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.
Compensation is one of the most discussed topics in the arena of civil law that requires research About solutions to the damages that arise from the promotion of extremist ideas, which were imposed by the developments taking place in society and the increasing escalation of accidents and their increasing risks, which now threaten individuals and their property on a daily basis in large numbers, as the injured party always seeks to require quick compensation from the person responsible for the damage that satisfies his desires and removes the effects of the damage caused, The importance of compensation increases if the violation affects a person’s physical integrity or his right to life, which is the highest right recognized for humans in
... Show MoreMycobacterium tuberculosis resistance to rifampicin is mainly mediated through mutations in the rpoB gene. The effects of rpoB mutations are relieved by secondary mutations in rpoA or rpoC genes. This study aims to identify mutations in rpoB, rpoA, and rpoC genes of Mycobacterium tuberculosis isolates and clarify their contribution to rifampicin resistance. Seventy isolates were identified by acid-fast bacilli smear, Genexpert assay, and growth on Lowenstein Jensen medium. Drug susceptibility, testing was performed by the proportional method. DNA extraction, PCR, and sequencing were accomplished for the entire rpoA, rpoB, and
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Gestational Diabetes Mellitus (GDM) is the most common metabolic disorder that found during gestation and is define as hyperglycemia of variable severity with onset or first recognition during gestation that does not clearly characterize any form of the preexisting diabetes (American Diabetes Association [1]). It affects approximately 16.5% of pregnancies worldwide (Plows, et al.[2]). The placenta is an organ that connects the mother and her fetus during pregnancy (Gul, et al.[3]). In the placenta, glucose can be transformed into glycogen for storage by either glycogen synthase or using glycogenin as a prime. However, the function of glycogen deposition stays a matter of debate, it may be the source of fuel for placenta itself or the storag
... Show MoreThe research presented the tagged (aesthetic and expressive characteristics in the works of Jean Dubuffet), so the research objective was: to know the aesthetic and expressive characteristics in the works of (Jean Dubuffet), and the research included four chapters. The aim of the research, the limits of the research, and the definition of terms. The second chapter included four topics. The first topic presented the aesthetic essence and style, while the second topic dealt with expressionism: approaches in concept and meaning.
While the third topic was preoccupied with presenting the aesthetic and expressiveness in the drawings of modernity and beyond, while the fourth topic dealt with: Jean Dubuffet and the experience of raw art. Th
This research aims to clarify the principles governing the exploration and utilization of outer space, emphasizing the role of international law, particularly international criminal law, in addressing crimes committed beyond Earth whether aboard spacecraft, the International Space Station, or in outer space generally. It examines relevant international treaties governing outer space activities, evaluates their strengths and ambiguities, and highlights deficiencies in their provisions. Furthermore, the study analyzes traditional principles of state criminal jurisdiction territoriality, nationality, universality, and protection and assesses their applicability to offenses committed in outer space.
Rapid development has achieved in treating tumor to stop malignant cell growth and metastasis in the past decade. Numerous researches have emerged to increase potency and efficacy with novel methods for drug delivery. The main objective of this literature review was to illustrate the impact of current new targeting methods to other previous delivering systems to select the most appropriate method in cancer therapy. This review first gave a brief summary of cancer structure and highlighted the main roles of targeting systems. Different types of delivering systems have been addressed in this literature review with focusing on the latest carrier derived from malarial protein. The remarkable advantages and main limitations of the later
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Shifting Sand of English in Iraq language Policy and Planning
Ovarian cancer has a high mortality and delayed diagnosis. Several immunological alterations take place during ovarian carcinogenesis, and can be of value in the surveillance of the diseases. This research was conducted to evaluate serum immunoglobulin levels in women with ovarian cancer and to assess their role in disease process. The present study is composed of 85 women (mean age = 62.03±12.4 yrs) with clinically and pathologically confirmed ovarian cancer and 65 healthy females as a control group (mean age = 61±12.1 yrs). ELISA test was achieved for the determination of serum [IgG, IgA, IgM]. The findings of current study illustrated significant (P=0.001) increase in serum IgG, IgA, and IgM levels as compared to co
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The employment of cognitive radio (CR) is critical to the successful development of wireless communications. In this field, especially when using the multiple input multiple output (MIMO) antenna technology, energy consumption is critical. If the principal user (PU) is present, developers can utilize the energy detecting approach to tell. The researchers employed two distinct phases to conduct their research: the intense and accurate sensing stages. After the furious sensing step was completed, the PU user was identified as having a maximum or minimal energy channel. There are two situations in which the proposed algorithm's performance is tested: channels for fading AWGN and Rayleigh. When the proposed methods' simulation results a
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