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 paper tries to explore the grammatical phenomenon of rankshift in Systemic Grammar, a functional grammar that establishes five units or the rank scale , : namely sentence, clause phrase, word and morpheme .Rankshift a Hallidayan term , occurs when a given unit is downgraded or shifted down the rank scale and operates further down its rank or a rank equal to itself as when a clause which has to operate in sentence structure operates at q “ qualifier” in a nominal group. The paper , quite significantly, introduces the systemic background that enunciates the systemic theory whose organising concept system rather than structure. The paper then, grammatically explores rankshifted elements, successive rankshifting, degrees of rankshifting
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G. tuberculosa is a newly recorded species from the Caryophyllaceae family for Iraqi flora, collected from the Arbil district from May to August. Morphological descriptions with macro and micro features illustrated with plates and dimensions, the species is related to G. pallida and distinguished from calyx properties, especially the presence of large prominent druses crystals. Keywords: Caryophyllaceae, Gypsophila, Iraq, New record, pallida.
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Reading strategies are of interest for what they reveal about the ways readers manage their interaction with written texts and how these strategies are related to text understanding, acquisition ,storage ,and retrieval of information .In EFL comprehension lessons, the students try to work out interpretations of the meaning related to the written word through the usage of different comprehension strategies. Yet, there are moments where the participants in the classroom fail to reach a successful understanding of the passage read despite the guidance of the teacher. The present research aims at investigating and identifying moments of comprehension failure and reasons behind them .It also aims at specifying the different strategies used in
... Show MoreMechanism of Arbitration in the Stock Exchange Disputes
The present study aimed to evaluate sera TGF- ?1 concentration in patients with urinary bladder carcinoma (UBC). All malignant of them was transitional cell carcinoma (TCC) type , patients with urinary bladder disorders (UBD ) and healthy control , and to study the correlation between sera TGF-?1 levels and tumor stages and grades in UBC patients . A direct ELISA test was used to quantify the seraTGF-?1 concentrations in sera of 58 patients with urinary bladder carcinoma UBC of different grades (G) and stages (T) all malignant of them was transitional cell carcinoma (TCC) type , 15 from patients with UBD and 15 healthy subjects . Sera levels of TGF-?1 were elevated in patients with UBC and UBD compared to healthy (P ? 0
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Perhaps masculinity and femininity in our Arabic language are among the linguistic issues that have occupied the attention of researchers, ancient and modern. Many books, works, and research have been written on this subject, but there is still something in it that must be revealed, clarified, and established, as the ancients did not classify the feminine and masculine into real, metaphorical, auditory, analogical,