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.
In networking communication systems like vehicular ad hoc networks, the high vehicular mobility leads to rapid shifts in vehicle densities, incoherence in inter-vehicle communications, and challenges for routing algorithms. It is necessary that the routing algorithm avoids transmitting the pockets via segments where the network density is low and the scale of network disconnections is high as this could lead to packet loss, interruptions and increased communication overhead in route recovery. Hence, attention needs to be paid to both segment status and traffic. The aim of this paper is to present an intersection-based segment aware algorithm for geographic routing in vehicular ad hoc networks. This algorithm makes available the best route f
... Show MoreThe concept of decolonization of trauma has intrigued researchers for years due to its prolonged effect on personal and cultural levels. The process of intellectual decolonization involves defensive survival mechanisms, such as cultural rituals using traditional practices, nostalgic dialogues that idealize memories and recollections, and conversations about identity to navigate postcolonial trauma displacement. Symbolic connections evoke strong emotional responses, bridging the gap between the characters‘ physical dislocation and their imaginary homeland. Cocooning identity represents a space where a multidimensional self emerges—one that holds the victim of trauma, the survivor who endures, and the narrator, who constructs an idealized
... Show MoreCultural and identity scars have been engraved in the body of ethnic minority of Muslims in America due to the bloody attacks of 9/11. These events have created thus traumatic experiences on the party who witnessed the events at close and the people on whom the blame is conclusively directed, Muslim Americans. For Americans, the attacks resulted in a proud reassertion of the national virtue and communal integrity from which Muslim Americans were excluded. This reassertion is accompanied for Muslims by a reconstruction of a cultural identity away from their origin homeland and under pressures and prejudices that made the process of reconstruction to be severely challenging. Accordingly, the challenge needed to be portrayed to overcome the d
... Show MoreThe location element indispensable in the film, it is the container that meets the all the elements of the artwork, and place in the cinema topic or space as the existence of a material perceptible senses, is one of the key elements in the drama because he is one of the conditions to achieve supply drama which, with the nature of the vehicle because it is linked to reality the real and the reality of mental imagined, and returns the importance of the place mentally to change the pattern in the building's traditional place in the world of the film, is that the space under the facts of the events imagined or mental and determined by the processors directorial, and where mental in the movies but found himself a world with a pace sometimes s
... Show MoreThe rehabilitation of deteriorated pavements using Asphalt Concrete (AC) overlays consistently confronts the reflection cracking challenge, where inherent cracks and joints from an existing pavement layer are mirrored in the new overlay. To address this issue, the current study evaluates the effectiveness of Engineered Cementitious Composite (ECC) and geotextile fabric as mitigation strategies. ECC, characterized by its tensile ductility, fracture resistance, and high deformation capacity, was examined in interlayer thicknesses of 7, 12, and 17 mm. Additionally, the impact of geotextile fabric positioning at the base and at 1/3 depth of the AC specimen was explored. Utilizing the Overlay Testing Machine (OTM) for evaluations, the research d
... Show MoreThere are a number of obstacles in the field of work of social workers that prevent them from performing their full role. Their tasks may sometimes be easy and manageable and at other times they may be difficult and complex, however professional roles are mostly the latter, contribute to the feeling of the inability to provide the work required at the level expected by others. In such cases, the relationship binding specialists to their work is affected negatively and this has devastating effects on the professional process as a whole, including their professional practice. This feeling of helplessness and depletion of energy and effort leads to a state of fatigue and emotional exhaustion that can be defined as job burnout, our study aims t
... Show MoreThe study of the concepts of "democracy" and "human rights" and their impact on development, has taken a prominent place in the context of general political and cultural concerns, or in specialized studies even though researchers and scholars do not agree on defining the concepts: Democracy, Human Rights, Development or deriving a global definition hindering them, and that because of the importance of this topic, which proceeds from a number of considerations standing in the forefront, of which:
First: What the world witnesses today in the first decade of this century of consecration of the unipolar theory, trying to give its concepts and perceptions through the law ((excessive force)) to the power of international
... Show MoreTurkey Consider Tigris and Euphrates rivers as a national rivers, and not an a International rivers, so that . It insists on its absolute sovereignty on that resources. The block ( levee ) which Turkey established should not create International problems.
The All International agreements and laws in this sect warrant the rights of all the states that located in river stream to use it without any consider to the regional absolute right.
During the 1980s, Turkey construct water projects, started with GAP, project which is one of the greatest project in the world, in spite of the plane of construct of the keep an levee on the Euphrates was pre of that project. The
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The Iraqi government seeks to overcome the financial crisis by investing and privatizing some projects to achieve sustainable growth. Most of the investment projects in Iraq suffer from many constraints that greatly impact the success of these projects. A survey of the opinions of a group of experts was conducted to identify the most important constraints facing the investment process in Iraq. Then the experts' answers were arranged in a closed questionnaire and distributed to the research sample for which the statistical analysis was conducted. Through it, the most important (17) factors that had the greatest impact on the failure of investment projects in Iraq were reached. One of the main constraints was
... Show MoreTransportation networks impact millions of people daily. Their efficiency immediately affects travel time, safety, and environmental sustainability. Unfortunately, various issues hinder the expected performance and efficiency of these networks. Traffic congestion is an up-to-date issue in the urban environment. Fuel consumption is high because travel time has increased, which has a passive environmental impact. Extensive research has been conducted to progress the intelligent transportation systems installed on communication networks and information to treat this congestion. However, there is a significant amount of affront residue in combining real-time data, estimation analytics, and 5G abilities effectively. This paper offers a n
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