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.
Background :Thalassemia is an autosomal
disease of the haemoglobin. Two types of
thalassemia are recognized: thalassemia major
and thalassemia intermedia.
The most serious cardiac complication in
thalassemia major is due to multiple blood
transfusions rather than the disease itself, which
is due to iron overload.
Cardiomyopathy is the most common cardiac
defect that occurs with iron overload. Pricarditis,
congestive heart failure and arrhythmias are due
to hemosidrosis and chronic aneamia.
Aim of the study: to demonstrate the prevalence
and types of electrocardiographic changes among
thalassemic patients with aged over ten years old.
Cloud Computing is a mass platform to serve high volume data from multi-devices and numerous technologies. Cloud tenants have a high demand to access their data faster without any disruptions. Therefore, cloud providers are struggling to ensure every individual data is secured and always accessible. Hence, an appropriate replication strategy capable of selecting essential data is required in cloud replication environments as the solution. This paper proposed a Crucial File Selection Strategy (CFSS) to address poor response time in a cloud replication environment. A cloud simulator called CloudSim is used to conduct the necessary experiments, and results are presented to evidence the enhancement on replication performance. The obtained an
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(1)
The media of all kinds have the task of introducing, expressing and objectively representing the cultures of different societies in various types and forms of press and media. The precept of media pluralism is the basis for freedom of expression & the cornerstone of its realization. Therefore, it is linked to the establishment of several conditions and elements in order to establish it as a principle and practice. Issues of cultural diversity in media and cultural pluralism are one of the most important elements and indicators. So, this paper aims to shed light on the concept of media pluralism and related concepts within the framework of cultural diversity and multicultural indicators. Thus, highlighting the feature
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The life insurance marketing faces many difficulties because it is not a current tangible commodity, so it needs a planning for promotional activities and data about prospective applicants according to many factors such as age and residence area , marital status and profession to determine the group wich need insurance covers. &nb
... Show MoreThe study aims at knowing the relationship between retirement problems and psychological flexibility, besides identifying the difference of retirement problems and psychological flexibility due to the wok place variable and sex variable.
The study sample consists of 250 registered retirees in both associations of the government and the UNRWA. The researcher had prepared and used a retirement problems scale and a psychological flexibility scale. The study findings show the following:
- The economic problems were greatly common by a relative weight of 76.3 %.
- The psychological compatibility was the most widespread domain in the psychological fl
Abstract
The present search addressed the "strategic Vigilance and their impact in Organizational success "Where has the objective of strategic Vigilance and Organizational success of increasing importance at the present time, for being fairly modern topics, which have a tremendous impact on the success of organizations. &
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(3)
The research aims to identify how to enhance the quality of the human resources, focusing on four dimensions (efficiency, effectiveness, flexibility, and reliability), by adopting an adventure learning method that combines theoretical and applied aspects at the same time, when developing human resources and is applied using information technology, and that Through its dimensions, which are (cooperation, interaction, communication, and understanding), as the research problem indicated a clear deficiency in the cognitive perception of the mechanism of employing adventure learning dimensions in enhancing human resources quality, so the importance of research was to present treatments and proposals to reduce this problem. To achieve
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In addition to being a novel medication in treating obesity and type 2 diabetes mellitus, tirzepatide is currently being studied to assess its effectiveness and safety on various health parameters, specifically with an emphasis on the neurological field, including sleep medicine and neurodegenerative conditions. In this perspective, we highlight the recent FDA approval of tirzepatide’s use for the treatment of obstructive sleep apnea, with recommendations for future research to extend use in children and adolescents.