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.
Competitive advantage is a substantial strategic objective for organizations. It requires high levels in the quality of products and services provided to customers, continuous improvement of costing , care for creativity and innovative employees, and speed unique to the marketing and financial engineering, and business re-engineering processes. The situation in this area, requires actors to attract and develop human resources, including help in proper implementation of the strategic tasks that targeted by those institutions. According to the opinions and viewpoints of management scholars, the competitive advantage resource is the most important issue for organizations in the third millennium, which can be a
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Concentrated research topic in the study of key variables in the work of the inspectors general offices , which are in the application of quality management standards audit work and reduce the incidence of corruption. It highlights the importance of current research in being a serious attempt aimed at highlighting the role of the importance of standards of quality management audit work , because they represent a router and leader of the accountant or ( Sergeant ) in the performance of his work and the extent of compliance with these standards , as well as highlight the role of quality audit in reducing the incidence of corruption , of during the professional performance of Higher auditors and determine the responsibilities entrus
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The objective of the research is to evaluate the risk management practices of the variables (risk management structure, risk management methods, key components of risk management) and their relation to the principled behavior of managers behavior(innovation, proactive, risk acceptance) By adopting the questionnaire as a main tool in collecting data from managers in the National and raq insurance companies of (50) officials Department manager, department administrator, unit administrator, and analyzed their answers using the SPSS In calculating arithmetic mean, standard deviation, percentage weight and simple correlation coefficient. The most prominent conclusions were:1.There is a positive trend in the sample in both companies and a high
... Show MoreObjectives: To assess nurses-midwives' knowledge about pain management during labor before and after implementation of educational program and to determine the effectiveness of educational program on nurses-midwives' knowledge about pain management during labor in Baghdad Maternity Hospitals.
Methodology: A quasi-experimental design has been conducted during the period of (February 27th 2019 through 2nd June 2019) on non-probability sample (purposive) consists of (44 Nurses/midwives') who are work in delivery room, the sample was exposed to pretest, educational program, posttest. The study was conducted in three Directories, (Baghdad Teaching Hospital) at medical city health
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Nowadays, the world adopts a philosophy that relates to environmental conservation. This philosophy can be achieved through providing environmentally friendly products while satisfying customers' needs as well. To attain that, a new systems and programs need to be applied in a scientific manner, and total quality environmental management (TQEM) is among these concepts. The research aimed to analyze the Relationship between (TQEM) Practices and its effect on Flexible Manufacturing in Badush factory. The research sample includes managers and head of divisions at top, middle and front line management levels which were (27) working in Badush factory. To achieve the objectives of the study, the descriptive anal
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The research aims to measure the relationship and impact of the operations of the knowledge of management of the six dimensions (diagnosis knowledge, define knowledge objectives, knowledge generation, knowledge storage, distribution of knowledge, application of knowledge) in the fiscal performance of the General Authority for taxes of the four dimensions (financial, customers (taxpayers), Operations Interior, learn and grow), the research aims also to the use of computerized programs for training and career development of the Authority that helps to add knowledge workers in the Authority, and to reach an appropriate arrangement for knowledge management processes in the Authority, as well as analysis of the reality of the Authority to get
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Heavy metals contamination in aquatic ecosystems is considered one of the most important threats of aquatic life. Submerge aquatic plants Ceratophyllum demersum in its non living form used for the removal of trace elements. This article studied the ability of the fine powder of C.demersum for the removal of some heavy metals (HM) like copper, cadmium, lead and chrome from aqueous solution with in variable experimental factors. The study occupy two treatments the first included different hydrogen ions pH within a range of 4, 5,6and 8 with a constant HM concentration (1000 ppm).While the second treatment represented by using variable HM concentrations within a range of (250,500,750and 1000 ppm) with a constant pH=7.In both treatments the a
... Show MoreInterface evaluation has been the subject of extensive study and research in human-computer interaction (HCI). It is a crucial tool for promoting the idea that user engagement with computers should resemble casual conversations and interactions between individuals, according to specialists in the field. Researchers in the HCI field initially focused on making various computer interfaces more usable, thus improving the user experience. This study's objectives were to evaluate and enhance the user interface of the University of Baghdad's implementation of an online academic management system using the effectiveness, time-based efficiency, and satisfaction rates that comply with the task questionnaire process. We made a variety of interfaces f
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The purpose of this study is aimed to lay down an arranged platform suited to Iraqi constructional associations which in charge to carry out multi constructional projects, as it fulfilled management requirements and supervising, so that low - cost projects will be controlled in due term and quality. Based on primary info and observed data collected, the study thesis has been formulated in this way: Iraqi constructional sector bodies which are in charge to implement simultaneously multi constructional projects in need to reformulate its organized structure so that it will be more fitted to management and control of these projects. This thesis includes a
theoretical part contained presenting the most important resources locally and int