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.
This study dealt with the management strategy as an independent variable and the integrated industrial distribution as a variable. The study aimed at finding the integrated industrial distribution that fits with the management strategy in providing the needs of the firm on the one hand and reducing the cost of management that is reflected in increasing its profits.
The researcher selected the data from (130) decision makers in the corporation and used the questionnaire as a tool for collecting data and used a set of statistical tools and tools suitable for the nature of information and were processed using the data analysis system (SPSS version 24) Based on the analysis of the responses of the sample and the test of correlation and
Low-level microbial activity due to the production of organic acids is a recognized problem during the initial phase of food waste composting. Increasing such activity levels by adjusting the pH values during the initial composting phase is the primary objective to be investigated. In this study, sodium acetate (NaoAc) was introduced as an amendment to an in-vessel composting system. NaoAc was added when the pH of the compost mixture reached a low level (pH < 5), the addition increased pH to 5.8. This had a positive effect on the degradation of organic materials i.e. the formation of methane gas compared to the results without NaoAc addition.
The results also proved that anaerobic-aerobic in-vessel composting could reduce the
... Show MoreBackground: The study aim was to evaluate thermocycling effect on microleakage of occlusal and cervical margins of MOD cavity filled with bulk filled composites in comparison to incrementally placed nanohybrid composite and to evaluate the difference in microleakage between enamel and dentin margins for the three materials groups. Materials and method: Forty eight maxillary first premolars were prepared with MOD cavities. Samples were divided into three groups of sixteen teeth according to material used: Grandio: Grandio. SDR: SDR +Grandio. X-tra: X-tra base + Grandio. Each group was subdivided into two according to be thermocycled or not. After 24 hrs immersion in 2% methylene blue, samples weresectioned and microleakage was estimated. Res
... Show MoreThe current research aimed to analyze the importance, correlation and the effect of independent variables represented by marketing variables on the dependent variable represented by local brand, through taking ENIEM as a model for this study, which represents a sensitive sector for the Algerian consumer. The results of the study evinced that the Algerian consumer has a positive image toward the brand ENIEM given marketing variables which has acquired considerable importance to this consumer. Also, the results of this study showed a statistically significant correlation between marketing variables and good perception toward the brand ENIEM, at the same time, the existence of a statistically significant effect for each of these variables o
... Show MoreThis study aimed identify the teachers of sociology. In the development of creative thinking. I have students in middle school .llvra literary. In schools. Second Karkh From the perspective of the teachers and the students themselves numbered (41), a teacher and a school. As The study population encompassed of some students the fourth and fifth preparatory stage in the Karkh II schools, totaling 200 male and female students. As the study sample were consisted of (7) and a teacher (34) and accented (85) of male students (115) were female student The researcher the questionnaire which consisted of (39) items And to achieve the objectives of the study it was ascertained sincerity And stability. And
... Show MoreAbstract
The study was conducted in Baghdad and aimed to:
The impact of moving the educational activities in the conservation of literary
texts and the development of literary taste in the fifth grade students moral "by
verifying the validity of hypotheses Elsafreeten following forms:
The first hypothesis:
- There are no differences in women with statistical significance between means
of scores of students three experimental groups, the experimental group first
used upstream activities in the teaching material of literature and texts, the
second experimental group used the activities of building in the teaching
material itself and the experimental group the third use activities concluding
taught the same
Objectives: To determine the effectiveness of the educational program on nursing staff knowledge about infection control measures at the Intensive Care Unit in Al-Diwaniya Teaching Hospital.
Methodology: A pre-experimental design (one group design: pre-test and post-test) was used. This study was conducted in Al-Diwaniya Teaching Hospital for the period from ( 20th February to 5th March, 2020) on a non-probability (purposive) sample consisting of (25 nurses) working in ICU. A questionnaire was built as a data collection tool and consisted of two parts:
First part: The demographic characteristics of the nursing staff (age, gender, level of education, years of experien
... Show MoreThe construction industry plays a crucial role in the countries' economy, especially in the developed country. This point encourages the concerned institution to use new techniques and integrate many techniques and methods to maximize the benefits. The main objective of this research is to evaluate the use of risk management, value management, and building information modeling in the Iraqi construction industry. The evaluation process aims at two objectives. The direct objective was to evaluate the knowledge in risk management (RM), value management (VM), and building information modeling (BIM). The indirect objective was to support the participants with information related to the main items mentioned. The questionnaire
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