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.
Tirzepatide is a revolutionary and promising medication with a high impact in the treatment of Obesity and T2DM with their complications. Its efficacy was proven through different trials in achieving favorable weight loss and a significant reduction in glycemic index. It also treated a large diversity of related co-morbidities, including fatty liver, cardiovascular disease, dyslipidemia, and more. Tirzepatide is well tolerated, has a good safety profile, and is highly reliable and suitable for use in a population.
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Witnessing the global arena many changes in the political, economic, social, scientific and technological have left their mark on the world as a whole, these changes require necessarily Advancement of the profession of auditing, and improve their performance, especially after the mixer skepticism the health of approach and the method followed by a check in the major audit firms global view as for the external audit of an active role in providing services to members of the community in various sectors, were to be provide these services to the highest level of quality.To ensure the quality of the audit process to be a proper planning is based on a scientific basis to be the substrate a strong underlying different audit works, and if planni
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Purpose – The main purpose of this research is to highlight the main role of strategic leadership skills for top managements in accessing to effective management in accordance with the (VUCA Prime) methodology in (VUCA) environment as Miniature virtual environment, which refers to (Volatility), (Uncertainty), (Complexity), and (Ambiguity).
methodology – To achieve the research objective, this study selected the quantitative approach in research design, Questionnaire was used as the main instrument for data collection, the sample comprised the opinion poll (106) individual who functions as a head department. (Structural equation modelling by (Smart Pls3)
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This research aims to knowledge of the scope of applying the international specification of which is regarded to occupational health and safety management system (OHSAS 18001) second edition for year 2007 by The AL-Mammon Factory / The General Company For Vegetable Oils Industry in order to diagnosis the gap between specification requirements and reality by using the checklist made based upon the items of the specification, after translating the English copy into Arabic. The results of the research and analysis that occupational health and safety management system in comparison to the specification requirements in all of its main items, which was (%22.26) applied and documented partly, this refer to the existence of great gap (%7
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The last ten years observed a shift enormous scientific in the method and way that it deals professional with the cost accounting and reflected the result those shift enormous scientific of increase the competitive environmental that accompanied the emergence of a modern manufacturing environmental on surface the long roductive life and emergence advanced information technology that give a central focus of his important on client with growing global markets growth on a large scale.
The research aim to define the concept of cost awareness, the concept and methods of strategic cost management and the role of cost awareness for managers of industrial units in strategic of cost managem
... Show MoreThe practice by the administration of human resources on effectiveness of organization crisis as two knowledge fields , it were be until now as center for many studies, but the collect it, study of relation between them ,and The role of practices by the administration of human resources on effectiveness of organization crisis administration were considered a new study and first according to the available and showing studies at this field .
The problem of this research was specified by answer for the question that deal for size of consciousness at the ministry of interior for import of&nbs
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The aim of the research is to know the level of time management application and its impact on the performance of the job, a survey search in the general company for communication and information technology and provide recommendations that help employees to optimize the use of time and improve performance, which is an important element in controlling the various functions of the company. In order to achieve the objectives of the research, the questionnaire was based on two main variables and distributed to a random sample of (44) employees in the company out of (308) employees, thus the proportion of the sample (14%). After collecting the samples from the sample, there are (6) incomplete forms that have been retri
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The aim of the research is to identify both the re-engineering of management processes and the strategic decision-making process in the research community and determine the nature of the correlation between the two variables and know the relationship between them to achieve the research goal. The researcher used a descriptive and analytical method. The research community consists of a group of professors and staff of the College of Education affiliated to the University of Mustansiriya in Baghdad, which their number were (45), the researcher has distributed the forms to all members of the sample, only (3) forms were excluded for invalidity and thus the number of forms approved in the analysis were (42) forms. The rese
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The research aims to determine the strength of the relationship between time management and work pressure and administrative leadership, where he was taken a sample of (47) of the administrative leadership at the Higher Institute of security and administrative development in the Ministry of Interior was used questionnaire as a key tool in collecting data and information and analyzed the answers to the sample surveyed by using Statistical program (spss) in the arithmetic mean of the calculation and test (t) and the correlation coefficient, the research found the most important results: the existence of significant moral positive relationship between both time management and work pressure and administrative leadership, the leadership of th
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