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.
(19)
To identify and explore the factors nurses perceive as influencing their knowledge acquisition in relation to diabetes care and its management in Saudi Arabia.
Diabetes continues to pose major healthcare challenges despite advances in diabetes management. Nurses have a crucial role in diabetes care, but diabetes knowledge deficits deter effective collaboration with other healthcare providers in educating patients about diabetes self‐management.
An exploratory descriptive qualitative design.
(20)
(26)
(2)
(45)
(39)
Abstract
The project of balad's major sewerage system is one of the biggest projects who is still in progress in salahulddin province provincial - development plan that was approved in 2013 . This project works in two parts ; the 1st is installing the sewerage networks (both of heavy sewerage & rain sewerage) and the 2nd is installing the life – off units (for heavy sewerage & rain sewerage , as well) . the directorate of salahuiddin is aiming that at end of construction it will be able to provide services for four residential quarters , one of the main challenges that project's management experience is how to achieve thes
... Show More
This study discusses risk management strategies caused by pandemic-related (Covid-19) suspensions in thirty-six engineering projects of different types and sizes selected from countries in the middle east and especially Iraq. The primary data collection method was a survey and questionnaire completed by selected project crew and laborers. Data were processed using Microsoft Excel to construct models to help decision-makers find solutions to the scheduling problems that may be expected to occur during a pandemic. A theoretical and practical concept for project risk management that addresses a range of global and local issues that affect schedule and cost is presented and results indicate that the most significant delays are due to a
... Show More
(6)
(7)
This study discusses risk management strategies caused by pandemic-related (Covid-19) suspensions in thirty-six engineering projects of different types and sizes selected from countries in the middle east and especially Iraq. The primary data collection method was a survey and questionnaire completed by selected project crew and laborers. Data were processed using Microsoft Excel to construct models to help decision-makers find solutions to the scheduling problems that may be expected to occur during a pandemic. A theoretical and practical concept for project risk management that addresses a range of global and local issues that affect schedule and cost is presented and results indicate that the most significant delays are due to a
... Show More
(6)
(7)
The problem of the study was to identify the possibility of benefiting from the application of the target cost system as a modern cost system to activate the environmental cost management instead of the traditional systems used in the company due to the great transformations witnessed by the business environment in all fields, which have resulted in the search for modern systems to provide more accurate and more appropriate information to reduce Costs, because accurate information makes the company have a complete vision to achieve the company’s goals. To solve this problem, the research was based on the following hypothesis (that the role of the target cost system leads to the activation of environmental cost management). Target c
... Show MoreThis research aims to identify and measure the role of TQM in the process of developing the financial performance of Diyala State Company and show the reality and obstacles, after applying the company's management to the requirements of ISO 9001: 2008 and compare it with its performance before applying this standard, The researcher measured the financial performance by conducting financial analysis of the financial statements and conducting a number of interviews at the company's headquarters, Diyala State Company (one of the Iraqi Ministry of Industry and Minerals formations) was sele
... Show More
BACKGROUNDS Nasoalveolar molding (NAM) application is among presurgical management (PSM) techniques used for infants with cleft lip and palate (CLP). It helps to approximate the palatal cleft and to reshape the nasoalveolar complex prior to primary lip repair. This study aimed to explore types of PSM and the dental speciality provision for infants with CLP in Baghdad. The status of NAM usage and surgeons’ perceptions toward NAM usage were assessed. MATERIALS AND METHODS This is a cross-sectional paper-based questionnaire study that collected responses of surgeons perform primary lip and nose repair regarding PSM. The questionnaire was distributed amongst public and private hospitals in Baghdad. Twenty surgeons were enrolled (only those su
... Show More
(1)