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 main purpose of the research is to diagnose the importance of the role that strategic memory plays with its three variables (content, structure, and processes) in helping the human resource department to use the COSO model with its five components (culture and governance, strategy and objectives, performance, communications and information, and feedback) in auditing activities and tasks Her own. As the research problem emphasized the existence of a lack of cognitive perception, of the importance of strategic memory, and the investment of its components in the rationalization of the application of the COSO model. and therefore it can be emphasized that the importance of the research is to provide treatments for problems relate
... Show MoreCompetitive advantage is a substantial strategic objective for organizations. It requires high levels in the quality of products and services provided to customers, continuous improvement of costing , care for creativity and innovative employees, and speed unique to the marketing and financial engineering, and business re-engineering processes. The situation in this area, requires actors to attract and develop human resources, including help in proper implementation of the strategic tasks that targeted by those institutions. According to the opinions and viewpoints of management scholars, the competitive advantage resource is the most important issue for organizations in the third millennium, which can be a
... Show MoreConcentrated research topic in the study of key variables in the work of the inspectors general offices , which are in the application of quality management standards audit work and reduce the incidence of corruption. It highlights the importance of current research in being a serious attempt aimed at highlighting the role of the importance of standards of quality management audit work , because they represent a router and leader of the accountant or ( Sergeant ) in the performance of his work and the extent of compliance with these standards , as well as highlight the role of quality audit in reducing the incidence of corruption , of during the professional performance of Higher auditors and determine the responsibilities entrus
... Show MoreChukar partridge Alectoris chukar (Gray, 1830) is the only species of the 46 species of the genus Alectoris to be found in Iraq. At least there are fourteen subspecies of chukar were described from east Europe, the Middle East and west Asia, two of them were known to be found in Iraq, A.c. Kurdestanica (Meinertzhagen, 1923) from Alpine bio-geographical zone of altitude more than 2000m high, and A.c. werae Zarundny and Loudon, 1904, from the foothills of altitude not more than 400m. In between these two regions, there is another bio-geographical region known as the Irano-toranian zone 400-2000m high. Using morphological, ecological, behavioural, reproduction and hybridization criteria this study discove
... Show MoreThe objective of the research is to evaluate the risk management practices of the variables (risk management structure, risk management methods, key components of risk management) and their relation to the principled behavior of managers behavior(innovation, proactive, risk acceptance) By adopting the questionnaire as a main tool in collecting data from managers in the National and raq insurance companies of (50) officials Department manager, department administrator, unit administrator, and analyzed their answers using the SPSS In calculating arithmetic mean, standard deviation, percentage weight and simple correlation coefficient. The most prominent conclusions were:1.There is a positive trend in the sample in both companies and a high
... Show MoreAbstract
Nowadays, the world adopts a philosophy that relates to environmental conservation. This philosophy can be achieved through providing environmentally friendly products while satisfying customers' needs as well. To attain that, a new systems and programs need to be applied in a scientific manner, and total quality environmental management (TQEM) is among these concepts. The research aimed to analyze the Relationship between (TQEM) Practices and its effect on Flexible Manufacturing in Badush factory. The research sample includes managers and head of divisions at top, middle and front line management levels which were (27) working in Badush factory. To achieve the objectives of the study, the descriptive anal
... Show MoreThe research aims to measure the relationship and impact of the operations of the knowledge of management of the six dimensions (diagnosis knowledge, define knowledge objectives, knowledge generation, knowledge storage, distribution of knowledge, application of knowledge) in the fiscal performance of the General Authority for taxes of the four dimensions (financial, customers (taxpayers), Operations Interior, learn and grow), the research aims also to the use of computerized programs for training and career development of the Authority that helps to add knowledge workers in the Authority, and to reach an appropriate arrangement for knowledge management processes in the Authority, as well as analysis of the reality of the Authority to get
... Show MoreObjectives: To assess nurses-midwives' knowledge about pain management during labor before and after implementation of educational program and to determine the effectiveness of educational program on nurses-midwives' knowledge about pain management during labor in Baghdad Maternity Hospitals.
Methodology: A quasi-experimental design has been conducted during the period of (February 27th 2019 through 2nd June 2019) on non-probability sample (purposive) consists of (44 Nurses/midwives') who are work in delivery room, the sample was exposed to pretest, educational program, posttest. The study was conducted in three Directories, (Baghdad Teaching Hospital) at medical city health
... Show MoreThree types of extracts ( aquatic, alcoholic, and oily ) were prepared from the fruits of coconuts, and a series of chemical tests were conducted in addition to the use of the FTIR equipment to determine the active locations in the prepared extracts. The results indicated the presence of active compounds (tannins, saponins, flavonoids, turbines and steroids) in the extracts prepared from the fruits of coconuts, also the antimicrobial capability of these extracts were tested on pathogenic bacteria isolated from wounds and burns infections cases. The results proved that the concentration 80 mg/ml of the aquatic extract is the minimum inhibitory concentration for the microbes: Proteus vulgaris and Pseudomonas fluorescence, while the
... Show More