Background: Blood vessels injury is one of the most
common causes of medical emergencies that admitted to
hospitals and at the same time it regarded as one of the
most important causes of death. They may represent less
than 15% of all injuries; they deserve special attention
because of their severe complications.
Objective: The aim of the present study is to assess
anatomically the injures of major arteries and veins in the
lower limb with their management.
Methods: The present study extended from April 2006 to
February 2007, in which 65 patients with lower limb
vascular injury were examined in Emergency Department
and Forensic Medicine Department of Tikrit Teaching
Hospital in Salah-Aldin governorate. Diagnosis was made
by clinical diagnosis alone, or in combination with
angiography. Some surgical interferences as vascular
repair was carried out, but if not possible the interposition
graft was used by great saphenous vein for vascular
reconstruction.
Results: The total cases were 65 patients (49 males and 16
females), ranging from 16 years to 67 years with a mean
age of 41.5±6.4 years. Penetrating trauma was the main
cause of injury for 52 patients. Seventeen cases had
bilateral limbs vascular injuries. Arterial injuries were most
common in the femoral arteries, followed by the tibial and
finally the popliteal arteries. Vascular repair were
performed in 16 cases, while in 11 cases great saphenous
vein interposition graft were done. There were 17 cases
associated with venous injury, of which 11 cases had
surgical vascular repair, and 6 had vein graft interposition.
There were concomitant femur fractures in 2 cases, fibula
fractured in 3, tibia fractured in 1 and the foot bones
fractured in 3.
Conclusion: Lower limb vascular injured patient should be
transferred to vascular surgery centers as soon as possible.
After first aid management, anticoagulant treatment may be
started post operatively to prevent the propagation of the
thrombosis. Early fasciotomy is done if there is any
suspicion of occurrence of compartment syndrome.
The issue of auditing contracts according to the related services is one of the important topics It has also become necessary to develop traditional procedures and auditing according to international standards to improve the profession of accounting and auditing. From this standpoint, the research aims to indicate the reflection of the contracting audit in accordance with the related services on the auditor's report. in line with the new directions regarding the need to adopt international standards in the Iraqi environment as the research problem focused on the non-comprehensiveness of the audit programs that deal with auditing contracts according to assurance commitments to contribute obtaining Governing evidence, The research
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The study was defined in four chapters: in the first chapter, a problem, the importance, and the aim of the research were presented. The second chapter contained the theoretical framewor
The 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
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