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 researcher aims to Diagnose the reality of research variables, strategic leadership and decision support systems, and their impact on crisis management in the General Company for Steel Industries because of their important role in preventing crises and reducing their occurrence for the research company in particular and other companies in general affiliated with the Ministry of Industry and Minerals, as well as clarifying theoretical concepts of research variables As it included the answer to questions related to the research problem, including (Is there an impact of the strategic leadership in managing crises if decision support systems are used), and the researcher adopted the descriptive and analytical approach in its comp
... Show More
(1)
Abstract
The research aims to diagnose the reality of applying the eighth requirement (operation) of the business continuity management system according to the international standard (ISO 22301: 2019), in the General Tax Authority, which is related to planning, implementing and controlling specific processes and procedures to address risks and opportunities, and the research adopted the checklist of the standard ( ISO 22301: 2019), in obtaining information, to measure the extent of application and documentation, the percentages and the weighted arithmetic mean were relied upon, and the research reached a set of result
... Show MoreThe aim of the research is to determine the impact of profit management practices on the quality of profits through the use of flexibility in determining accounting methods and practices profit information is one of the most important information that concerns current users in general and observing users in particular. Some corporations managements manipulate the results of the company's profit or loss (income statement) and financial position statement with multiple reasons, including capital market motivations to raise their share prices in the stock market and attract investors, and on the other hand the motives of funding and borrowing loans, and the use of the flexibility in accounting policies and estimates to change the in
... Show More
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
... Show More
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.
(3)
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)
... Show More
(1)
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 MoreThis 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
... Show More
The 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
... Show More