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.
A new simultaneous spectrophotometric-kinetic method was developed to determine phenylephrine (PHEN) and tetracycline (TETR) via H-point standard addition method (HPSAM). The proposed procedures rely on the measurements of the difference in the rate of charge-transfer (CT) reaction between each of PHEN and TETR as electron donors with p-Bromanil (p-Br) as an electron acceptor. Different experimental factors which affect the extent of the complex formation were investigated by monitoring the value of absorbance at 446 nm. Time pair of 50 -100 sec was selected and employed, among different examined pairs since it results in the highest accuracy for HPSAM-plot. Linear calibration graphs in the concentration ranges of 10.0-40.0 and 10.0–50.0
... Show MoreThe aim of the research is to reveal the reality of teacher performance evaluation in the Sultanate of Oman in light of some global models. The study followed a qualitative descriptive research design. Seven forms of teacher formative and summative assessments were analyzed. Besides, an analytical template was developed, consisting of six areas related to the teaching performance of teachers. These included: lesson planning and preparation, learning environment, education, professional development, student academic, and community and parental partnership. The study reached a number of results; the most notable is the lack of change of forms for more than a decade despite the rapid development of the educational system in the sultanate in
... Show MoreThe search aims to find out the most important requirements for the success of marshes investment and maximize the expected returns of investment was marked by a problem find aquestion for availability requirements necessary for the success of marshes investment has a research community owners decision in the province Maysan the most important conclusions to the search is that the investment great importance in support of the economy and raising the cultural and social level, there is no investment successful but only with configure the investment environment appropriate economic, social, cultural, political, and security ways. the most important recommendations are working on the provision of the investment environment appropria
... Show MoreTo investigate the research objectives, the researchers put the following hypothesis:
There was no statistically significant difference at the level of (0.05) between the average score of the students of the experimental group who studied the language of rhetoric according to model of learning method, and the average score of the students of the control group who studied the same article in the traditional way acquiring rhetorical concept. The researchers relied on the experimental design with the partial setting of the post-test, which depends on the experimental group that is taught using the model of the learning method, and the control group taught using the traditional method.
... Show MoreThe economical units in the world face great and rapid challenges in all aspects, a matter that requires facing these challenges throughout continuous improving and developing in their performance to keep their competitive position "place".
The Benchmarking Technique is one of the modern managerial tools that are proved to be successful in application throughout making continuous comparisons between products or services and the best – performance levels the compete with it . This is achieved to develop its performance and give it the competitive criterion with which it faces its competitors.
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In this paper will be applied to a probability model of inventories periods of multiple stores of raw materials used in the cement industry, cement factory in Samawah and basic materials are limestone, soil normal, iron soil, fuel oil and gypsum. It was built of this model after the test and determine the distribution of demand during the supply period (waiting period) for each subject and independently of the rest of the material as it is not affected by any of the materials above interrelated in the process of supply, this test has been using the Statistical Package of (SPSS) and then was determining the amount of request optimum seeking in each batch and each substance known volume of economic optimization of
... Show MoreSystemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by the production of autoantibodies against nuclear antigens and a systemic inflammation that can damage a broad spectrum of organs. SLE patients suffer from a wide variety of symptoms, which can affect virtually almost any tissue. As lupus is difficult to diagnose, the worldwide prevalence of SLE can only be roughly estimated to range from 10 and 200 cases per 100,000 individuals with dramatic differences depending on gender, ethnicity, and location. Although the treatment of this disease has been significantly ameliorated by new therapies, improved conventional drug therapy options, and a trained expert eye, the underlying pathogenesis of lupus still
... Show MoreThe Urban Residential has developed and changed in different periods of time with successive and gradual shifts, as it cast a shadow over the characterization of modern urbanism in Iraq. The semi-total absence of the governing legislation of urbanization as well as the weakness of the State's role of supervisory in addition to neglecting urban heritage contributed in offering a strange environment in relation to its traditional identity. That was increased by the pressure of the using urban environment as a result of the increasing of population as well as the growth of people’s needs. The research aims to provide an objective view for a mechanism of the application of urban legislation to monitor the implementation o
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