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.
Many drilling problems (lost circulation, hurdle in running casing, poor cement jobs, high torque and drag and the necessity of re-drilling and, mechanical stuck caused by cutting accumulation in the wellbore) can be avoided by good hole cleaning during drilling operation especially in directional wells.
In this experimental work, the cutting transport ratio (CTR) in hole inclined (60 degree) from vertical was estimated by using three values of drilling mud viscosities, three annular velocities, two types of cuttings size and two rotation speed of inner pipe (RPM). Note that the rig consisted from PVC outer casing 4 1/2 inch as OD diameter and inner dri
Precarity means the lack of social and economic networks; a considerable exposure to danger and harm. Minority groups are precariat for they lack rights and full citizenship. Precarity is related, states Judith Butler, with the individual’s performativity, and his ability to perform his gender role. Toni Morrison continually goes to past to retell the history of African Americans. The issues of race, gender and national identity are recurrent in her work. Reading her book Home (2012) evokes the idea of precarity and performativity since the two main characters, Frank and Cee are precarious characters that fail to perform their gender role properly, and eventually are exposed to hazard and harm. This research displays how African American
... Show MoreSystematic Reviews in Pharmacy is a monthly Peer-review open access Journal,different scientists involved in Pharmaceutical research and development
Here, we found an estimation of best approximation of unbounded functions which satisfied weighted Lipschitz condition with respect to convex polynomial by means of weighted Totik-Ditzian modulus of continuity
The aim of this research is to study the modern Spanish writings on the biography of Prophet Mohamed (PBUH), which gave the glorious biography its due by objective study and analysis with a scholarly approach, unlike the old Spanish and European oriental writings with its biased approach. In the past, Spanish and European writings on Prophet Mohamed were influenced by religious extremism and did not do any justiceto Prophet Mohamed. But this has changed in the modern times, and modern writing on the Prophet biography is based on objective analysis and reliance on original sources instead of the sources of the churches which were full of hate and wicked intentions to eliminate Islam.The research came to the conclusion that the modern Span
... Show MoreTo cite the short stories of Kathrine Mansfield, all contain characters who are
revealed through their own thoughts. In her stories, the world is always seen through
the eyes of her characters in the form of points of view presented to the readers
through the characters' minds. This way of revealing characters and figuring out the
world, through the presentation of the characters' thoughts, is linked to the 'stream of
consciousness.' Kathrine Mansfield has been compared with Virginia Woolf in
particular in that both writers used the thoughts and the points of view of their
characters as material for their work through the stream of consciousness.
According to Leech and Short (1981), there are five linguistic techn
Blood lipids are important mediators of host defense during the acute phase of innate immunity. Parasites may induce significant changes in lipid parameters, as has been shown in vitro study where substitution of serum by lipid/cholesterol in medium and in experimental models (in vivo). Thus changes in lipid profile occur in patients that having active infections with most of the parasites. Toxoplasma cannot synthesize cholesterol and depends upon acquisition of low density lipoprotein (LDL)-derived from the host cell, via endocytosis mediated by the LDL receptor or the LDL receptor-related protein.The present study is conducted to evaluate the changes in lipid profile in T. gondii infected women.A total of patients included 87 aborted wom
... Show MoreThe paradise, the collection of a paradise through which it shows us the wonders of the divine-made, and reflect us the pleasure of looking and luster of beauty, and the splendor of creation, and all this is in the interest of this human being; To be a safety valve to collapse. But if this man deviates and forgot the blessed man, drowned in the vanity and vanity, and deviated from the divine method, this same heaven will disown him and reveal to him another face of destruction and devastation.
What we will see in the folds of the search, God willing