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 gamma camera, along with SPECT and PET scanners, is one of the main imaging technologies in nuclear medicine. A collimator is typically constructed from tungsten to provide high absorption of gamma photon energies. It has a hole or holes for imaging. Gamma rays from a radioactive source within the body are emitted in all directions, while the photons required constructing an image travel through the hole. A scintillator is the most common material used to convert the high energy of gamma radiation into a lowenergy optical photon. These detectors are one of the primary secrets to radio-diagnosis in nuclear medicine. The photomultiplier tube (PMT) is a versatile device with extraordinarily highly sensitivity and response. A typical photom
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Various Hall Effects have been successfully observed in samples of n-type indium antimonide with values for conductivity, energy gap, Hall mobility and Hall coefficient all agreeing with theory. A particular interest in developing a method for obtaining accurate values of carrier concentrations in semiconductor samples has been fulfilled with an experimental result of (1.6×1016 cm-3 ±10.7%) giving a percentage difference of (6.7%) to a quoted value of (1.5×1016cm-3) at (77K) using an (80mW C.W. CO2) laser beam at (10.6μm) to illuminate a similar sample of n-type indium antimonide, an "Optical" Hall effect has been observed. Although some doubt has been raised as to the validity of effect i.e. "thermal" rather than "Optical", values o
... Show MoreA simple, rapid, accurate and sensitive spectrophotometric method for the determination of thiaminehydrochloride has been developed. The method is based on the formation of the Schiff’s base between the primary amino group present in thiamine hydrochloride and aldehyde group present in the vanillin reagent to produce a yellow colored complex having maximum absorption at 390 nm. Beer’s law has obeaid over the concentration range of 2-28µg/mL, with molar absorptivity of 0.96x104L/mol.cm. The average recovery which is a measure of accuracy is 100±1.3% and the relative standard deviation (RSD) is less than1.5 .The present method is considered to be
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Review of multidrug sensitivity and resistance in enterococcus
There is talk of the Prophet ﷺ proud of his relative, which is the uncle, and the importance of this subject, this search for doctrinal matters related to the two things between us: the interest of the Prophet ﷺ responsible, and also responsible forbidden marriage and marriage as it is forbidden to marry the uncle, and in the uncle language: mother's brother, aunt Her uncle may spend his uncle's nephew, the uncle may embrace his nephew, the uncle shall be the guardian of the little or the small, not to cut off the uncle if he steals from his nephew's money. "
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International law has proven that it is an evolving and flexible law over the years, and despite that, this development takes a very long time, as the concept of peremptory norms took 83 years to crystallize and have concrete and impactful applications, and within this development another modern concept emerged, which is the obligations Erga Omnes in the Barcelona Traction case 1970. We have concluded that these two concepts fall under a broader concept, which is peremptory norms, and this concept represents the common supreme interests of the international community, and consists of rules that transcend all other rules in international law, and it is not permissible to derogate or deviate from them. On the other hand, it bears the oblig
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