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.
Tor (The Onion Routing) network was designed to enable users to browse the Internet anonymously. It is known for its anonymity and privacy security feature against many agents who desire to observe the area of users or chase users’ browsing conventions. This anonymity stems from the encryption and decryption of Tor traffic. That is, the client’s traffic should be subject to encryption and decryption before the sending and receiving process, which leads to delay and even interruption in data flow. The exchange of cryptographic keys between network devices plays a pivotal and critical role in facilitating secure communication and ensuring the integrity of cryptographic procedures. This essential process is time-consuming, which causes del
... Show MoreCo-composting process can be acquired by combining organic fraction of municipal solid waste (OFMSW) with sewage sludge (SS) and mature compost (MC) as enhancement and bulking agent to overcome the problems of municipal solid waste and wastewater treatment plants besides the finally produced fertilizer usage for agriculture and horticulture. The effects of different mixture ratios of (OFMSW), (SS) and (MC) on the performance of composting process were investigated in this study. Piles of about 10 kg were prepared by mixing OFMSW, SS and MC in three different ratios (w/w) [OFMSW: SS: MC= 3:1:1, 3:2:1, and 3:3:1]. Results showed that the pile [3:1:1] was most beneficial to composting. The final compost products contained a
... Show MoreAn intelligent software defined network (ISDN) based on an intelligent controller can manage and control the network in a remarkable way. In this article, a methodology is proposed to estimate the packet flow at the sensing plane in the software defined network-Internet of Things based on a partial recurrent spike neural network (PRSNN) congestion controller, to predict the next step ahead of packet flow and thus, reduce the congestion that may occur. That is, the proposed model (spike ISDN-IoT) is enhanced with a congestion controller. This controller works as a proactive controller in the proposed model. In addition, we propose another intelligent clustering controller based on an artificial neural network, which operates as a reactive co
... Show MoreAbstractOBJECTIVES: To evaluate the long-term remission efficacy and safety of isotretinoin in the treatment of Behcet's disease (BD). PATIENTS and METHODS: This single-blind, controlled therapeutic study was conducted in the Department of Dermatology and Venereology at Baghdad Teaching Hospital from February 2011 to January 2012. Thirty patients with BD were included in this work. Each patient received isotretinoin 20 mg orally once daily for 3 months. They were assessed at week 2 and then monthly depending on the Clinical Manifestation Index (CMI) and to record any side effects. At week 12, isotretinoin was stopped and patients were given placebo therapy in a form of glucose capsules for another 3 months. RESULTS: Thirty patients were tre
... Show MoreThe research aims to demonstrate the dual use of analysis to predict financial failure according to the Altman model and stress tests to achieve integration in banking risk management. On the bank’s ability to withstand crises, especially in light of its low rating according to the Altman model, and the possibility of its failure in the future, thus proving or denying the research hypothesis, the research reached a set of conclusions, the most important of which (the bank, according to the Altman model, is threatened with failure in the near future, as it is located within the red zone according to the model’s description, and will incur losses if it is exposed to crises in the future according to the analysis of stress tests
... Show MoreThe study aimed to identify the importance of time in the Faculties of Physical Education and Sports Sciences at the University of Baghdad, as well as to identify the relationship between time management and the level of staff functional performance. The research population consisted of the staff members who work in the Faculties of Physical Education and Sports Sciences for Girls in Al-Jadriya for the academic year 2017-2018. A random sample of 50 staff members from each faculty were selected, that is the total number was (100) staff members. The researchers identified the concept of time management and functional performance, after that a questionnaire consisting of (39) statements and (6) parts presented to a specialized group of experts
... Show MoreMany managers in geometrical and technical organizations prefer to deal with quantitative values to choose between the available options and choose the best alternative to avoid randomization and bias in decision making. One of them Baghdad Water Department, which seeks to develop the quality of its product (drinking water) and achieve its objectives under increasing growing population and the demand for water, Some of TQM tools, especially the statistical, have this ability because there is chance to use historical data and experiment of employees in Application . Two statistical tools were applied: the nominal group technique, matrix data analysis technique as well as the brainstorming tool to search for the best o
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