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.
Most of the literature on the management and application terkzat waved the last period on large organizations was the negligence of knowledge management in small organizations where research aims to find out knowleddge management, small projects In oxygen Ahli plant in Iraq, and the fact the role of knowledge management in small projects from the standpoint of employees in order to achieve this used production method results. The results showed that knowledge management has a role in the high level of productivity during the years 2010-2013. The results showed that knowledge management has a role in the high level of productivity during the years 2
... Show MoreIn the last years of the twentieth century, scholars solidly focused on paradiplomacy as a study subject, linking it to federalism and decentralised systems. In the Arab world, which has 22 countries, a few states have adopted federalism or decentralisation. Only five countries, i.e., 22.7%, have adopted federalism and decentralised experience. Therefore, limited research and academic work has been conducted regarding paradiplomacy. This paper aims to research the relationship between federalism and paradiplomacy conceptually and practically and then analyse the Arab experiences in federalism and whether they applied paradiplomacy and succeeded in doing so. To explore that, the paper studies and compares the related articles of constitution
... Show MoreSub-threshold operation has received a lot of attention in limited performance applications.However, energy optimization of sub-threshold circuits should be performed with the concern of the performance limitation of such circuit. In this paper, a dual size design is proposed for energy minimization of sub-threshold CMOS circuits. The optimal downsizing factor is determined and assigned for some gates on the off-critical paths to minimize the energy at the maximum allowable performance. This assignment is performed using the proposed slack based genetic algorithm which is a heuristic-mixed evolutionary algorithm. Some gates are heuristically assigned to the original and the downsized design based on their slack time determined by static tim
... Show MoreFunctionalized Multi-Walled Carbon Nanotubes (MWCNTs-OH) network with thickness 4μm was made by the vacuum filtration from suspension (FFS) method. The morphology, structure and optical properties of the MWCNTs film were characterized by SEM and UV-Vis. spectra techniques. The SEM images reflected highly ordered network in the form of ropes or bundles with close-packing which looks like spaghetti. The absorbance spectrum revealed that the network has a good absorbance in the UV-Vis. region. The gas sensor system was used to test the MWCNT-OH network to detect NH3gas at room temperature. The resistance of the sensor was increased when exposed to the NH3gas. The sensitivities of the network w
... Show MoreThis experiment was conducted in order to estimate azulene and apigenin in chamomile flowers. Ethanol extracts were examined singly or in combination with some drugs in their biological activity against some pathogens causing skin infection. Ethanol extract was applied at a concentration of 40 mg/ml for the treatment of induced skin infection of mice. Among the topicals used, Claforan was found the most effective on microorganisms causing skin diseases; ethanol extract was more effective than the drug Candimazole solution 1%. HPLC was used for the determination of azulene and apigenin active compounds of chamomile plant.
The study aimed to identify the role of public relations management in its dimensions (mental image, media, advertising, and the public) on green human resource management practices in Jordanian private hospitals in Amman, and this study relied on the quantitative approach (descriptive and analytical) to test hypotheses. Where the questionnaire was relied upon to collect data and their number was (1771) workers, and the study population consisted of workers in the hospitals that were studied on them and their number was 10 hospitals, where 316 questionnaires were distributed, 300 questionnaires were retrieved, and 16 questionnaires were not valid for analysis. That is, 91.7% of the sample, and the study relied on proportional stratified
... Show MoreBackground: Ear infections can manifest in many forms depending on site of infection whether external, middle or internal ear and the culprit pathogen whether viral, bacterial or fungal. Acute middle ear infections are usually accompanied by aural discharge. Objective: 1. To get an overview on the bacterial pathogens involved in ear infections. 2. To assess the antibiotic resistance of bacterial pathogens. Methods: A cross sectional study conducted in Al-Kindy Teaching Hospital / Baghdad /Iraq. Swabs taken from 225 patients suffering from aural discharge were tested for culture and sensitivity for the duration of two years 2018-2019. Aural discharge is cultured by inoculating it into blood, MacConkey agar, chocolate agars and Sabou
... Show MoreHepatitis B and Hepatitis C viruses are the major health problem in the worldwide. In the Middle East, the prevalence of HBV in general population with the chronic infectionsis 2-5%,whereas the prevalence of HCV is about 1% in Arabian Gulf countries. World Health Organization (WHO) revealed that the risks of HBV and HCV transmissionas well as human immunodeficiency virus (HIV) through the transfusion of contaminated blood and blood products is high, because of the fragility of health services in these countries. Several viral diseases are transportby different modes like bloodtransfusion, sexual contact, and unsafe injections. The mostcommon blood-transmitted viruses are hepatitis B virus(HBV), hepatitis C virus (HCV) and humanimmunodeficie
... Show MoreBackground: Acute urinary tract infection is a common bacterial infection causing illness in infants and children. At age of seven, 8% of girls and 2% of boys will have at least one episode. Although drinking water and using home remedies are known to help to flush away bacteria and keeps them from sticking to the bladder wall, researches to test the efficacy and safety of hydrochlorothiazide's diuretic effect as adjuvant to the antibiotics in pediatric age groups are lacking, and so this research was to address this subject.
Objectives: To assess the effectiveness and the safety of hydrochlorothiazide as adjuvant therapy to the antibiotics in treating acute urinary tract infect
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