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 research aims to statement the main obstacles that prevent the application of total quality management (TQM) in a number of Iraqi service organizations, and by one organization in each of the sectors (health, finance, education, higher education, tourism), which are, (Al-Yarmouk Teaching Hospital, Rafidain Bank/ Branch of Hay Al-Arabi Al-Jadid, Al-Karkh/1 Directorate of Education, College of administration and Economics/ Baghdad University, International Palestine Hotel). The research also, tries to classify the priority of the obstacles depending on the type of service organization surveyed. And diagnoses the extent to which or the difference of the research sample members views on the order of obstacles of TQM, and also proposes a
... Show MoreThis 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 <
... Show More
The world is witnessing a remarkable development in the use of technology, which has made it an essential means of investment, especially in the field of management, which provided many of the facilities experienced by the institutions, including improving revenues, shortening time and saving labor. Islamic investment technology as a successful means of management and we touched on the Zakat Foundation as an application model.
(2)
Background: the condition of hallux valgus is considered as the most common deformities affecting females more than males, characteristically manifested as lateral deviation of the big toe and widening of first and second inter -metatarsal angle with a deformity of second toe in some severe cases. Objective: to make a radiological and clinical assessment of two surgical methods of osteotomy used in treatment of hallux valgu and to compare between them: first one is the distal dome osteotomy, and second one is a distal wedge metatarsal osteotomy. Patients and methods: a total of 36 feet of 28 patients suffer from hallux valgus, with mean age of 50.3 years were included in this study, followed for 6- 30 months ( mean follow-up of 8.8 months).
... Show More
(1)
(1)
(5)
The research aims to identify the role determined by the dimensions of marketing in the relationship represented by (trust in the relationship, commitment to the relationship, communication during the relationship) in how to contribute to the success of the industrial project management in Iraq as a case study in the General Directorate of Industrial Development. Their number is (50) workers, where the research problem centered on knowing the impact and importance of relationship marketing on the success of industrial project management. The descriptive analytical approach. Using SPSS and Amos, the researcher tested and analysed hypotheses about the relationship and the influence between the research variables through a questionnaire . Test
... Show More
(3)
The problem of the paper focused on the role of the learning organization in the crisis management strategy, and the extent of the actual interest in both the learning organization and the crisis management and aimed at diagnosing and analyzing that and surrounding questions. The Statistical Package for the Social Sciences (SPSS) program was used to calculate the results and the correlation coefficient between the two main variables. The methodology was descriptive and analytical. The case study was followed by a questionnaire that was distributed to a sample of 31 teachers. The paper adopted a seven-dimensional model of systemic thinking that encourages questioning, empowerment, provision of advanced technologies, and strategic lea
... Show More
(15)
(9)
The aim of this study is to assess nurse's knowledge and role in the management of thalassemic patients in the Sulaimania Thalassemia Centre. Methodology: This study utilized a qualitative approach to explore nurses’ knowledge about thalassemia through semi structured group interviews. Questionnaire was synthesized through a comprehensive review of literature. Results: The results show that nurses in Kurdistan region of Iraq have a limited role in terms of decision making and there is lack of nursing documentation other than that of recording abnormal events, and a lack of knowledge about and engageme