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.
Contracting companies play a prominent role today in economic activity, due to their contribution to the implementation of major construction projects which together constitute the infrastructure of society. Most construction projects also suffer from exceeding the time and cost specified and planned for the completion of the project, and this comes for several reasons, including the work environment, country conditions, The method of managing project costs and the techniques used in its implementation Accordingly, the concepts of lean construction came, which help in addressing the causes of waste, both in time and cost, in addition to the fact that project management needs techniques that are useful in controlling the control and manag
... Show Moreيهدف هذا العمل الى بيان طبيعة العلاقة بين الادارة بالتجوال والتجديد الاستراتيجي ، ومدى تأثير المتغير المستقل في المتغير التابع. تضمنت فقرات الاستبانة بوصفه الأداة الرئيسة لجمع البيانات ثلاث جوانب اساسية، تضمن الاول البيانات الشخصية للمستجيبين، فيما تضمن الجانب الثاني الفقرات الخاصة بمتغير الادارة بالتجوال من خلال خمسة ابعاد، فيما اشتمل الجانب الثالث على فقرات التجديد الاستراتيجي عبر تناول اربعة ابعاد. ي
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(13)
Human Resources Management Practices (HRMP) and managerial control represent two academic fields that have been and still are the focus of many studies. However, merging both fields and studying the relationship that connects them and also the role that HRMP play in achieving the requirements of managerial control represents a new and novel study according to the available literature in these fields.
To achieve these goals, this study has been conducted, using the surveying questionnaire method, on a sample of ten general inspector offices in Iraq that work in the field of control for ministries and independent committees. A questionnaire has been used to collect the data which was analyzed with several s
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(1)
Sewage pumping stations are considered an important part of any sewerage system. Pumps failure in these stations means that the pumps are unable to work at the design requirement (flow capacity and head) and that may cause sewer overflow and flooding leading to sewer deterioration. In this paper, two main sewage pumping stations in Baghdad city were selected as case studies, Al- Habibia and Al-Ghazali located on Zublin trunk sewer 3000 mm and Baghdad trunk sewer 1200-2100 respectively. This study focused mainly on the operation of main sewage pumping stations and their effect, both directly and indirectly, on changing hydraulic properties, which leads to an increase in the deterioration of sewage pipes. The hydraulic analysis was co
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(26)
Management of Foreign Exchange Rate Exposure by Using Financial Hedging An Analytical Empirical Study The main purpose of this Research is to investigate the ability to reduce the effect of exchange rate fluctuation on firm value , by usage appropriate hedging strategies to provide the firms force to adopted with complex and highly uncertainty conditions , characteristic of the most of the financial markets . The field of this study is the giant five Multinational on the world. Nokia, Toyota Motor, Intel , Coca Cola, Microsoft. practical analysis is provide the truth of all study's hypothesis , and it is reach to many of conclusion, the most important of them is Stem from unexpected fluctuation on nominal ex
... Show MoreBackground The traditional management of appendicular mass is an initial conservative treatment followed by interval appendectomy. Recently interval appendicectomy has been questioned.
Objective: The purpose of this study was to clarify the need and the role of interval appendicectomy after successful initial conservative treatment.
Method: This is a prospective study conducted in a major hospital in Basra from April 2006 to Septemper2010, included 65 patients with appendicular mass which subsequently proved postinflammmatory (phlegmonous) changes of the appendix were treated conservatively.
Results: Routine interval appendicectomy was not performed and needed after successful treatment in the majority of the patients (84.6%). F
Abstract
The mine object for this research is determine the nature of the relation and effect between Human resources management strategic to less the work stress , Human resources management strategic represent a set of procedures and practices to manage the human resources at the organization. the stress of work effect on the performance of the human resources , al rasheed bank select to applied the qustioneer on the 32 person the work on the sebaa branch , using the qustioneer as a tool to collect data that is design according some of the standards and make the validity and stability. to analyses this data by using spss for computation " percentage , mean , standard , deriation
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This research dealt with the process of reducing costs through some strategic methods of management accounting targeted cost analysis unassembled and Alkeisen, where he focused this research through his theory on a review of some administrative accounting strategic technologies, while the second practical side through the application of targeted cost analysis unassembled and Alkeisen, acquired Search importance of focusing on the decisions to cut costs, through the use of some administrative accounting strategic methods and this we can unassembled analysis, continuous improvement, and the cost of quality) when applied quality, "in light of this has been reached to a set of conclusions that the most important of the company's relian
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