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.
Our research sheds light on one of the most important aspects of David Grossman's play, "Ricky's Garden, גן ריקי " which is characterized by its realistic portrayal of characters. Grossman gradually moves towards the inner awareness of his characters, expressing their emotions and thoughts through conversations and emotional conflicts, referring to their past and rooted background. Grossman transformed the main subject of his play (psychological depth) into a presentation and arrangement of all the elements of the play in a way that expresses emotional nature more powerfully by each child in the garden. This is reflected in their actions and words, making Grossman's works suitable for study and always of interest to specialized resear
... Show MoreThe study aimed to assess the level of ANG‑2 in MM patients at diagnosis and in remission state and elaborate on its correlation with interleukin‑6 (IL‑6) and beta‑2 microglobulin (B2M) levels. Sixty MM patients; 20 newly diagnosed (ND), and 40 patients in remission were included. Twenty healthy individuals were included as a control group. Plasma levels of ANG‑2, B2M, and IL‑6 were tested by enzyme‑lin ked immunosorbent assay. There are significant statistical differences between ND patients and those in remission in hemoglobin, neutrophil count, blood urea, serum creatinine, glomerular filtration rate, B2M, IL6, and ANG‑2 (P = 0.001, 0.033, 0.005, 0.001, 0.001, 0.001, 0.004, and 0.001, respectively). ANG‑2 showed signifi
... Show MoreThe subject of the organizational Ambidexterity of the vital Topics through which it seeks organizations to provide mentalities renewable for their members and maintain its survival and continuity according to different organizational methods of access for strategic success. The research aims to demonstrate the impact of organizational Ambidexterity in achieving strategic success in the National bank of Iraq, and the questionnaire was prepared as a tool for collecting data and information through sample survey of (16) managers and heads of departments , The results were analyzed by using the statistical program (SPSS) in calculating mean, standard deviation, percent and test (f), coefficie
... Show MoreThe goal of the extant revision was to explore the influence of caffeic acid (CA) extracted from Arctium lappa L. on lipid profile and histology of aorta in rats . Analytical study demonstrated a high percentage of both chlorogenic and caffeic acid in the 80 % methanol extract of the aerial parts (leaves and stems) of Arctium lappa L. from the family Asteraceace. Hypolipidemic activity of caffeic acid was studied against cholesterol induced hypercholesterolemia in Wistar albino rats for thirty days. Rats were separated into normal group (A), hypercholesterolemic positive controller group (B). While, the rest three groups (C, D and E) attended as hypercholesterol
... Show MoreFrictional resistance occurs whenever sliding happens, negatively impacting treatment outcomes and duration. It is a clinical challenge and must be dealt with efficiently to achieve the best orthodontic results. Aims of this study: compare and evaluate the static frictional forces under the wet condition to mimic the oral environment produced by using a polycrystalline ceramic bracket, monocrystalline ceramic bracket, 0.014 of an inch nickel-titanium (Rhodium coated archwires, and ilusio aesthetic archwires), and 0.019 x 0.025 of an inch stainless steel (Rhodium coated archwires, and ilusio aesthetic archwires). Ninety-six aesthetic brackets (48 monocrystalline and 48 polycrystalline brackets) were used and stored in different incub
... Show MorePigeons have accompanied humans since ancient time because they are used as a source of food, pets, hobby, and religious symbols. Pigeons have shown high prevalence rate of infection with gastrointestinal helminths and protozoan. This study was conducted to evaluate the prevalence of parasitic infections in the domestic pigeon (Columba livia domestica) from October, 2017 to April, 2018, purchased from bird market of Zakho City, Kurdistan region. The samples were taken from 50 adult pigeons (28 males and 22 females). The birds were transferred to Parasitology Laboratory, Faculty of Science, Zakho University. In the laboratory, each bird was sacrificed and immediately the feather and skin of under wings, chest and the rest of the
... Show MoreThis study was conducted to detect C.sakazakii PIF and raw milk. Two hundred samples of PIF were taken from the infected hospital infants who used this type of milk and from the local markets in addition to 16 sample of raw milk were collected. The study is the first to report the isolation of C. sakazakii and Enterobacter spp. from raw milk in Iraq. The distribution of C.sakazakii and Enterobacter spp. among the presumptive isolates using Vitek-GN2 system gave 1/16(6.25%) isolates of C.sakazakii and 4/16 (25%) isolates of Enterobacter spp. Enterobacter spp. isolates include (E.cloacae ssp. cloacae and E.cloacae ssp. dissolvens, E.hormaechei, and E.ludwigii) that isolate from raw milk Differences in between percentages of each isolate perse
... Show MoreThe provision of electric power is necessary for the advancement of the country's economy. It is the main engine of the economy and its various activities. It is an indicator of social welfare and it is considered as the basic pillars for achieving sustainable development (economic, social, environmental and institutional) by raising the levels of performance and meeting local needs. The problem of research was the absence of a program to audit the performance of the electricity sector contributes to ensure the application of sustainable development. The research was based on the hypothesis that the preparation of a proposed program to audit the performance of the electricity sector contributes to the achievement of The researchers sough
... Show MoreSAIs has a pivotal role in enhancing public sector performance through its quest to achieve the greatest possible efficiency and effectiveness in its, so it has to adopt applied framework for abilities building, the research aims to shed light on the role of SAIs and the nature of their work, and the definition for its abilities building, and to prepare a proposal for abilities building applied to work with the SAI in the Republic of Iraq (of the Federal Board of Supreme Audit ),the Researchers reached conclusions, namely: abilities building is the outcome of the interaction between the reality of all of the employees of the SAI and the institution itself and the environment and the specific requirements of the de
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