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 Next-generation networks, such as 5G and 6G, need capacity and requirements for low latency, and high dependability. According to experts, one of the most important features of (5 and 6) G networks is network slicing. To enhance the Quality of Service (QoS), network operators may now operate many instances on the same infrastructure due to configuring able slicing QoS. Each virtualized network resource, such as connection bandwidth, buffer size, and computing functions, may have a varied number of virtualized network resources. Because network resources are limited, virtual resources of the slices must be carefully coordinated to meet the different QoS requirements of users and services. These networks may be modifie
... Show MoreIn this paper, effective slab width for the composite beams is investigated with special emphasis on the effect of web openings. A three dimensional finite element analysis, by using finite element code ANSYS, is employed to investigate shear lag phenomenon and the resulting effective slab width adopted in the classical T-beam approach. According to case studies and comparison with limitations and rules stipulated by different standards and codes of practice it is found that web openings presence and panel proportion are the most critical factors affecting effective slab width, whereas concrete slab thickness and steel beam depth are less significant. The presence of web opening reduces effective slab width by about 21%.
... Show MoreA numerical investigation has been performed to study the effect of eccentricity on unsteady state, laminar aiding mixed convection in a horizontal concentric and eccentric cylindrical annulus. The outer cylinder was kept at a constant temperature
while the inner cylinder was heated with constant heat flux. The study involved numerical solution of transient momentum (Navier-Stokes) and energy equation using finite difference method (FDM), where the body fitted coordinate system (BFC) was
used to generate the grid mesh for computational plane. The governing equations were transformed to the vorticity-stream function formula as for momentum equations and to the temperature and stream function for energy equation.
A computer progra
Background: One of the more significant hormonal systems, the renin-angiotensin-aldosterone system, controls the kidney function, adrenal gland through its effect on the balance of sodium and potassium, blood pressure, fluid volume, and also manages the functions of cardiovascular. Objective: To clarify the interrelationship between renal dysfunction and renin-angiotensin-aldosterone system. Patients and Methods: One hundred samples were collected from December 1, 2022, to February 18, 2023, from Al Shams Medical Laboratories (56 male, and 44) female, age range (of 45-60 years), all of them were volunteers suffering from chronic renal failure in the third stage the average glomerular filtration rate was 35. 70 ± 0.37 12
... Show MoreTo decrease the impact on the environment of building waste, the recycled aggregate may be used in various sustainable engineering applications, such as roller compacted concrete pavement (RCCP). This research examined how using recycled aggregate as a partial replacement for natural aggregate as coarse or fine affected the mechanical properties of roller-compacted concrete pavement. The recycled aggregate was crushed and sieved to coarse and fine aggregate before being used in the roller-compacted concrete pavement. Compressive strength, splitting tensile strength, and flexural strength were all evaluated after the samples were prepared at 28 and 90 days of curing. According to the study's findings, the partial replacem
... Show MoreThe study objectives were to (1) describe the characteristics of the pharmacy professionals and (2) explore the association between job satisfaction and factors, such as work control, work stress, workload and organization and professional commitments.
This study was a cross-sectional design. The survey items were mainly adapted from the US National Pharmacist Workforce Survey. An electronic (Qualtrics) questionnaire was posted on pharmacist social media in several A
The aim of this paper is to shed the light on the concepts of agency theory by measuring one of the problems that arise from it, which is represented by earnings management (EM) practices. The research problem is demonstrated by the failure of some Iraqi banks and their subsequent placement under the supervision of the Central Bank of Iraq, which was attributed, in part, to the inadequacy of the agency model in protecting stakeholders in shareholding institutions, as well as EM, pushed professional institutions to adopt the corporate governance model as a method to regulate the problem of accounting information asymmetry between the parties to the agency. We are using the Beneish M-score model and the financial analysis equations in
... Show MoreThis research delves into the realm of asphalt technology, exploring the potential of nano-additives to enhance traditional asphalt binder properties. Focusing on Nano-Titanium Dioxide (NT), Nano-Aluminum Oxide (NA), and Nano-Silica Oxide (NS), this study investigates the effects of incorporating these nanomaterials at varying dosages, ranging from 0% to 8%, on the asphalt binder’s performance. This study employs a series of experimental tests, including consistency, storage stability, rotational viscosity, mass loss due to aging, and rheological properties, to assess the impact of nano-additives on asphalt binder characteristics. The findings indicate a substantial improvement in the consistency of the asphalt binder with the add
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