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.
Because of the fierce competition between service organizations on the one hand and the increasing demands of customers on the other. Therefore, these organizations sought to distinguish their service by taking care of all aspects. One of these important aspects is the service encounter environment and its reflection on customer emotions, so we choose the current research to clarify the importance and impact on customer satisfaction, the problem of research is how the interest of Iraqi restaurants in the service encounter environment and how to care about its elements and whether this interest is sufficient to reflect the satisfaction of the customer. the goal of the current research was to clarify how much the application of the
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This study examines emotional blackmail from a discursive pragmatic standpoint to gain insights into how this psychologically manipulative phenomenon is revealed in the discourse of some American movies. Five extracts from five American movies are purposely selected and analyzed using an eclectic model based on a discursive pragmatic approach to navigate this unexplored study area. The model incorporates Halliday’s (2014) transitivity system, Martin and White’s (2005) attitude system, Forward and Frazier’s (1997) types and tools of emotional blackmail, and Mayfield’s (2010) informal fallacies. The present study is guided by four research questions that identify the types and tools of emotional blackmail employed in the selec
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Hydrocarbon displacement at the pore scale is mainly controlled by the wetness properties of the porous media. Consequently, several techniques including nanofluid flooding were implemented to manipulate the wetting behavior of the pore space in oil reservoirs. This study thus focuses on monitoring the displacement of oil from artificial glass porous media, as a representative for sandstone reservoirs, before and after nanofluid flooding. Experiments were conducted at various temperatures (25 – 50° C), nanoparticles concentrations (0.001 – 0.05 wt% SiO2 NPs), salinity (0.1 – 2 wt% NaCl), and flooding time. Images were taken via a high-resolution microscopic camera and analyzed to investigate the displacement of the oil
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This essay aims to highlight the most important issues and difficulties facing implementing large projects that follow the turn-key method, considered one of the types of contractual methods in Iraq, especially for large and complex projects requiring speedy completion. The projects implemented in this way face delays and delays in completion, which led to the lack of benefit from the projects for which they were implemented, especially those affecting the lives of citizens within the health sector. The case study dealt with the construction of hospitals with multi-bed capacities within multiple governorates in Iraq, With large financial allocations within the federal budget of the Government of Iraq over several years.
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The present study aims at answering the following questions:.
1-Which is more effective in enriching students. Vocabulary ,the use of short stories or the traditional way?
2-What extent has the use of short stories an effect upon the students. achievement in vocabulary test?
3- Is there any significant difference between the male and female student of the experimental group in vocabulary achievement test?
 
... Show MoreDestiny functional theory (DFT) calculations are undertaken in order to scrutinize the electrochemical and calcium (Ca) storage characteristics of a graphyne-like aluminum nitride monolayer (G-AlNyen) as an electrode material for Ca-ion batteries (CIBs). The results show that the change in internal energy as well as the cell voltage values for the CIB with the G-AlNyen anode are comparable to others with two-dimensional 2D nano-materials. It is shown that Ca is adsorbed primarily onto the center of a hexagonal and triangular ring of G-AlNyen with absorption energies of −2.06 and −0.42 eV. After increasing the concentration of Ca atoms on G-AlNyen, the adsorption energy as well as the cell voltage decreases. Lower values of 0.15–0.32 e
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CIGS nanoink has synthesized from molecular precursors of CuCl, InCl3, GaCl3 and Se metal heat up 240 °C for a half hour in N2-atmosphere to form CIGS nanoink, and then deposited onto substrates of soda-lime glass (SLG). This work focused on CIGS nanocrystals, indicates their synthesis and applications in photovoltaic devices (PVs) as an active light absorber layers. in this work, using spin-coating to deposit CIGS layers (75 mg/ml and 500 nm thickness), without selenization at high temperatures, were obtained up to 1.398 % power conversion efficiency (PCE) at AM 1.5 solar illumination. Structural formations of CIGS chalcopyrite structure were studied by using x ray diffraction XRD. The morphology and composition of CIGS were studied using
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In this study, industrial fiber and polymer mixtures were used for high-speed impact (ballistic) applications where the effects of polymer (epoxy), polymeric
mixture (epoxy + unsaturated polyester), synthetic rubber (polyurethane), Kevlar fiber, polyethylene fiber (ultra High molecular weight) and carbon fiber.
Four successive systems of samples were prepared. the first system component made of (epoxy and 2% graphene and 20 layer of fiber), then ballistic test was
applied, the sample was successful in the test from a distance of 7 m. or more than, by using a pistol personally Glock, Caliber of 9 * 19 mm. The second
system was consisting of (epoxy, 2% graphene, 36 layers of fiber and one layer of hard rubber), it was succeeded
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