particular situation or what is good for him/her. It is also a feature of making social relations and communications move smoothly and become stronger. The current study aims to investigate the strategies of the speech act of advice by old females and males for the younger generation in written signs. Comparison is made between old females and males regarding their pragmatic use of advice and the way they are manifested in expressing gender identity differences. The sample of the study consists of (30) written signs of advice divided equally between the two gender groups. Hinkel’s (1997) classification of the strategies for perceiving th
... Show MoreCosmetic products contain variable amounts of nutrients that support microbial growth. Most contaminants in cosmetic products include bacteria such as Staphylococcus, Pseudomonas, Klebsiella, Achromobacter and Alcaligenes. Contaminated water is a likely source of organisms found in cosmetic products. Products such as shampoo, hand and body lotion, facial cleanser, and liquid soaps were analyzed. In this study, out of 60 cosmetic products analyzed, 26.4% were found to be contaminated. Most of the contamination was from bacteria and no fungal contamination was detected. The highest level o
... Show MoreConflict is a common but complicated phenomenon. It has been extensively researched in many domains, including philosophy, sociology, psychology, and linguistics. Using the Critical Discourse Approach, this study examines the issue of self-society conflict in The Handmaid’s Tale. The significance of this work lies in the identification and explanation of the discursive strategies that force the ideological polarization of the positively portrayed self versus the negatively portrayed other. The purpose of this study is to answer two questions: what are the discursive strategies used in The Handmaid’s Tale to create a positive or negative representation, and how are these strategies implemented? Five extracts from The Handmaid’s
... Show MoreThis study shows impoliteness as a form of face-threatening that can be intentionally caused by verbal threats in a particular setting. It investigates: what strategies and mitigators do Iraqi-Kurdish English as a foreign language (EFL) learners use in situations of threat responses? The present investigation paper aims to examine impoliteness strategies and mitigators by these learners when they respond to threatening situations in their context. Thus, it fills a gap in pragmatics literature by investigating the reactions to threats in an Iraqi-Kurdish EFL context. To this end, 50 participants have participated in this study. An open-ended questionnaire in the form of a Discourse Completion Task (DCT) is used to elicit responses fr
... Show MoreThe present research studies numbers and its uses in the Islamic ornament. The study consists of four chapters; the first is dedicated to the problem of the research, the value of the study, and the aim of the study, and its limit. The problem of the study deals with the uses of numbers in Islamic ornament and how these numbers were used for aesthetic purposes. What are the analytical bases that enable us to read the geometrical compositions ornament numerically? The value of the research is the study forms an analytical and visual study of the numbers in the Islamic ornamentation. Additionally, this study is an aesthetic assessment to the philosophy of the number and its uses in Islamic architecture. The study is limited to the ornament
... Show MoreAt the time when many important political events and evolutions took place, the cinema has been pretty active, and witnessed the historical events before and after the two world wars and the cold war. During the first half of the 20th century, the cinema had great interest from the major countries and their politicians, as well as the commercial turnout of large companies to invest in that field for the profits. In the beginning of the 20th century, the major powers like the Soviet Union, the United States, Germany, Italy, England, and France started to compete in the development of their film industry and the investment of the new medium and the transformation of some famous works of fiction into films that perpetuate their cultur
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