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.
This study uses the performance of the discretionary estimation models by using a sample of listed companies in the Netherlands and Germany. The actual accounting framework provides a wide opportunity for managers to influence data in financial reporting. The corporate reporting strategy, the way managers use their discretionary accounting, has a significant effect on the company's financial reporting. The authors contribute to the literature through enhancement to these models to accomplish better effects of identifying earnings management as well as to present evidence that is particular to the Dutch and German setting.
For this, we followed the methodology of Dechow, Sloan, and Sweeney (1995) and Chan
... Show MoreThe current research aims to test the impact of the strategy of merger (as an explanatory variable) in human resources management practices (as a response variable), and the importance of the subject being an important topic that mimics the Iraqi environment, where has seen many mergers that have not been addressed by former researchers in the field. In addition, the future prospects carry many mergers, and the problem of research was the lack of understanding among departments in how to manage the integration and deal with it, on the basis of scientific which reflected negatively on the practices of human resources management, and the research was based on two main hypotheses Six sub-hypotheses emerge to explore the correlation
... Show MoreIt is an analytical study carried out at university of Basra using a sample included the dean ,assistants and managers of scientific dept. in the university for about(63)managers .The study aimed at discovering a model of crises management in the university.The researcher adopted the descriptive survey methodology.To achieve the objective of the study ,a questionnaire of (41)statements was developed covering five main variables like ,signal detection, prevention and preparedness, response, recovery and learning .The validity of the questionnaire was done by a group of referees .Its stability was determined by Cronbach,s Alfa .The questionnair,s stability coefficient was(0.
... Show MoreThe growing population and the rising standard of living in cities as well as the increased commercial, industrial and agricultural activities around the world led to
massive production of waste containing different materials and one of them is the municipal solid waste (MSW), so there is a major problem facing the cities around the world about the waste, how to collect, transfer it and how to discard it. Because the accumulation of wastes, whether in the city alleys or in its squares and especially in its residential areas affect the health of their populations besides this situation will be a major indication of the deteriorating quality of life in the city, as hygiene considered a fundamental criterion for the city beauty as well
The impact of management control systems (MCS) on organizations performance empirical research has been the subject of numerous studies during the past decade in developed and emerging economies. In the contemporary competitive, complex and changing global business environment, firms are being challenged to adopt business models that enable them to address the strategic uncertainties and risks they face in their business environments. The main issue of this study is that management accounting researchers argue that one of the ways firms can continually rejuvenate themselves to survive and succeed in these complex and uncertain environments is to understand the role of management control systems in Formulating a b
... Show MoreThe problem for the search to identify the role of loyal workers through (emotional loyalty, moral loyalty, continued loyalty) in enhancing the market share of the corporate center the human resource management strategies, namely (selection, training and development, and performance evaluation, and returns the system) for the parent company of cellular Allotsalat in Baghdad ,, and show the importance of research through the benefit to the company, through the importance of the search results, it draws the attention of decision-makers and those in charge of managing these human resources on the importance of those resources and work to develop them and keep them in order to increase their loyalty towards their organization and the
... Show MoreBackground: Background: Diabetes mellitus is a life-threatening disease. Global prevalence of diabetes mellitus is increasing rapidly providing a worrying indication and major threat to global health unless interventions are created through community awareness and knowledge regarding different aspect of DM.
Aims: To assess the level of awareness regarding diabetes risk factors, prevention and management among community members in Baqubah city and to identify any association between awareness level and some variables.
Methods: Across sectional study was carried out from the 1st of January - 30th of November 2019 in all primary health care centers (six centers) in center of Baqubah city. A convenien
... Show MoreStrategic Cost Management Tools Under Technological Development and Change in Customer Tastes Critical Studies