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.
Quality is the key to success in today's world, which is based mainly on competition in the provision of high quality services through the application of the modern management method which is called total quality management in organizations. This includes describing the provision of health services and satisfaction of patients . .  
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Objective: The aim of the study to evaluate the nursing care management for diabetes mellitus patient
with total hip replacement after fractured hip.
Methodology: A field study carried out on patients with diabetes mellitus and have total hip
replacement after fractured hip in orthopedic ward at the hospital of surgical specialization (malefemale)during
January 2002 to January 2003.Physical and psychological nursing
assessment
immediately after the surgery was done for the both subjects (control and experimental) and then a
scientific management with daily nursing care were provided to the experimental subject with daily
nursing care to the patient condition by using a scientific and practical methods and leave th
Respiratory tract infections in sheep are among the important health problems that affect all sheep ages around the world. Nine bacterial isolates obtained from sheep with respiratory tract infections were selected to be used in the current study. The isolates included 3 Staphylococcus aureus, 4 Klebsiella pneumoniae, and 2 Pseudomonas aeruginosa. Following the primers design by the Primer3Plus software tool and optimization of the conventional polymerase chain reaction (PCR), the primers were validated for their use in the multiplex PCR experiments. The MFEprimer program was used to check the suitability of the primer set combinations for multiplex PCR. The MFEprimer software was successful in designing the multiplex-PCR experiments and de
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Organizations nowadays, whether public or private organizations, productive or service (such as banks), face major challenges as a result of rapid and continuous changes, and in front of these challenges traditional management operations and tools become unable to make the organization able to work, which makes it imperative for these organizations to follow the methods and management practices, including the proposed knowledge risk management and strategic direction so that it can elevate its actions at the level of developments in reality, in the sense that these organizations and in the light of environmental developments to characterize their strategic direction as an intellectual approach characterized by mo
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The current research aims to study the extent to which the Independent High Electoral Commission applies to information security risk management by the international standard (ISO / IEC27005) in terms of policies, administrative and technical procedures, and techniques used in managing information security risks, based on the opinions of experts in the sector who occupy positions (General Manager The directorate, department heads and their agents, project managers, heads of divisions, and those authorized to access systems and software). The importance of the research comes by giving a clear picture of the field of information security risk management in the organization in question because of its significant role in identifying risks and s
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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
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It 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.
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The 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