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 Knights of Labor, the first national industrial union in the United States, was founded in Philadelphia on December 9, 1869, by Uriah Stephens (1821-82) and eight other Philadelphia garment cutters. Intended to overcome the limitations of craft unions, the organization was designed to include all those who toiled with their hands. By mid-1886 nearly one million laborers called themselves Knights, making the organization the largest and most influential labor union in nineteenth century America. Stephens aspired to unite all wage-earners into a single organization regardless of skill, race, or sex. The organization excluded liquor dealers, lawyers, bankers, and professional gamblers. Stephens stressed the importance of solidar
... Show MoreIn this study, gamma-ray spectrometry with an HPGe detector was used to measure the specific activity concentrations of 226Ra, 232Th, and 40K in soil samples collected from IT1 oil reservoirs in Kirkuk city, northeast Iraq. The “spectral line Gp” gamma analysis software package was used to analyze the spectral data. 226Ra specific activity varies from 9 0.34 Bq.kg-1 to 17 0.47 Bq.kg-1. 232Th specific activity varies from 6.2 0.08 Bq.kg-1 to 18 0.2 Bq.kg-1. 40K specific activity varies from 25 0.19 Bq.kg-1 to 118 0.41 Bq.kg-1. The radiological hazard due to the radiation emitted from natural r
... Show MoreLasmiditan (LAS) was formulated as a nanoemulsion based in situ gel (NEIG)with the aim of improving its oral bioavailability via application intranasally. The solubility of LAS in oils, emulsifiers, and co-emulsifiers was determined to identify nanoemulsion (NE)components. Phase diagrams were constructed to identify the area of nanoemulsification. LAS NE was formulated using the spontaneous nanoemulsification method. Four NEs (F19, F24, F31, and F34) containing 7-15 % oleic acid (OA) as an oily phase, 40-55% labrasol (LR), and transcutol (TC) as emulsifier mixture at (1:1), (2:1), (3:1), and (1:2) ratio with 30-53 % (w/w) aqueous phase, having suitable optical transparency of 95–98%, globule size of 104-140 nm and polydisper
... Show MoreThe study aims to identify the impact of the round-robin strategy on the logical thinking of fourth-year middle school students in chemistry. Two groups were employed: an experimental group consisted of (30) students who were taught according to the round-robin strategy, and the control group consisted of (30) students who were taught according to the traditional method. The researcher adopted the experimental design with partial control by preparing the visual thinking test tool, which consists of (20) multiple-choice items, it was applied as a post-test on the research sample. The result showed that there was a statistically significant difference in favor of the experimental group, which was taught according to the Round Robin s
... Show MoreThis study concerned with phytochemical investigation and methods of extraction and separation of active constituents from Valeriana officinalis plant cultivated in Iraq. Due to the large number of active constituents in Valeriana officinalis, it was necessary to make analytical study of its constituents to determine the chemical nature of these constituents and then determine the main classes (terpenes and iridoids) using chemical reagents specific for each class. Different organic solvents like ethanol (70%) used in soxhlet apparatus and hexane, ethyl acetate and methanol were used separately to extract the main active constituents by maceration. Through comparison between these solvents using thin layer chromatograph
... Show MoreThis study illustrates in vitro effect of cold atmospheric plasma (CAP) on the treatment of Leishmania. In addition, the study evaluated the effect of drug treatment (pentostam) and the combination treatment of pentostan and CAP at different doses and incubation time 24 h in order to assess the most effective treatment. The duration of the cold plasma doses was 1 min, 2 min and 3 min, while the pentostam doses were 2.5 µg/ml and 5 µg/ml. The combinations therapies included combining the three cold plasma doses with the pentostam doses to test 6 combinations of treated in vitro. The maximum growth inhibition was given by combination treated 46% and 44% for donovani and tropica leishamnia respectively; these results give an indi
... Show MoreThe parasite was isolated from a stool sample, cultivated and maintained in vitro using Locke-egg medium (LEM) and Liver infusion agar medium (LIAM) . The culture was maintained for up to 21 months, and the best time to maintain the parasite was every 48 hours, although the growth in the culture media continued for 13 days without a maintenance. Additionally, no cyst formation was observed during cultivation of parasite in the two culture media. Although, was observe young cyst formed in LEM media were deletion of maintained. The diagnosis of bacteria growth in the culture media, bacterial content (Escherichia coli) was an dominance and essential requirement for a successful cultivation of Entamoeba histolytica in the two culture media.
A theoretical model is developed to determine time evolution of temperature at the surface of an opaque target placed in air for cases characterized by the formation of laser supported absorption waves (LSAW) plasmas. The model takes into account both plasma dynamics and time variation of incident laser pulse (i.e. pulse shape or profile).Shock tube relations were employed in formulating plasma dynamics over target surface. Gaussian function was chosen in formulating the pulse profile in the present modeling