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.
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Signature verification involves vague situations in which a signature could resemble many reference samples or might differ because of handwriting variances. By presenting the features and similarity score of signatures from the matching algorithm as fuzzy sets and capturing the degrees of membership, non-membership, and indeterminacy, a neutrosophic engine can significantly contribute to signature verification by addressing the inherent uncertainties and ambiguities present in signatures. But type-1 neutrosophic logic gives these membership functions fixed values, which could not adequately capture the various degrees of uncertainty in the characteristics of signatures. Type-1 neutrosophic representation is also unable to adjust to various
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Incremental sheet metal forming is a modern technique of sheet metal forming in which a uniform sheet is locally deformed during the progressive action of a forming tool. The tool movement is governed by a CNC milling machine. The tool locally deforms by this way the sheet with pure deformation stretching. In SPIF process, the research is concentrate on the development of predict models for estimate the product quality. Using simulated annealing algorithm (SAA), Surface quality in SPIF has been modeled. In the development of this predictive model, spindle speed, feed rate and step depth have been considered as model parameters. Maximum peak height (Rz) and Arithmetic mean surface roughness (Ra) are used as response parameter to assess th
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This 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
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The 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
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Objectives: To assess quality of health care for clients at outpatient consultancy clinics in Al-Hilla City Hospitals, and to find out significant differences between the clients' perspectives toward quality of health care dimensions and their demographic characteristics such as (residence, age, gender, level of education, and occupation ).
Methodology: A descriptive analytic study design was carried out at outpatient consultancy clinics of Al- Hilla city hospital (Al-Hilla and Al-Imam Al-Sadiq general teaching hospital) from April 10 th to June 15 th 2019. Non – probability (purposive) sample of 200 clients who were coming to the Outpatient Consultancy Clinics were selected. Data is collected through used of an assessment tools an
This paper aims at the analytical level to know the security topics that were used with data journalism, and the expression methods used in the statements of the Security Media Cell, as well as to identify the means of clarification used in data journalism. About the Security Media Cell, and the methods preferred by the public in presenting press releases, especially determining the strength of the respondents' attitude towards the data issued by the Security Media Cell. On the Security Media Cell, while the field study included the distribution of a questionnaire to the public of Baghdad Governorate. The study reached several results, the most important of which is the interest of the security media cell in presenting its data in differ
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