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.
Cardiovascular disease is one of the most common comorbidities associated with enlarged extremities, occurring in 60 % of patients with acromegaly. The aim of this study is to evaluate the relationship of growth hormone and insulin such as growth factor-1 with obesity, dyslipidemia, hyperglycemia, and pro-inflammatory cytokines (IL-2, IL-6, IL-10), as risk factors for cardiovascular disorder in acromegaly patients. Eighty subjects were included and categorized into two groups: 40 acromegaly patients and 40 of the control group. The results indicated weight excess, hyperglycemia, hypertension, lipid disorder, and elevated levels of interleukins (2, 6, and 10). The correlation of both GH and IGF-1 with each of weight, BMI, systolic blood p
... Show MoreThis study delves into the realm of advanced cooling techniques by examining the performance of a two-stage parallel flow indirect evaporative cooling system enhanced with aspen pads in the challenging climate of Baghdad. The objective was to achieve average air dry bulb temperatures (43 oC) below the ambient wet bulb temperatures (24.95 oC) with an average relative humidity of 23%, aiming for unparalleled cooling efficiency. The research experiment was carried out in the urban environment of Baghdad, characterized by high temperature conditions. The investigation focused on the potential of the two-stage parallel flow setup, combined with the cooling capability of aspen pads, to surpass the limitat
... Show MoreIn this study, a genetic algorithm (GA) is used to detect damage in curved beam model, stiffness as well as mass matrices of the curved beam elements is formulated using Hamilton's principle. Each node of the curved beam element possesses seven degrees of freedom including the warping degree of freedom. The curved beam element had been derived based on the Kang and Yoo’s thin-walled curved beam theory. The identification of damage is formulated as an optimization problem, binary and continuous genetic algorithms
(BGA, CGA) are used to detect and locate the damage using two objective functions (change in natural frequencies, Modal Assurance Criterion MAC). The results show the objective function based on change in natural frequency i
This article discusses how women have significant abilities to cope with the difficulties of war times. They are not the weak and vulnerable victims who are thought to be. On the contrary, they have the power to control over many-sided fronts, like participating in the battlefield as nurses or activists for peace, or even fighters, as well as through the tasks and responsibilities assigned to them to protect and support their families during wartime. The researcher will examine the impact of war upon women. Like men, women suffer during wartime. They are being injured, tortured and killed. Yet, they are able to give examples of love and courage even in the difficult times of war. Hana is one of those women who lived during wartimes,
... Show MoreThe social contract represents a set of laws and determinants agreed upon by a group of individuals in order to organize society for the better.This agreement guarantees them to live in peace according to the pre-agreed laws, and on the basis of that, it represents the key to resolving the crisis relations between the state and society, and this is what prompted Iraqi society to move towards the formulation of a new social contract through popular protest movements in 2019.To overcome the old social contract that shook the trust between the state and society as a result of its negative outputs at various political, economic and social levels, and many problems emerged that hindered the process of building the social contra
... Show MoreThe culture of theatre performance has a vital role in the process of reading the linguistic and visual signs of the performance. And the process of transforming a theatre performance from its original context into a new hosting cultural context starts from the actual reading of the text. Directors derives their new signs out of his personal culture, depending on the society where they lives and the culture that forms the social conventions, traditions and beliefs. The text is usually written within its own historical and temporal culture. The process of its production usually takes it away from its original culture, when it interprets the codes of the original writer and their visual and linguistic signs and instils new alternative sign
... Show MoreThis work presents the modeling of the electrical response of monocrystalline photovoltaic module by using five parameters model based on manufacture data-sheet of a solar module that measured in stander test conditions (STC) at radiation 1000W/m² and cell temperature 25 . The model takes into account the series and parallel (shunt) resistance of the module. This paper considers the details of Matlab modeling of the solar module by a developed Simulink model using the basic equations, the first approach was to estimate the parameters: photocurrent Iph, saturation current Is, shunt resistance Rsh, series resistance Rs, ideality factor A at stander test condition (STC) by an ite
... Show MoreThe study examines the religious references of the art of miniatures in the Iranian school "Bahzad model" completed in Iran during the twelfth century AH, according to the controls and characteristics of the authoritative references. The researcher presented the problem of research, its importance, the need for it and its purpose, defined the terms in the research. The theoretical framework came with three investigations. The first topic of the concept of the reference in the field of knowledge, which concluded the most important features of the reference, is that each symbolic existence corresponds to a real existence and symbolic presence is an input to the realization of the reference. The reference then becomes a sign that acts as a
... Show MoreThe theatre is one of the main pillars of the human aesthetic thinking as it contains logical explanations for the public human life aspects outside time and environment. When we find that the directive philosophical thinking moving away from the stylistic constants and the virtual laws in taboos that control the accomplishment in terms of the traditional shapes, the employment and the theatrical reception. Some directors moved in post-modernism concepts in a perceptive that liberates thought from its natural context in thinking into an innovative perceptive. The aesthetic images are the basic premise in the prohibition of the philosophical thinking interpretation in order to move the directive thinking and this movement depends on the v
... Show MoreThe study introduces the twentieth century background where the image of teacher is shaped by various factors according to the wide emergence of new educational institutions in the aftermath of the Second World War. A group of writers mirrored the influence of the war on educational institutions and accordingly on the image of teacher in their novels whose main action is set in and around the campus of a university. The genre dates back to the nineteen forties. where they show the foibles of human nature and reactions to external pressures. One of the early examples of this genre is Lucky Jim (1954). The image of teacher is swinged in many shapes from the tyrant to the rebellion to the defiant. All is personified in the characters of these
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