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.
Background: Laparoscopic cholecystectomy (LC) has become the treatment of choice for elective cholecystectomy.Objectives: To evaluate the safety and feasibility of early LC for AC and to compare the results with delayed LC.Methods: A prospective study done from April 2011 to October 2013, 88 patients with diagnosis of AC were divided randomly into two groups according to the mode of treatment; (early group n=40) treated by early LC within first 72 hours or (delayed group, n=48) initial conservative treatment for 4-6 weeks, followed by delayed LC.Results: There was no difference between the two groups (early & delayed LC), operating time (early 80min, delayed70min), conversion rate (early 7.5%, delayed 6.25%),postoperative complicatio
... Show MoreObjective: The study deafs with nursing performance in the surgical wards in general hospital at
Baghdad city.
Methodology : A descriptive evaluation design using, observational method was carried out. Non
probability (purposive) sample of (151) nurses was selected for the study and comprised all nurses who
worked in general surgical wards in the four health sectors( Rusaffa , Al-Karkh, Al-Yarmok, Medical
city health sector) at time of collecting the data. A check list questionnaire was constructed by the
researcher for the purpose of the study; it is composed of (2) major parts, part (I) is concerned with
socio-demographic data and the second part is composed of two minor parts thev concerned with
availability of
The management of construction projects needs to complete the basics of system management and work. Starting from the idea and how to turn it into a full study and ended at the construction project completion arriving at the purpose prepared for it, so the projects need to control on its operation and integration system in order to succeed.
It is no secret for who concerned in construction projects field that the design stage is a very important stage in construction project because it determines the final features of the project through the requirements provided by the employer for the consultant to formulate it during this phase in the form of plans, drawings, and specifications, then translated on the ground as the shape of co
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In this study multi objective optimization is utilized to optimize a turning operation to reveal the appropriate level of process features. The goal of this work is to evaluate the optimal combination of cutting parameters like feed, spindle speed, inclination angle and workpiece material to have a best surface quality Taguchi technique L9 mixed orthogonal array, has been adopted to optimize the roughness of surface. Three rods of length around (200 mm) for the three metals are used for this work. Each rod is divided into three parts with 50 mm length. For brass the optimum parametric mix for minimum Ra is A1, B1 and C3, i.e., at tool inclination angle (5), feedrate of 0.01, spindle speed of 120
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Embedded advertisement constitutes a special kind of communication. As it performs many important roles such as giving information, highlighting the value of the product, and urging the target consumer to buy it by influencing his/ her behavior using an attractive manner of mind and conscience. Both cinema and television are the most prominent and powerful advertising media that enjoy the interest of all audiences and capture most of the advertising spending. As advertisers have paid attention to the importance of indirectly incorporating their products into content that the audience loves and is keen to follow, since the actual impact lies in the inclusion of the product within content that the audience appeals to. Hence, this leads to
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Abstract
This study investigated the optimization of wear behavior of AISI 4340 steel based on the Taguchi method under various testing conditions. In this paper, a neural network and the Taguchi design method have been implemented for minimizing the wear rate in 4340 steel. A back-propagation neural network (BPNN) was developed to predict the wear rate. In the development of a predictive model, wear parameters like sliding speed, applying load and sliding distance were considered as the input model variables of the AISI 4340 steel. An analysis of variance (ANOVA) was used to determine the significant parameter affecting the wear rate. Finally, the Taguchi approach was applied to determine
... Show MoreThe current research problem is focused on the level of human resource managers' performance of their contemporary roles and the impact of this on achieving organizational excellence. The research aims at diagnosing and interpreting the nature of the relationship between the roles of human resource manager and organizational excellence. ), And oil companies located in Baghdad governorate. The research included (boards of directors), and collected data from (83) respondents representing the research community exclusively and comprehensively
represented in the positions of function (Directors-General, Associate Directors-General, heads of departments, divisions and divisions). (49) questions, as well as th
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Nanofluids (dispersion of nanoparticles in a base fluid) have been suggested as promising agents in subsurface industries including enhanced oil recovery. Nanoparticles can easily pass through small pore throats in reservoirs formations; however, physicochemical interactions between nanoparticles and between nanoparticles and rocks can cause a significant retention of nanoparticles. This study investigated the transport, attach, and retention of silica nanoparticles in core plugs. The hydrophilic silica nanoparticles were injected into limestone core as nanofluid of different nanoparticles size (5 nm, and 20 nm), concentration (0.005 – 0.1 wt% SiO2), and base fluid salinity (0 – 3 wt% NaCl) at different temperatures (23, and 50 °C). D
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Transient displacement of laminated plates under combined load based on Mantari' s displacement field are investigated. The solution is implemented under transient mechanical load (sinusoidal, step and triangular sinusoidal distributed pressures pulse) and thermal buckling for plates with different layer orientation and thickness ratio. Equations of motion based on higher-order theory are derived through Hamilton' s principle, and solved using Naviertype solution for simply supported laminated plates. The results are presented for many effective parameters such as the number of laminate and orientation on the dynamic response of plates. Results show the validity of this displacement field in studying response of laminated thick and
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