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.
Abstract
The aim of the study is to study the relationship between strategic orientation and organizational performance. The strategic direction is the main purpose for which the organization is found. Therefore, it is the main engine for all the activities and tasks that the institution can carry out to achieve its objectives within the environment in which it operates. ,. The research problem was formed by several questions to determine the level of the strategic direction and the nature of its relationship with organizational performance in the Iraqi Ministry of Defense / Inspector General's Office as the field of application to answer. The sample was selected by a sample of 60 individuals, department managers, And the que
The efficiency of Nd:YAG laser radiation in removing debris and smear layer from prepared root
canal walls was studied. Fifty-seven human extracted single rooted anterior teeth were divided into three
groups. A group that was not lased is considered as a control group. The remaining teeth were exposed to
different laser parameters regarding laser energy, repetition rate and exposure time. For the case of the set of
parameters of 7 mJ laser energy, the cleaning was maximum at 3 p.p.s. repetition rate for 3 seconds exposure
time for, the coronal, middle and apical thirds. Above and below this energy level, there was an overdose
(melting) or under dose (no effect). Nevertheless for 10mJ laser energy case, the cleaning effi
A descriptive evaluation study is conducted on primary health care centers in Baghdad City in order to
evaluate the organization structure as component of quality improvement of maternal and child health promotion
from April 10th 2012 to May20th 2013. A total of (22) primary health care centers. Study instrument was
comprised of three questionnaires and overall items included in these questionnaire were (65) items. Data are
collected through the utilization of the developed questionnaire and the interview technique as means of data
collection. Data are analyzed through the application of descriptive statistical data analysis methods which
includes the measurement of the frequencies, percentages, and computation of mean
The aim of the research is to shed light on the dimensions of the strategic lens and its impact on achieving the pioneer tax performance and represented by the dimensions (strategic direction, growth, pilot indicator, renewal and modernization, efficiency and effectiveness) in the General Tax Authority. The questionnaire was adopted as a tool to collect data and information from the adult sample They are (91) who are on the site (Assistant Director General, Head of Division, First Division Deputy, Second Division Deputy, Division Officer, Division Officer Associate) The statistical program (SPSS) has been used to calculate (the mean, the standard deviation, the correlation coefficient, the difference coefficient, the F test, the
... Show MoreThe Evolution Of Information Technology And The Use Of Computer Systems Led To Increase Attention To The Use Of Modern Techniques In The Auditing Process , As It Will Overcome Some Of The Human Shortcomings In The Exercise Of Professional Judgment, Then It Can Improve The Efficiency And Effectiveness Of The Audit Process, Where The New Audit Methodologies Espouse The Concept Of Risk Which Includes Strategic Dimension With Regard To The Capacity Of The Entity To Achieve Its Goals, Which Requires Auditors To Rely On Advanced Technology That Can Identify The Factors Which Prevent The Entity From Achieving Its Objectives. The Idea Of Research Is To Preparing An Electronic Program Fer All Audit Work From Planning Through Sampling And Document
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This research set to indicate the role of the opportunity cost in the overall economic development (human and social development) by selecting the most appropriate alternative for the growth of the country in exchange for sacrificing profit limits to achieve this growth and development of the country, especially in the present circumstances of the country and after studying the reality of the economic case for him, as the problem lies with don't selecting the best alternative that enhances the gross domestic product, which extends to promote overall economic development and revive the industrial and agricultural sectors, productivity is more like Impotent, versus sacrifice alternative consumption may bring more financially lucrative than
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