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 principal objective of this study is to demonstrate how green quality management and product life cycle costing may help an organization gain a competitive advantage. Green quality management's influence on increasing product quality and meeting environmental criteria, as well as tracking the activities of product life cycle before, during, and after production, is demonstrated. Orienting these activities toward the production of eco-friendly products that fulfill the needs of customers, hence increasing organization's market share. We found from our study that proposed framework can help organizations improve their competitiveness. Green quality management contributes to environmental protection and the provision of high-qualit
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Total quality management is considered a modern management concept that achieved success in all fields of various industrial and service sectors in advanced countries . One of these sectors is insurance. This concept aims at improving and developing the performance of insurance service continually . It is the gate that can enable radical change in the organization culture inside the company to transform it from using the traditional management style into using the modern style which achieves high quality standard of insurance service . As a result many insurance companies headed to applying the principles of total quality management in their companies . This study aims at raising the standard of the performance of the Iraqi Insurance Com
... Show Moreobjective the research to diagnosis and interpretation of the nature of the effect between the basic elements of knowledge management (tecgnology , structure , culture , process , human resource ) and the strategic performance of the Iraqi private banks, the research community and the level dimensions, and I've tested this research in the private banking sector represented by (7), especially in Baghdad, Iraqi banks, and applied research on sample consisting of 100 distributors in several administrative levels Director (Director, Director of the department, branch manager), and use the researcher questionnaire Head to collect data and information tool, and some private banks annual reports, has sought research to test
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For businesses that provide delivery services, the efficiency of the delivery process in terms of punctuality is very important. In addition to increasing customer trust, efficient route management, and selection are required to reduce vehicle fuel costs and expedite delivery. Some small and medium businesses still use conventional methods to manage delivery routes. Decisions to manage delivery schedules and routes do not use any specific methods to expedite the delivery settlement process. This process is inefficient, takes a long time, increases costs and is prone to errors. Therefore, the Dijkstra algorithm has been used to improve the delivery management process. A delivery management system was developed to help managers and drivers
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The research aims to identify the availability of some basic competencies that are required to be available to workers in digital agricultural Extension from the point of view of senior management, middle management, and, employees with Post-graduate education degrees, represented by the following: Transition to digital agricultural Extension for sustainable and smart family farms, benefiting from international expertise and experiences in applying for Digital agricultural Extension, preparing and implementing Extension messages through platforms, factors affecting the effectiveness of digital agricultural Extension and its platforms, following up and evaluating the activities and programs of the digital Extension platform. The research pop
... Show MoreThe research aims to verify the Role of Internal Auditing in Assessing the Risks of Strategic Operations (Acquisition) and then reflect on management decisions. Since all corporations wish to expand, growth and domination of the market may expose them to multiple risks that lead to failure. The research assumes two main hypotheses. First, there is no role for internal audit in evaluating the strategic operations (acquisition). Second, there is no relationship between internal auditing in assessing the risks of strategic operations (Acquisition) and management decisions. The data was collected by using a questionnaire distributed to a group of private bank employees. The statistical analysis regarding research rejected the two hyp
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Background: Several risk managem-ent standards had been developed including the Project Management Institute, the National Institute of Standards and Technology, actuarial societies, and ISO standards.
Objective: The study aimed at evaluating risk management among managers of model and ordinary primary health care centers in Baghdad City and comparing the risk management among these centers.
Methods: A descriptive comparative des
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