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.
تعد الموازنة الأداة الأساسية لتنفيذ أولويات أية دولة، ويتوجب النظر إليها في ضوء المناخ الاجتماعي والسياسي والاقتصادي، لأنها تساعد في توجيه الاقتصاد لتحقيق النمو ورفع مستوى الرفاهية. اعتمدت وزارة المالية في أعداد الموازنة السنوية بعد 9/4/ 2003 أسلوباً مغايراً لما كان معتمداً في العقود الماضية، إذ كانت هناك موازنتين الأولى الموازنة الجارية، والثانية الموازنة الاستثمارية رغم وجود قانون يحتم إصدار موازنة
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Most of the big companies and especially the intillictual ones become a ware of an important fact, and That is, The intillictual capital in new global economy, is a new source for Them & This Valuable source exceed in importance. The other company's sources.
The Traditional disclouser systemes are unable to supply the decisions makers with the Fundimental information require to handel the on going operations which are based on Knowledge and intangible source. But the measuring of this source and the disclose for it in the financial Statements will lead to gain features Statements which will benefit all the parties and lead to make the value of the company great.
And as a resul
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Soft clays are generally characterized by low shear strength, low permeability and high compressibility. An effective method to accelerate consolidation of such soils is to use vertical drains along with vacuum preloading to encourage radial flow of water. In this research numerical modeling of prefabricated vertical drains with vacuum pressure was done to investigate the effect of using vertical drains together with vacuum pressure on the degree of saturation of fully and saturated-unsaturated soft soils. Laboratory experiments were conducted by using a specially-designed large consolidometer cell where a central drain was installed and vacuum pressure was applied. All tests were conducted
... Show MoreIn the present work, the image and representation of Adela, the youngest daughter of the family of the Casa de Bernarda Alba, one of the most popular works of the Spanish author Federico García Lorca (1898-1936), will be analyzed. In this work, there are different themes, but what concerns us is to show the repression, oppression and rebellion of this character in a context of customs of the 1920s in Spain. They are revealing elements in that period in which women were relegated to the background, despite the fact that a feminist movement had already begun in Spain. By studying Adela, we seek to see how a single woman confronts her family and the society that surrounds her to fight for freedom, although its end is finally linked to
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Since the beginning of the second decade of the twenty-first century, Saudi Arabia tried to pursue an open foreign policy towards many countries in the Horn of Africa, especially with Ethiopia and Somalia, due to the geostrategic qualities that these two countries possess.Despite the development of Saudi foreign policy towards Ethiopia and Somalia, it was soon affected by the tension after the events that the Gulf states went through, that is, the Qatari crisis with Saudi Arabia,especially after most of the countries of the Horn of Africa adhered to a policy of neutrality towards the Gulf-Gulf crisis.
Thus it is expected that despite the geographical proximity and the historical, economic and political relations between Saudi Ara
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The research aims to demonstrate the impact of governance mechanisms on the quality of financial reports in the light of the accounting disclosure for sustainable development represented in (accounting disclosure for economic development, accounting disclosure for environmental development, and accounting disclosure for social development) in a sample of banks listed in the Iraq Stock Exchange.
Governance mechanisms were measured by evaluating and analyzing the mechanisms in banks for the research sample consisting of (15) banks, based on the governance guide issued by the Central Bank, as well as the banks’ financial reports for the years 2016 -2018, and the dimensions of accounting disclosure for sust
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