Transient drop in the heart beat or transient heart block (AVB) may be consider the main cause of syncope or presyncope inpatients with bifascicular block and syncope According to the Guidelines for cardiac pacing pacemaker consider part of treatment. Aims of our study were to evaluate whether there is role for EPS in patients BFB and to evaluate the symptoms after pacing. 42 patients were enrolled in this study, with mean age value (63.4± 12.2years), suffer from interventricular conductive defect and syncope; patients underwent EPS on admission time, and pacemaker implantation accordingly and programmed follow up for the device in the last four years. Our patients were 25 (59.5%) male and 17 (40.5%)female, all of them with syncope or presncope and good left ventricular systolic function and the left ventricular ejection fraction (LVEF ≥55%). Left bundle branch block was found in 28 (66.71%) patients, while right bundle branch block were found in,14 (33.3) of them, the result of the EPS was find the cut of HV interval for pacing which represent that that the threshold at level of 75 have a sensitivity of 91% and specificity of 80%. The greater HV intervals gave more successful results for pacing. Pacemaker was implanted in 27 (64.3%) of the patients, with significant relation between pacing and syncope disappeared after pacemaker implantation (p value 000) and in 15 (35.7%) no pacemaker was implanted with persistent symptoms. Pacing were more between patients with coronary artery disease and LBBB with abnormal EPS finding. Permanent pacemaker implantation can implant directly in those old patients with syncope and bifascicular block that associated with LBBB and coronaries artery diseases without or before EP study
The international business environment faces many challenges, including the intensity of competition, the speed of expansion, and control of the market. This leads to its shadow on the local business environment, which prompted many economic units to adopt modern strategies, including mergers and acquisitions, for expansion and prosperity. The research was conducted to verify the role of internal audit in the governance of strategy operations (Mergers and acquisitions) and its reflection on management decisions and making them efficient and effective. Internal auditing is the independent variable related to the other variable, the governance of strategic operations and its impact on management decisions for strategic operations as a depende
... Show MorePoetry is regarded an interesting area of inquiry in linguistic studies due to its eccentric and aesthetic use of language. A lot of studies have been carried out so far for the analysis of poetry, yet few have dealt with pastoral poetry. The present research attempts to investigate the language of pastoral poetry in two different languages i.e. English and Arabic with the aim of finding similarities and differences. The data of the study consists of one English and one Arabic pastoral poems. Leech and Short's (2007) checklist is used as a model for analysis. The findings of the study reveal that there are more similarities than differences between English and Arabic pastoral poems as the poems rely on contrast in the use of the lex
... Show MoreThe research intent evaluates the performance of material technical department / Technical College -Baghdad.
The study depend on the descriptive analytical approach to determine and treating the variables to get data and information that related to study, the researchers depended on questionnaire designed for this purpose and contains eight main dimensions that’s are scientific reference , academy course, staff member , administrative system, physical facilities , student ,scientific research, graduate service , in addition each dimension involved (5) items contacted with mean dimensions, which translate aspects of performance evaluation, the questionnaire applied on two samples staff member
... Show MoreThis study is qualitative, it illustrates H.G. Wells\\'s The Time Machine through the scientific and social framework of the Victorian Era. Wells\\'s portrayal of future societies examines the rapid technological progress and social changes of the 19th century. The analysis scrutinizes the division between the Eloi and the Morlocks, tracing the consequences of social division. To meet the objective of the study, Victorian frame of mind is utilized to examine the class struggle that is symbolized by the Eloi and the Morlocks. The analysis highlights the economic and social effects of industrialization and how Wells examines the capitalist system and its impact on human relationships and class division. The study also utilizes concepts from D
... Show MoreCitrus fruit contain variety of flavonoids such as Hesperidin (the principal flavonoid in oranges and grapefruit). Hesperidin is found in high concentration in fruit peel of oranges and in substantially lower concentration in juice of these fruits. Hesperidin was extracted from oranges peel by treating the peels with calcium hydroxide. HPLC technique was used to determine hesperidin. Hesperidin was saperated and purified in a purity of about 90.1-95.7% and yield about 1.5 %w/w from oranges peel dry powder. Both hesperidin and oranges peel extract showed significan antibacterial activity. Sensitivity to hesperidin and oranges peel extracts were not similar for the chosen bacteriaCrude orange peel extract gave a various antimicro
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