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 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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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
Objective(s): The aim of this study is to determine the effectiveness of education program on Health Care Workers’ practices toward Primary Health Care Centers waste management and to identify the relationship between these practices and the demographic characteristics of the health workers. Methodology: A quasi- experimental design (pre-post tests) has been used in the present study for the period of November 16th 2014 to June 22nd 2015 .The allocated sample in the present study is consisted of (60) health care worker. The sample was randomly divided into two groups of (30) health care workers each. The stu
Asset management involves efficient planning of economic and technical performance characteristics of infrastructure systems. Managing a sewer network requires various types of activities so the network can be able to achieve a certain level of performance. During the lifetime of the network various components will start to deteriorate leading to bad performance and can damage the infrastructure. The main objective of this research is to develop deterioration models to provide an assessment tool for determining the serviceability of the sewer networks in Baghdad city the Zeppelin line was selected as a case study, as well as to give top management authorities the appropriate decision making. Different modeling techniques
... Show MoreThis Paper assesses the knowledge management system (KMS) requirements at Al-Ameed University concerning ISO 30401:2022. Specifically, the research aims to ascertain the degree to which international standards have been complied with and gaps that have been identified. A case study was conducted using field observations, interviews, and checklists to assess the institution's compliance with the KMS framework. The level of implementation and documentation of knowledge management processes was assessed using a seven-point scale. The findings reveal that Al-Ameed University has severe gaps in knowledge creation, sharing, and support for knowledge management in terms of strategic leadership. While certain elements like availability of r
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The reality of the field of construction projects in Iraq refers to needing for the development of performance in order to improve quality and reduce defects and errors and to control the time and cost, so there is needing for the application of effective methods in this area, one of the methods that can be applied in this area is the manner of Six Sigma. This research aims to enhance the performance and quality improvement for the construction projects by improving performance in the work of the implementation of the concrete structure depending on the Six Sigma methodology, and for the purpose of achieving the aim of the research, the researcher firstly depends on the theoretical study that include the concepts of qual
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