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.
Role of public relations (PR) and from one community to another, depending on the different cultures of these societies in General, and different ethical values established by their practitioners in these communities organizations , public relations in developed societies, and in some developing countries have taken great strides to contribute to the strategic planning and decision-making, in the framework of their commitment to the values and ethical standards for practitioners, In contrast, we find that applied in Iraq still skips phase coordinate with different communication means with the aim of advertising and publicity for the organization. As a result of the limited recognition of the strategic and vital
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Abstract:
The prose poem of the 1990s is considered one of the important
contributions of the Iraqi poetic scene. The poem found a position in the Iraqi
poetry because of the favor of a group of youth poets who lefty clear traces.
Their linguistic techniques often violate the domain o9f language, significance
and image.
The poems of those youth poets moved the verse towards reality to
drink from its abundant springs in order to stand on a rigid ground. Their
linguistic traces are characterized by paradox and astonishment that are used
by the poet to construct his poem.
The paradox was considered an ideal means for constructing a
poem by some of them. The poem moved towards definitions and these
de
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Abstract:
Al-Marba'aniyah, which is a long cold wave, was defined by ancient
Iraqis. It represents the coldest days in Iraq. In this research paper, a new
scale was put to define it. It shows that the period between the minimum
temperature degree recoded in December and the minimum temperature
degree recorded in January is considered to be the period of Al-Marba'aniyah.
The research concluded that Al-Marba'aniyah is unsteady and it changes in
the days of its occurrence. It was also concluded that the dates of the
beginning and the end of Al-Marba'aniyah are unsteady, too. Moreover, it was
found out that each of the Siberian high, European high, and finally the
subtropical high are the responsible systems for
Suffer most of the facilities of the high cost of inventory , which affects the high cost of the product and thus affects many administrative decisions , as well as suffer the facilities of the systems developed by the provisions of inventory control , and this problem is exacerbated in the construction sector where the inventory in the form of Construction spin of the Year for another it becomes difficult to control the cost effectively , and is the research problem in question follows: What are the implications of the use of the system in time inventory accounting system for the contracting company does kills Alrkaah to the provisions of the cost of inventory and what is the optimal approach to inventory control ? Find assumed
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Abstract
The current research sought to demonstrate the effect of material flow cost accounting on reducing products through the application of material flow cost accounting technique, which works on the optimal utilization of materials and energy and the reduction of environmental impacts.The research aims to clarify the knowledge foundations for material flow cost accounting, in addition to studying the material flow cost accounting technique that helps reduce the cost of products and make them environmentally friendly. To achieve this, the research relied on the descriptive approach with regard to the theoretical aspect of the resea
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Conclusion and results
1. The research concluded through considering the rhetorical visions,
appropriate relationships between utterances with a language derived
from the reality of the social, religious, and, cultural life.
2. The poet compound between realism and the documentation of the
poetic structure, its depth, and the conjugation of its symbolic
metaphors, and also between its phonetic music and the right artistic
nature and the inanimate rules to take in consideration what Dr. Ahmad
Haikal concluded that the tried to com up with something better than
that of the previous generation, but he is still following their orbit, and
their trend method of poem building.
3. The realistic images visionary r
The number of infections caused by microorganisms is increasing significantly over the last few years. A total of 140 patients admitted to the central teaching hospital of pediatrics from the 1st of Jun 2017 to 31 October 2017. The Clinical samples was processed from culture and sensitivity testing. Antibiotic discs used for gram negative isolates. The most prevalent gram negative isolates included Escherichia coli 63 (45.0 %), Pseudomonas spp. 21 (15.0 %), Klebsiella spp. 19 (13.6 %) predominantly. Escherichia coli were the most prevalent isolates from urine 45 (71.4 %), Klebsiella spp. 11 (57.9 %) and Enterobacter spp. 11 (68.8 %) followed by Escherichia coli 10 (15.9 %) predominant from blood. 68 (48.6 %) of specimens were urine, 47 (33.
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