Background: The first and second choice for vascular access in patients with end stage renal disease (ESRD) is radio cephalic and brachio cephalic arteriovenous fistula (AVF).In patients with failed previous AVF e or poorly visualized or impalpable cephalic veins, the basilic vein can be mobilized and superficialized to create an AVF with the brachial artery.Objective: The aim of this study is to report our experience at the Vascular Surgery Department/ Surgical Specialty Hospital in brachio-basilic (BB) vascular access for hemodialysis.Methods: From January 2006 to December 2009, 31 patients with ESRD whose cephalic veins were thrombosed or impalpable or had previous unsuccessful vascular access procedures were referred to the Vascular Surgery Department/Surgical Specialty Hospital for creation of vascular access. Brachio - basilic mobilization AVF was offered to them. There were 20 females and 11 males. Their ages ranged from 12 to 70 years with a mean of 40. following a careful clinical assessment of the patients, particularly their upper limb superficial veins, Doppler study of both subclavian veins was done to all patients; those with a vein stenosis exceeding 40% were excluded from the study. All patients had mobilization of basilic vein under general anesthesia via a hooky racket incision on medial aspect of upper arm extending from the axilla to the antecubital fossa. The vein is tunneled subcutaneously and anastomosed end to side to brachial artery. The postoperative condition was monitored looking for any complication. The follow up period lasted for 6 months.Results: nineteen patients (61.3%) had left-sided operations. All fistulae except one functioned well primarily (a success rate of 96.8%). One patient had primary thrombosis of the fistula while another patient developed an aneurysm of the AVF 4 months after the operation. The remainder had a smooth non-complicated postoperative course. All fistulae matured and were ready for cannulation in 6 weeks and remained functioning during the 6 months of follow up.Conclusion:: Brachio-basilic AV fistula with anterior basilica vein mobilization is an acceptable option for dialysis with good success rate and fewer complications
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Sub-threshold operation has received a lot of attention in limited performance applications.However, energy optimization of sub-threshold circuits should be performed with the concern of the performance limitation of such circuit. In this paper, a dual size design is proposed for energy minimization of sub-threshold CMOS circuits. The optimal downsizing factor is determined and assigned for some gates on the off-critical paths to minimize the energy at the maximum allowable performance. This assignment is performed using the proposed slack based genetic algorithm which is a heuristic-mixed evolutionary algorithm. Some gates are heuristically assigned to the original and the downsized design based on their slack time determined by static tim
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In The Bluest Eye (1970), the American-African writer, Toni Morrison explores how
Western standards of ideal beauty are created and propagated with and among the black
community. The novel not only portrays the lives of those whose dark skinned and Negroid
features blight their lives; it also shows how the standard of white beauty, when imposed on
black youth, can drastically damage one’s self-love and esteem which usually occurs when
beauty goes unrecognized. Morrison in this novel focuses on the damage that the black
women characters suffer through the construction of femininity in a racialised society where
whiteness is used as a standard of beauty.
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The world's renewable energy sources have taken on great importance, for its cleanness and its environmental effects as well as being a renewable source, Increased demand for fossil energy sources is also causing global warming and climate change. Iraq is an appropriate area for renewable energy This study shows that renewable alternative energy has not been used sufficiently enough at present. But this energy can play an important role in the future of renewable energy in Iraq. This research aims to study the renewable energy in Iraq (solar energy) and it is appropriate to develop this alternative energy for crude oil, which is characterized by the use of the most appropriate and less economical and more environmentally friendly. Solar
... Show MoreBones were recorded in the skeleton of some species of Iraqi turtle Mauremys rivulata; the objectives of this study came in light of current conditions, environmental developments, talents and techniques of biological studies taking place in the country, need for an anatomy guide in river turtles of Iraqi species, to identify all kinds of similarities and differences with their preaching, this work or study has become written in response to those modern needs. It is designed to be one of the resources for those interested in biological studies, beginners or professionals, and veterinarians, distinguishing them from marine and global species. Turtles were dissected in the laboratories of the Research Center and Museum of Natural Hist
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This research focused on clarifying the relationship strategic decisions for operations management & performance excellence organizational, The research emerges from a problem which explained by many application questions. Special questionnaire has been prepared for this purpose distributed (72) to sample of management levels (Top, middle) in the General company for mining industries and aquatic Insullation & the General company of batteries industry, The research has tried to test a number hypotheses related to the relation and regression among the variables of the research, and the differences among the <
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