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.
The paper presents a highly accurate power flow solution, reducing the possibility of ending at local minima, by using Real-Coded Genetic Algorithm (RCGA) with system reduction and restoration. The proposed method (RCGA) is modified to reduce the total computing time by reducing the system in size to that of the generator buses, which, for any realistic system, will be smaller in number, and the load buses are eliminated. Then solving the power flow problem for the generator buses only by real-coded GA to calculate the voltage phase angles, whereas the voltage magnitudes are specified resulted in reduced computation time for the solution. Then the system is restored by calculating the voltages of the load buses in terms
... Show MoreThe ring modulator described in part I of this paper is designed here for two operating wavelengths 1550nm and 1310nm. For each wavelength, three structures are designed corresponding to three values of polymer slot widths (40, 50 and 60nm). The performance of these modulators are simulated using COMSOL software (version 4.3b) and the results are discussed and compared with theoretical predictions. The performance of intensity modulation/direct detection short range and long rang optical communication systems incorporating the designed modulators is simulated for 40 and 100Gb/s data rates using Optisystem software (version 12). The results reveal that an average energy per bit as low as 0.05fJ can be obtained when the 1550nm modulator is d
... Show MoreThe present study stresses two of the most significant aspects of linguistic approach: Pragmatics” and the “Speech Act Theory”, revealing its importance and the stages and levels of development through Hebrew language’s speech acts analysis including (political speech, the Holy Bible, Hebrew stories).
Chronologically, Pragmatics has always been the center of linguists’ interests due to its importance in linguistic decryptions, particularly, through “Speech Act Theory” that has been initiated and developed by the most prominent philosophers and linguistics.
The prese
... Show More
(101)
(99)
(7)
(4)
Background: Enforcement of sustainable and green chemistry protocols has seen colossal surge in recent times, the development of an effective, eco-friendly, simple and novel methodologies towards the synthesis of valuable synthetic scaffolds and drug intermediates. Recent advances in technology have now a more efficient means of heating reactions that made microwave energy. Efforts to synthesize novel heterocyclic molecules of biological importance are in continuation. Microwave irradiation is well known to promote the synthesis of a variety of organic and inorganic compounds. The aim of current study was to conceivea mild base mediated preparation of novel Schiff base of 2-Acetylpheno with trimethoprim drug (H2TPBD) and its complexes w
... Show MoreCoupling reaction of 2-amino benzoic acid with 8-hydroxy quinoline gave bidentate azo ligand. The prepared ligand has been identified by Microelemental Analysis,1HNMR,FT-IR and UV-Vis spectroscopic techniques. Treatment of the prepared ligand with the following metal ions (ZnII,CdII and HgII) in aqueous ethanol with a 1:2 M:L ratio and at optimum pH, yielded a series of neutral complexes of the general formula [M(L)2]. The prepared complexes have been characterized by using flame atomic absorption, (C.H.N) Analysis, FT-IR and UV-Vis spectroscopic methods as well as conductivity measurements. The nature of the complexes formed were studied following the mole ratio and continuous variation methods, Beer's law obeyed over a concentration range
... Show More
(9)