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 upbringing of Yehuda Amichai and the conditions he lived in had a great influence on his deep sense of pain, which made him think of death and suicide. Especially after the Nazis came to power in Germany, and his emigration with his family. Amichai searched for love throughout his life, and his failure was one of the most important factors affecting his psyche, which is A deep influence that made him live in harsh and painful pains that broke him, and prevented her from achieving his ambitions in life.Dramatic texts are characterized by repetition in writing and presentation. It is a textual discourse that has two advantages, first, that it can be read as a literary text like all other literary texts, and second, that it can be consider
... Show MoreThe research topic (The Impact of the Compulsory Reserve on the Banks Credit-an applied research on a sample of Iraqi banks), was chosen on basis of the Iraqi private Banks attempts to increase their credit activities in hope to gain more profits.This coincided with the CBI aim to back the private banking market.It is thus apparent why the CBI issued its regulation to those banks to increase their capitals up to IDB250. On the other hand,the CBI acted as an obstacle in the way of increasing the private banks of their capitals,that is by implementing the quantitive monetary tool so called the compulsory reserve.This is why we intended to overlook at this contradictional problome
... Show MoreThe success of any institution must be based on means to protect its resources and assets from the waste, loss, misuse and the availability of accurate and reliable data by accounting reports to increase its operational efficiency, namely, that the internal control system is considered as a safety valve for top management in any economic unit. The problem is represented by the need for an efficient system, so to ensure its success, there must exist external parties which monitor and evaluate the performance because of its importance by following clear criteria. So, the research problem came to address performance evaluation indicators which are set by the Federal Board of Supreme Audit (FBSA) and identify the extent of its contribution t
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Abstract
The research aims to investigate the private sector attitudes toward operational contracting in special education schools. The research adopted the qualitative approach by using personal interviews with a sample of (45) private school owners and managers in Oman. The results of the research revealed that there is an agreement among the majority of respondents on the ability of the private sector to manage special education schools, the advantages of the partnership, as well as the need for guarantees to support this partnership. The government should fully assume it. The role of the private sector remains to raise the operational efficiency of schools. Opinions vary about the level of powers granted to t
... Show MoreAfter harvesting, Alfalfa plant was washed, dried and ground to get fine powder used in treatment water. We used alfalfa plant with ethanol to made alcoholic extract and characterized it applying (GC-Mass, FTIR, UV) spectroscopy to determine active compounds. Alcoholic extract was used to prepare zinc nanoparticle. We characterized Zinc nanoparticles by using FTIR, UV, SEM, EDX Zeta potential and AFM. Zinc nanoparticle with Alfalfa extract and alfalfa powder was used to treat pollutant water with pesticides and negative ions by two methods, namely Batch and continuous processing. Batch process was used two times firstly, with Alfalfa plant to treat water affected by pesticides and negative ions, after 1h pesticides (glyphosate 44.76%, sulfo
... Show MoreThe aim of the research is to use this technique and to determine the effect of this method in reduce cost per unit of the company. The traditional method used in the company the research sample to determine the indirect costs, the definition of the concepts and characteristics of the method of cost-based activity and the cost method based on time-driven activity and justifications applied to companies. In order to achieve the research objectives, the main hypotheses were formulated. That was represented: (The applied of (TDABC) Time driven activity based costing method in reducing indirect costs, leads reduce cost per unit than the use of the traditional method of allocating indirect costs in the research sample company).&nb
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The Research is interested in the detailed comparative study of certain selection of
Imam Alsamarqandi in some subjects of washing and touching the Gracious Quran.
The value of this study is that it is related to one aspect of the duties obliged on Muslim
like parity.
The study has tried to collect certain scholars’ opinions of eight doctrines with the
selection of Alsamarqandi to make a comp arson between them and to show how
Alsamarqandi is able to create legal laws from his sources to lead the researchers nto have
knowledge about the syllabi of the famous scientists.
Finally we ask God to bless to what is right and to accept this study and make it part of
our good deeds, Ameen.
The construction industry plays a crucial role in the countries' economy, especially in the developed country. This point encourages the concerned institution to use new techniques and integrate many techniques and methods to maximize the benefits. The main objective of this research is to evaluate the use of risk management, value management, and building information modeling in the Iraqi construction industry. The evaluation process aims at two objectives. The direct objective was to evaluate the knowledge in risk management (RM), value management (VM), and building information modeling (BIM). The indirect objective was to support the participants with information related to the main items mentioned. The questionnaire
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Autorías: Nuha Mohsin Dhahi, Muhammad Hamza Shihab. Localización: Revista iberoamericana de psicología del ejercicio y el deporte. Nº. 6, 2022. Artículo de Revista en Dialnet.
This research aims at recognizing the concept of Innovation in offering the banking services as well as the concept and dimensions of competitive advantage . And to identify and analyze the relationship ( correlation and impact ) between the concept of Innovation in offering the banking services and the dimensions of the competitive advantage under discussion . The research includes all Iraqi private banks in Baghdad city only of the (20) banks . The researcher adopted , in this study , a random sample of the distribution of the questionnaire to members of the research sample are managers , customers and employees in these banks , and were distributed ( 115 ) form questionnaire , ( 97 ) form w
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