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 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.
This study revolves around the rapid changes of science and a comparison of the formal and practical aspects and the reason behind summoning the changes and their types, which are subject to the influence of the recipient. This transformation represents formal and intellectual production cycles and formal functional generation that is subject to the goals of the system of multiple differences at the level of time and place. It meets the needs and the request for change, but access to it comes through multiple systems and portals that are different from the normal and the usual, so this study was called (meta and its dimensions in the designed biological formation (virtual reality environment - a model). The research seeks to find solutio
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Due to the remarkable progress in photovoltaic technology, enhancing efficiency and minimized the costs have emerged as global challenges for the solar industry. A crucial aspect of this advancement involves the creation of solar cell antireflection coating, which play a significant role in minimizing sunlight reflection on the cell surface. In this study, we report on the optimization of the characteristics of CeO2 films prepared by pulsed laser deposition through the variation of laser energy density. The deposited CeO2 nanostructure films have been used as an effective antireflection coating (ARC) and light-trapping morphology to improve the efficiency of silicon crystalline solar cell. The film’s thickness increases as laser fluence i
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The load shedding scheme has been extensively implemented as a fast solution for unbalance conditions. Therefore, it's crucial to investigate supply-demand balancing in order to protect the network from collapsing and to sustain stability as possible, however its implementation is mostly undesirable. One of the solutions to minimize the amount of load shedding is the integration renewable energy resources, such as wind power, in the electric power generation could contribute significantly to minimizing power cuts as it is ability to positively improving the stability of the electric grid. In this paper propose a method for shedding the load base on the priority demands with incorporating the wind po
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Background: Pregnancy is a physiological condition that affects the general and oral health.It is also associated with an increase in oxidative stress, which may presispose to oral diseases including dental caries. Aim of the study: This study aimed to measure salivary protein carbonyl, glutathione peroxidase and selenium levels of women who are pregnant and their association with dental caries in comparison to non-pregnant women, and to find out the mostly affected biomarker of oxidative stress during pregnancy. Subjects, materials and methods: A cross-sectional research was performed for a samples of 30 pregnant and 30 non-pregnant women who were chosen from city of Baghdad's Primary Healthcare Centers. Both groups aged 25-30 years. In
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Background: Orofacial cleft is the most common craniofacial birth defect and the fourth most common congenital malformation in humans that have an effect on oral health in addition to nutrient intake affected in those children. This research aims to investigate gingival condition, dental caries experience and nutritional status among children with orofacial cleft and compare them with normal children. Materials and methods: The study group included 36 children with an age ranged (4-9) years of orofacial cleft. The control group included 37 children matched the control group in age and gender. Gingival condition measured by Gingival Index (Löe and Silness, 1963), while dental caries status was measured by (D1-4MFs/d1-4mfs) index according
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תקציר :
המחקר הזה הוא ניסיון לשפוך אור על נושא מרכזי וחשוב בחייהם של היהודים, "הממד הדתי" אצל היהודים, מחקרי הנקרא "הממד הדתי בסיפור העברי המודרני" גם מתייחס להשפעת התרבות הדתית של המספר והחוג המשפחתי שחי בו, ואיך שיקף המספר את כל הדברים האלה ביצירותיו הסיפורית .
המספר בוחר במילים ובמונחים בעלי משמעויות דתיות או מביא את הסיפור הזה אשר קרוב אל נושא הסיפור ההולך באותה מגמה .גם כן השפעת התיאולג
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Nonmissile penetrating traumatic brain injuries (pTBIs) are low-velocity injuries which can be caused by a variety of inflicting tools and represent a rare entity in children. Poor outcome has been attributed with an initial admission Glasgow Coma Scale (GCS) of <5, asymmetrical pupil size, and specific initial computed tomography scan findings including brainstem injury.
We report a case of an 11-year-old boy who presented to our ER with a GCS of 6 after being assaulted on his head by a 30 cm length metallic tent hook penetrating his forehead reaching down to the central skull bas
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Eight patients (3 male and 5 female) were treated in this study by Endovenous Laser Ablation (EVLA); Mathematical models are proposed to estimate the applied laser power and to assess the recovery period. The estimations of the applied laser power and recovery period in these models will be depended mainly on the diameter of the incompetent vein. In addition, Excel Program was utilized to find the proposed models. A 1470 nm diode laser up to 15W continuous power (CW) was used in the treatment of venous ulcers by EVLA procedure. Following up by duplex ultrasound was started in the 1st week after the first session until the vein is completely closed. The present study concluded that the relationship both between
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