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.
This study evaluated the extent to which obturation materials bypass fractured endodontic instruments positioned in the middle and apical thirds of severely curved simulated root canals using different obturation techniques. Sixty resin blocks with simulated root canals were used, each with a 50° curvature, a 6.5 mm radius of curvature, and a length of 16.5 mm, prepared to an ISO #15 diameter and taper. Canals were shaped using ProTaper Universal files (Dentsply Maillefer) attached to an X-smart Plus endo motor (Dentsply), set at 3.5 Ncm torque and 250 rpm, up to size S2 at working length. To simulate fractures, F2 and F3 files were weakened 3 mm from the tip, then twisted to break in the apical and middle sections of the canal, re
... Show MoreAccurate description of thermodynamic, structural, and electronic properties for bulk and surfaces of ceria (CeO2) necessitates the inclusion of the Hubbard parameter (U) in the density functional theory (DFT) calculations to precisely account for the strongly correlated 4f electrons. Such treatment is a daunting task when attempting to draw a potential energy surface for CeO2-catalyzed reaction. This is due to the inconsistent change in thermo-kinetics parameters of the reaction in reference to the variation in the U values. As an illustrative example, we investigate herein the discrepancy in activation and reaction energies for steps underlying the partial and full hydrogenation of acetyl
... Show MoreMost researchers concentrate their studies on the design, stress and pressure distributions of the prosthetic socket. A little attention is considered for the stiffness of the various materials of the prosthetic sockets. Prosthetic laminated sockets in Iraq are costly to be manufactured while polypropylene socket is relatively cheap in comparing with the laminates.
Experimental study is conducted to compare the stiffness of five prosthetic sockets made of different materials. Compression, three point flexural and tensile tests are implemented by the Testometric machine. The laminate sockets give better results in compression than polypropylene. Polypropylene gives good results in bending compared with the laminate sockets. When t
... Show MoreProsthetic hands are compensatory devices for the hand amputees as a result of injury, various accidents or birth deformities, types of prosthetic hand vary depending on the mechanism they operate and how they perform. There are common types in use that are characterized by their complex mechanisms, which are difficult for the amputee to use or exclude use because of their high cost, therefore the aim of this research is to design an artificial hand that is suitable in terms of simplicity of use and low cost and similar to a natural hand with regard to dimensions and shape that operated in the mechanism of links. This research involves Stress and strain analysis of the prosthetic hand and its fingers that modelled from (Petg CR)
... Show MoreThis contribution reports a comprehensive investigation into the structural, electronic and thermal properties of bulk and surface terbium dioxide (TbO2); a material that enjoys wide spectra of catalytic and optical applications. Our calculated lattice dimension of 5.36 Å agrees well with the corresponding experimental value at 5.22 Å. Density of states configuration of the bulk structure exhibits a semiconducting nature. Thermo-mechanical properties of bulk TbO2 were obtained based on the quasi-harmonic approximation formalism. Heat capacities, thermal expansions and bulk modulus of the bulk TbO2 were obtained under a wide range of temperatures and pressures. The dependency of these properties on operational pressure is very evident. Cle
... Show MoreWe describe the synthesis and characterization of a novel 2D-MnOx material using a combination of HR-TEM, XAS, XRD, and reactivity measurements. The ease with which the 2D material can be made and the conditions under which it can be made implies that water oxidation catalysts previously described as “birnessite-like” (3D) may be better thought of as 2D materials with very limited layer stacking. The distinction between the materials as being “birnessite-like” and “2D” is important because it impacts on our understanding of the function of these materials in the environment and as catalysts. The 2D-MnOx material is noted to be a substantially stronger chemical oxidant than previously noted for other birnessite-like manganese oxi
... Show MoreObjectives: The study aims: (1) To determine effectiveness of instructional health education vascular access on hemodialysis patients' knowledge, (2) To find out the association between effects of instructional health education vascular access and demographic characteristics of (age, gender and educational level). Methodology: A quasi experimental study –control study design is carried out at AL-Hussein Teaching Hospital in AL-Nasiriyah City, from 3November,2015 to 2 June, 2016. A non-probability (Purposive sample) of (80) patients with vascular access devices on maintenance hemodialysis patients divided int
Background:The document on hypertension in the elderly promoted by the American college of cardiology and the American heart association (ACCF/AHA) was written with the intent to be a complete reference at the time of publication on the topic of managing hypertension in the elderly. More recently, the European society of hypertension (ESH) and the European society of cardiology (ESC) issued the 2013 ESH/ESC Guidelines for the management of arterial hypertension, followed by The 2014 Canadian Hypertension Education Program (CHPE), and the Eighth Report of the Joint National Committee (JNC8), all of which has endorsed specific recommendations for the management of elderly hypertensive patients.
Total quality management considers one of the modern scientific entrances which practiced by productivity service organizations alike to provide appropriate quality required outputs according to the needs and desires of customers manage , enable the organization seeking to continue and grow in light of the increasing competition from the satisfy and provide the appropriate total quality management requirements whenever led to face risks that they may have in a manner in which they can be addressed and find ways to avoid them in the future when repeated. &n
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