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.
Management Representations Letter plays a significant role as an evidence to get conclusions the Auditor is looking for. These conclusions could show the professional opinion of auditor over the fairness and integrity of financial statements for many issues and numbers that management claims, Hereby, the research aims at highlighting the importance of Management Representations Letter and the way of using as an evidence with expressing its meaning and means of application in addition to identify the Responsibility of Auditor on that Letter, This research discusses also the effect of Management Representations Letter on the credibility of financial statement and enhancing the credibility of the submitted reports, From other side, in the t
... Show MoreTo investigate the antiplaque and antigingivitis efficacy in addition to evaluating side effects and subjects’ perceptions of three commercially available mouthwashes.
This study was a double‐blind, parallel, and short‐term trial. A total of 75 dental students with biofilm‐induced gingivitis were included in the final analysis of the current study. Clinical parameters (plaque index and bleeding on probing) and the staining effect were measured at baseline and after 7 days. In addition, a VAS‐based assessment questionnaire was completed by the participants.
The goal of this research to identify a set of criteria that can be measured on the basis of which the effectiveness of the application of the Balanced Scorecard in the Jordanian Public Institutions in order to identify the basic requirements to ensure the application of balanced performance measures. The study population consisted of the staff of the Public Institution for Social Security - Irbid of directors of departments and heads of departments and administrative staff, was the use of a random sample of (50) an employee and the employee. The questionnaire was used as a tool to collect data, and as a result of subjecting these standards for the field test and the use of statistical analysis tools to the results of the study c
... Show MoreThe issue of intellectual capital is a critical issue in the success and excellence of organizations, especially if it is linked to the management of customer experience, and because of the characteristic of the Iraqi environment, which affected all sectors, including the banking sector, it was important to discuss the types of intellectual capital and its relationship to the management of customer experience, especially when managers private banks, the importance of research lies in the linking of its variables to build the strategic capabilities of banks to achieve excellence and sustainability, it aims to diagnose the extent of interest in the types of intellectual capital and management of customer experience in the Iraqi ban
... Show MoreDatabase is characterized as an arrangement of data that is sorted out and disseminated in a way that allows the client to get to the data being put away in a simple and more helpful way. However, in the era of big-data the traditional methods of data analytics may not be able to manage and process the large amount of data. In order to develop an efficient way of handling big-data, this work studies the use of Map-Reduce technique to handle big-data distributed on the cloud. This approach was evaluated using Hadoop server and applied on EEG Big-data as a case study. The proposed approach showed clear enhancement for managing and processing the EEG Big-data with average of 50% reduction on response time. The obtained results provide EEG r
... Show MoreEvery so often, a confluence of novel technologies emerges that radically transforms every aspect of the industry, the global economy, and finally, the way we live. These sharp leaps of human ingenuity are known as industrial revolutions, and we are currently in the midst of the fourth such revolution, coined Industry 4.0 by the World Economic Forum. Building on their guideline set of technologies that encompass Industry 4.0, we present a full set of pillar technologies on which Industry 4.0 project portfolio management rests as well as the foundation technologies that support these pillars. A complete model of an Industry 4.0 factory which relies on these pillar technologies is presented. The full set of pillars encompasses cyberph
... Show MoreThe present study addressed "Performance Appraisal of Human Resource Management and Its Effect on Achieving the Organizational Success", for the topics of performance appraisal of human resource management and the organizational success gained an increasing interest being relatively important and modern topics which had a great effect on the future of organizations.
The study aimed at revealing the pattern of appraising the performance of human resource management for the study sample, and whether it was qualified to lead the ministry towards the organizational success, for this purpose two main hypotheses were formulated: 1) there is a positive significant correlation between both variables: performanc
... Show MoreThe current study is based on previous findings, where corporate governance (CG) significantly increased corporate social responsibility (CSR) to enhance transparency while reducing the tendency of corporate management to engage in earnings management (EM). A sample of 11 Iraqi banks listed on the Iraq Stock Exchange from 2010 to 2020 was selected. The CG was included in the board size and board independence apart from the variables of Chief Executive Officer (CEOs) gender, majority shareholder ownership, foreign ownership, and institutional ownership. The CSR included the wage growth rate, bank contribution growth rate for social security, training programmes, subsidies, environmental protection, and bank compliance with the law. Specifica
... Show MoreThe aim of the present study is to provide the adequate knowledge about the role of time management in facilitate the work requirements for employees of the administrative department at the Ministry of Higher Education and Scientific Research. The research depend on studying four important dimensions which are (time planning, time organization, time direction and time observation). In addition to study other five dimensions which are (new procedures, clear procedures, short procedures, the available information and the simplicity of the methods
used).Questionnaire sheets consist of (38 questions) distributed to (170) employees and (146) sheets only were considered in the study. SPSS program was used
... Show MoreThe primary objective of root canal therapy is adequate biomechanical preparation of root canal system followed by 3D obturation.in clinics we are encountered with several anatomical variations, which we need to manage efficiently. One of the major factors responsible for failure of root canal therapy is missed canals. Recent technological advances have given the clinician opportunity to identify anatomical variations and treat them to satisfaction.