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 accession of countries to the World Trade Agreement and the openness of markets to each other without restrictions led to the emergence of the philosophy of "a world without borders and business units without countries", which required adapting the modern business environment to that philosophy, which is considered as objectives for the activities of the units that must be implemented in order to achieve competition. The objective of the units has changed from making profit to meeting the desires of customers, which is what imposed a new role for management accounting as a field of knowledge renewed in it visions of competitiveness between units. Because of the increasing needs for information in light of environmental change
... Show MoreAs cities across the world grow and the mobility of populations increases, there has also been a corresponding increase in the number of vehicles on roads. The result of this has been a proliferation of challenges for authorities with regard to road traffic management. A consequence of this has been congestion of traffic, more accidents, and pollution. Accidents are a still major cause of death, despite the development of sophisticated systems for traffic management and other technologies linked with vehicles. Hence, it is necessary that a common system for accident management is developed. For instance, traffic congestion in most urban areas can be alleviated by the real-time planning of routes. However, the designing of an efficie
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Purpose: The purpose of the study is to compare and evaluate Earnings Management in Tunisia and Iraq. Theoretical framework: Earnings Management is an important topic that has been studied by a significant number of researchers, as well as those who are interested in the accounting profession. Earnings Management has gotten a lot of attention from academics, professionals, and other interested parties in recent years (e.g. Kliestik et al., 2020; Rahman et al., 2021; Gamra &Ellouze, 2021) Design/methodology/approach: The sample includes ten banks listed on the Bourse of Tunisia and Iraq Stock Exchanges for the year 2017. We have used a model of Kothari et al., (2005) as a tool to measure Earnings Management in both mark
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The purpose of this research is defining the main factors influencing on decision of management system on sensitive data in cloud. The framework is proposed to enhance management information systems decision on sensitive information in cloud environment. The structured interview with several security experts working on cloud computing security to investigate the main objective of framework and suitability of instrument, a pilot study conducts to test the instrument. The validity and reliability test results expose that study can be expanded and lead to final framework validation. This framework using multilevel related to Authorization, Authentication, Classification and identity anonymity, and save and verify, to enhance management
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Purpose – measure the relationship between operation management strategies as an independent variable on the customer's delight as an approved variable.
Design/methodology/approach – The research sample vocabulary included sales representatives and customers of the researched markets at a rate of (100%). The recovery rate is (95) Customers and (95) delegates for the products for the factory in neighbourhood (Banooks and Karrada ) regions were randomly chosen from an open community in these two residential areas. Statistical methods were used (arithmetic media, standard deviations, t-test, correlation coefficient (Horst), simple regression analysis).
Findings – The people in charge of the factory management nee
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objective the research to diagnosis and interpretation of the nature of the correlation between the basic elements of knowledge management (tecgnology , structure , culture , process , human resource ) and the strategic performance of the Iraqi private banks, the research community and the level dimensions, and tested this research in the private banking sector represented by (7), especially in Baghdad city, Iraqi banks, and applied on sample consisting of 100 distributors in several administrative levels Director (Director, Director of the department, branch manager), and use questionnaire Head to collect data and information tool, and some private banks annual reports, has sought research to test a number of h
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Background: Periodontal pathogens can induce free radicals over-formation and thus may cause collagen and periodontal destruction. Anti-oxidants are used as supplements to counteract the over production of free radicals in periodontal disease, that can reduce of collagen destruction. Coenzyme Q10 serves as an endogenous antioxidant, regenerates other antioxidants, stimulates cell growth, and inhibits cell death. Because it is an antioxidant, coenzyme Q10 has received much research attention associated with periodontal diseases. Perio Q gel may possibly be effective as a topical agent and as an adjunct to scaling& root planing in treatment of gingivitis and chronic periodontitis. Aim of study:Determine the periodontal health status in a foll
... Show MoreImpairment of financial assets defined according to IFRS 9 as the difference between all contractual cash flows that are due to an entity in accordance with the contract and all the cash flows that the entity expects to receive, the entity should estimates all the cash flows through looking to the contract terms during the life time period of the assets or for shorter period if possible, the cash flow should include the amounts of selling any collateral taken or any other enhancement. On the other hand, the Central bank of Iraq guidelines regards impairment differ from the IFRS 9 that’s does not consider the collateral value on calculating the impairment that’s effects on the net profit through recognizing exaggerated loss an
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knowledge management and managers have a primary school principals from the standpoint of their assistants M . Dr. Suad Vegetables Abbas Research problem: The administration school require a leader administratively The efficiency and skills of management and knowledge to make it effective in the administration follows the scientific method and knowledge of those who through administrative methods emanating from the trends of modern management in the management of educational , as well as the presence of the leaders of effective management has the knowledge and know-how administrative work and how to deal with others and investment optimized for all of the resources available through the future capable of Orientalism to the extent that ou
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