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.
Software-Defined Networking (SDN) has evolved network management by detaching the control plane from the data forwarding plane, resulting in unparalleled flexibility and efficiency in network administration. However, the heterogeneity of traffic in SDN presents issues in achieving Quality of Service (QoS) demands and efficiently managing network resources. SDN traffic flows are often divided into elephant flows (EFs) and mice flows (MFs). EFs, which are distinguished by their huge packet sizes and long durations, account for a small amount of total traffic but require disproportionate network resources, thus causing congestion and delays for smaller MFs. MFs, on the other hand, have a short lifetime and are latency-sensitive, but they accou
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The research deals with the important and modern two subjects, strategic leadership which have six demotions and knowledge management
(four demotions') . the gools & the research is to know the relation & the effect them in the oil ministry (project department) , the sample was (50) persons who works in the department the questionnaire was the tool of data gathering .
The research divided to four parties, the first to the theotical review of the research variables, the second to the research methrology, the third to analysis and discoed the empirical results the last to the conclusions and recommendations .
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The current research aims at testing test the relationship and the impact of strategic leadership (strategic vision, Core competencies , human capital, organizational culture and Ethical practices) in the talent management (to attract talent, performance management talent, developing talent and retain talent) among managers in the Ministry of Science and Technology Iraq, and figuring out a number of recommendations to the ministry to help achieve its desired objectives, and to clarify the relationship between the variables to find the main and secondary aim of the research two major hypotheses have been formed which split into ten sub-hypotheses. Collecting data on a form questionnaire has been relied on as an essenti
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Objectives: The study aims to assess and evaluate the caregivers knowledge about management of the children with growth hormone deficiency and to find out the relationship between caregivers kowledge and caregivers age, gender, number of individual in house hold, Date of treatment started ,Caregivers level education and economic status Methodology: Quazi expermental study design was carried out at (Child's Central Teaching Hospital, Medical City of Al Imamian Al Khadhmain Teaching Hospital, and National Centre for Treatment and Research of Diabetes,Specialized Center for Endocrine Diseases and Diabetes, and Department of Medical City Children Welfare Teaching Hospital started from
... Show MoreThose interested in the educational process and lesson management sought to invest the information experience with industrial intelligence and technology because of its importance in increasing the effectiveness of lesson management and developing the creative capabilities of the teacher in directing and managing his lesson. Field research for sports educational institutions that are interested in managing the lesson and preparing mathematical teaching cadres is an important issue and necessary means for identifying the most important phenomena that accompany the process of managing the educational process, as the teacher's success in providing the appropriate conditions to provide rich and influencing experiences in managing and directing
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Produced water is accompanied with the production of oil and gas especially at the fields producing by water drive or water injection. The quantity of these waters is expected to be more complicated problem with an increasing in water cut which is expected to be 3-8 barrels water/produced barrel oil.Produced water may contain many constituents based on what is present in the subsurface at a particular location. Produced water contains dissolved solids and hydrocarbons (dissolved and suspended) and oxygen depletion. The most common dissolved solid is salt with concentrations range between a few parts per thousand to hundreds parts per thousand. In addition to salt, many produced waters also contain high levels of heavy metals like zinc, bari
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Global virtual teams (GVTs) are a recent organizational adaptation created to meet the needs of globalizatized marketplace. GVTs are essentially teams that are distributed across national boundaries and concerned through advanced information and communication technology (ICT) such as email, instant messaging, and video conferencing. The research on GVTs is important in the information system (IS) field because GVTs are dependent on information communication technology and the use of other technologies; GVTs also consists of people from different cultures. This paper tried to answer two research questions. The first one is: what are the GVTs problems facing the project manager (PM). A literature review was conducted to answer the fir
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Solid waste is a major issue in today's world. Which can be a contributing factor to pollution and the spread of vector-borne diseases. Because of its complicated nonlinear processes, this problem is difficult to model and optimize using traditional methods. In this study, a mathematical model was developed to optimize the cost of solid waste recycling and management. In the optimization phase, the salp swarm algorithm (SSA) is utilized to determine the level of discarded solid waste and reclaimed solid waste. An optimization technique SSA is a new method of finding the ideal solution for a mathematical relationship based on leaders and followers. It takes a lot of random solutions, as well as their outward or inward fluctuations, t
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The paper presents a neural synchronization into intensive study in order to address challenges preventing from adopting it as an alternative key exchange algorithm. The results obtained from the implementation of neural synchronization with this proposed system address two challenges: namely the verification of establishing the synchronization between the two neural networks, and the public initiation of the input vector for each party. Solutions are presented and mathematical model is developed and presented, and as this proposed system focuses on stream cipher; a system of LFSRs (linear feedback shift registers) has been used with a balanced memory to generate the key. The initializations of these LFSRs are neural weights after achiev
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