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.
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Current Thesis has aimed to identify : The Psychological barriers for university students , Differences in psychological barriers depending on the variable sex (Males – Females) , Adjustment to College life for university students, Differences in Adjustment to College at university life depending on the variable sex (Males – Females), and finally, The correlation between psychological barriers and Adjustment to College life. The researcher has prepared a sample consisted of (100) male and female students who were randomly selected from university students, The researcher has adopted a measure of (2002) to measure the psychological barriers, also the researcher adjustment scale with university life.
The results showed that universi
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The environmental problems that have emerged recently as a result of pressure on the environment due to the increase in population size, especially in urban cities, where this increase was accompanied by the need for housing as well as the need for services and activities. This led to the establishment of many vertical residential buildings represented by residential complexes within the urban fabric of the city of Baghdad. As part of following the methodology of urban dictation policies in empty areas, and to accommodate the largest number of residents as a result of the multiplicity of floors and housing, these buildings must be subject to the standards and requirements of sustainability at the level of their spatial location and their
... Show MoreImproving students’ use of argumentation is front and center in the increasing emphasis on scientific practice in K-12 Science and STEM programs. We explore the construct validity of scenario-based assessments of claim-evidence-reasoning (CER) and the structure of the CER construct with respect to a learning progression framework. We also seek to understand how middle school students progress. Establishing the purpose of an argument is a competency that a majority of middle school students meet, whereas quantitative reasoning is the most difficult, and the Rasch model indicates that the competencies form a unidimensional hierarchy of skills. We also find no evidence of differential item functioning between different scenarios, suggesting
... Show MoreA high-performance liquid chromatography method was employed for the quantitative determination of ascorbic acid (AA) which called vitamin C in three types of Iraqi citrus (orange mandarin and aurantium ) and to establish this goal , evaluation of ascorbic acid degradation is so important due to its significant criticality when exposure to ordinary atmospheric conditions. The chromatographic analysis of AA was carried out after their sequential elution with KH2PO4 ( as mobile phase) by reverse-phase HPLC technique with C8 column and UV detection at 214 nm. .Bad resolutions was appeared clearly for C8 column , so another alternative condition were carried out to improve the resolution by replacement of C8 by C18 column .Statistical treat
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Integrated project delivery is collaboratively applying the skills and knowledge of all participants to optimize the project's results, increase owner value, decrease waste, and maximize efficiency during the design, fabrication, and construction processes. This study aims to determine IPD criteria positively impacting value engineering. To do this, the study has considered 9 main criteria according to PMP classification that already covers all project phases and 183 sub-criteria obtained from theoretical study and expert interviews (fieldwork). In this study, the SPSS (V26) program was used to analyze the main criteria and sub-criteria priorities from top to bottom according to their values of the Relative Importance In
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