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.
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The paper deals with claims in construction projects in Iraq and studies their types, causes, impacts, resolution methods and then proposes a management system to control the impacts of claims. Two parts have been done to achieve the research objective (theoretical part and practical part). The findings showed that the main types of the claims are extra work claims, different site condition claims, delay claims and the main causes of the claims are variation of the orders, design errors and omission, delay in payments by owner, variation in quantities and scheduling errors. The claims have bad impacts on the cost by increasing (10% to 25%) and also on the duration of the project by increasing from (25% to 50%).The negotiation is the main
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تتحقق اهداف الدول عبر توظيف امكانياتها ومواردها ، وهذا التوظيف يقترن بوسائل مختلفة باختلاف الامكانيات المتاحة. وتتفاوت هذه الوسائل ما بين الاكراه والترغيب ، واحياناً من الممكن استخدام كلا الوسيلتين ، وتندرج هذه الوسائل من حيث تصنيفها ضمن نوعين رئيسين هما: القوة الصلبة ]القوة العسكرية والاقتصادية[ والقوة الناعمة ]استخدام جميع ادوات الترغيب وتسخيرها من اجل ان تُعجب بها الدول الاخرى وتنصاع
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AIM: To evaluate the short-term effectiveness of Gamma knife radiosurgery as a modality of treatment of brain arteriovenous malformation. METHODS: Sixty-three patients with arteriovenous brain malformations underwent Gamma knife radiosurgery included in this prospective study between April 2017 and September 2018 with clinical and radiological with MRI follow up was done at three months and six months post-Gamma knife radiosurgery. By the end of the 12th-month post-Gamma knife radiosurgery, the patients were re-evaluated using digital subtraction angiography co-registered with M.R.I. During the 12 months follow up, CT scan or MRI was done at any time if any one of the patients᾽ condition deteriorated or developed signs and s
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Objective: To assess prospectively functional outcome of interlocked intramedullary nailing fixation in management of closed tibia shaft fractures. Methodology: This prospective study included 134 patients with closed shaft tibia fractures with age 18-60 years and isolated closed fracture of shaft of tibia. The fractures were fixed by interlocking intramedullary nail. At follow-up after 12 months postoperatively, the functional outcome was assessed radiographically for the sign of union and clinically according to Klemm-Borner criteria. Results: The mean age was 38.55 years. Out of 134 patients, 55.2% were male. The cause was road traffic accident in 44.8%, majority of the fracture occur in the mid-shaft (41.8%), and oblique fracture was th
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Abstract:
The aim of the research is to highlight the role of electronic human resources management practices in the sustainability of knowledge capital as one of its success factors, as well as the diagnosis and interpretation of the relationship between research variables and their dimensions. The research problem is that the University of Babil implements some electronic human resources management practices not in a complete way, The level of its application and the problems it faces, as well as the extent to which these practices reflect the knowledge capital and sustainability in the university, and highlights the importance of research as it is concerned with the electronic aspects and achieve the competitive advant
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Background: Penetrating neck injuries are common problem in our country due to increasing violence, terrorist bombing and military operations.
These injuries are potentially life threating and need great attention and proper management.
Objective: The aim of this study is to focus on the importance of anatomical zonal classification of the neck in the management of penetrating injuries of the visceral compartment of the Neck.
Methods :70 patients with various injuries who were managed at causality unit and Otolaryngology department in Al-Kindy Teaching Hospital during aperiod from January 1st 2015 to October 31st 2015.
The study carried on those patient depending on proper clinical examination and their urgent management.
Background: urethrocutaneous fistula after hypospadias surgery repair is the most common complication and remains a frustrating problem for surgeon and the patient. The problem is exacerbated because the urethrocutaneous fistula may recur which adds more demands surgery. Objectives: The purpose of this study is to evaluate of the use of oral mucosal graft for management of recurrent urethrocutaneous fistula after hypospadias repair. Patients and Methods: twelfth patients with age ranging from 4 year to 15 years were presented with history of recurrent fistula. Most of fistula were located in proximal penile and penoscrotal region (58.3%) . those patients were repaired by using oral mucosal graft with mean postoperative follow up period up t
... Show MoreThis paper aims to review the intellectual to the most important thought leaders administrative and strategic They both (Henry Fayol and Michelle Porter), who forward a lot of ideas that have helped countries in the advancement and progress their economies , has been drawing literature theoretical common border in Contributions ( Fayol ) philosophical and between applications ( Porter ), which reversed strategies of the three ( the leadership of the cost, differentiation, and focus ), so browse search how to apply and use the principles of Fayol in the implementation of strategies competitiveness of Porter, and stems from a problem ( ( to what extent a reflection of the principles ( Fayol) fourteen strategies (Porter ) competitiv
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That analytical procedures are of analytical tools important because it gives assurance to the auditor-free financial statements of the economic units replace the audit of cases offraud and errors and distortions, and thereby to increase the effectiveness of the audit process and confirm the possibility oftrust and reliance on the financial statements that Adfgaha auditor.
Inspite of identify evidence of proof necessary to enhance the auditor's opinion the results reached in the audit p