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.
The application of physiological oxygen (physoxia) concentrations is becoming increasingly commonplace within a mammalian stem cell culture. Human mesenchymal stem cells (hMSCs) attract widespread interest for clinical application due to their unique immunomodulatory, multi-lineage potential, and regenerative capacities. Descriptions of the impact of physoxia on global DNA methylation patterns in hMSCs and the activity of enzymatic machinery responsible for its regulation remain limited. Human bone marrow-derived mesenchymal stem cells (BM-hMSCs, passage 1) isolated in reduced oxygen conditions displayed an upregulation of SOX2 in reduced oxygen conditions vs. air oxygen (21% O2, AO), while no change was noted for either OCT-4 or NA
... Show MoreThe recent advancements in security approaches have significantly increased the ability to identify and mitigate any type of threat or attack in any network infrastructure, such as a software-defined network (SDN), and protect the internet security architecture against a variety of threats or attacks. Machine learning (ML) and deep learning (DL) are among the most popular techniques for preventing distributed denial-of-service (DDoS) attacks on any kind of network. The objective of this systematic review is to identify, evaluate, and discuss new efforts on ML/DL-based DDoS attack detection strategies in SDN networks. To reach our objective, we conducted a systematic review in which we looked for publications that used ML/DL approach
... Show MoreObjectives: Serratia marcescens is a gram-negative pathogen of many species. The ability of S. marcescens to form biofilms and its potent innate resistance to antimicrobials and cleaning solutions are both essential for its pathogenicity and survival. The present study was conducted to investigate the effect of glyceryl trinitrate (GTN) on the biofilm of S. marcescens, as an alternative for antibiotic therapy. Methods: Different specimens, including ear swabs, burns, mid-stream urine, wound swabs, and sputum, were collected from patients who were brought to Al-Ramadi Hospital, Iraq. All samples were cultured, and the colonies that were obtained were detected using the VITEK® 2 compact. The ability of biofilms to develop was e
... Show MoreThe study targets exploring the similarities and differences between Iraqi and Malaysian learners of English in refusing marriage proposals. Also, it examines the favored politeness strategies that learners use to protect their interlocutors’ face, heeding both their social distance and status. Data were gathered by a Discourse Completion Task (DCT) which contained six marriage situations. Responses were analyzed based on Beebe et al.’s (1990) refusal taxonomy and Scollon et al.’s (2012) politeness system. The findings indicated that both the Iraqi and Malaysian learners preferred the indirect refusal strategies in marriage proposals, as well as the hierarchical politeness in the form of independence strategies regardless of t
... Show MoreCloud-based Electronic Health Records (EHRs) have seen a substantial increase in usage in recent years, especially for remote patient monitoring. Researchers are interested in investigating the use of Healthcare 4.0 in smart cities. This involves using Internet of Things (IoT) devices and cloud computing to remotely access medical processes. Healthcare 4.0 focuses on the systematic gathering, merging, transmission, sharing, and retention of medical information at regular intervals. Protecting the confidential and private information of patients presents several challenges in terms of thwarting illegal intrusion by hackers. Therefore, it is essential to prioritize the protection of patient medical data that is stored, accessed, and shared on
... Show MoreIn this paper, a mathematical model consisting of a prey-predator system incorporating infectious disease in the prey has been proposed and analyzed. It is assumed that the predator preys upon the nonrefugees prey only according to the modified Holling type-II functional response. There is a harvesting process from the predator. The existence and uniqueness of the solution in addition to their bounded are discussed. The stability analysis of the model around all possible equilibrium points is investigated. The persistence conditions of the system are established. Local bifurcation analysis in view of the Sotomayor theorem is carried out. Numerical simulation has been applied to investigate the global dynamics and specify the effect
... Show MoreAccurate computation of the roughness coefficient is important in the studies of open channel flow. To measure and identify the hydraulic characteristics of the flow system, the model simulation is necessary to study and get the results of the hydraulic properties to specify Manning coefficient of the Euphrates River. In this study, the reach is extended along the Euphrates River from Haditha Dam to Ramadi Barrage with a distance of 169km. The HEC-RAS model was implemented to simulate the flow within the study reach. The geometry of the river was represented by more than two hundred cross-sections surveyed in 2013 and 2021. The model was calibrated using some observed discharges at the Heet gage station for records of th
... Show MoreIn this paper, we propose a new and efficient ferroelectric nanostructure metal oxide lithium niobate [(Li1.075Nb0.625Ti0.45O3), (LNTO)] solid film as a saturable absorber (SA) for modulating passive Q-switched erbium-doped fiber laser (EDFL). The SA is fabricated as a nanocomposite solid film by the drop-casting process in which the LNTO is planted within polyvinylidene fluoride-trifluoroethylene [P(VDF-TrFE)] as host copolymer. The optical and physical characteristics of the solid film are experimentally established. The SA is incorporated within the cavity of EDFL to examine its capability for producing multi-wavelength laser. The experimental results proved that a multi-wavelength laser is produced, where stable four lines with central
... Show MoreThe study targets exploring the similarities and differences between Iraqi and Malaysian learners of English in refusing marriage proposals. Also, it examines the favored politeness strategies that learners use to protect their interlocutors’ face, heeding both their social distance and status. Data were gathered by a Discourse Completion Task (DCT) which contained six marriage situations. Responses were analyzed based on Beebe et al.’s (1990) refusal taxonomy and Scollon et al.’s (2012) politeness system. The findings indicated that both the Iraqi and Malaysian learners preferred the indirect refusal strategies in marriage proposals, as well as the hierarchical politeness in the form of independence strategies regardless of t
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