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 Sarmord Formation is one of the overlooked formations that require more investigations than that achieved before. There are many problems in its definition, age, stratigraphy and aerial distribution. Previously in most parts of the Sulaymaniyah, it is not mapped and its outcrops combined with Balambo Formation while in the present study it is differentiated, mapped in the field on the Qaywan anticline and its problems discussed in details with a suggestion of solutions. For laboratory studies, 31 samples are taken on the Qywan Mountain (anticline) at 23 km north of the Sulaimani city for nannofossils biozonation. This study identified 19 species of the recorded calcareous nannofossils, the studied section reveals three biozones
... Show MoreOur research subject (environmental impact in the cultural output of the civilizations of ancient East) the environmental impact on human civilization and how her and adapted to serve in various cultural aspects especially in ancient cultures whether punches or sculptures and other addresses as well as tracing precious stones and raw materials. It was the environment of the civilizations of Mesopotamia and Egypt and another effective impact in drawing ancient history through human interaction and responsiveness. The Iraqi environment was marked by poverty and cruelty on the one hand and on the other cultural elements contributed to the civilization in General and research dealing with technical and product sourcing raw materi
... Show MoreIn light of crises, the need for efficient and flexible public administrations to make quick and decisive decisions, also institutions capable of directing the internal elements and components of them and adapting them to the requirements of rapid change due to crises and disasters, which led to scarce resources becoming scarcer and economic, political and social problems becomes more prominent. For the majority of developing countries, including Iraq, the increasing need for the importance of moving towards enhancing the efficiency of the performance of public institutions while trying to predict their future, can only be achieved. Through solid mechanisms and principles of governance that enhance the ability of institutions and make them
... Show MorePathogenic microorganisms from hospitals, communities, and the environment remain great threats to human health. The increasing concern about antibiotic resistance has also necessitated the search for robust alternatives. Therefore, this study aims to isolate, screen and evaluate the antibiotic susceptibility of Pseudomonas aeruginosa isolated from a soil sample taken from northern, western and eastern parts of Kelana Jaya Lake against four antibiotics (gentamycin, tetracycline, ampicillin, and penicillin) on a Mueller-Hinton Agar media plate. Pseudomonas identification was done by using API 20 kit. Disc diffusion was employed as well as the oxidase test. From the positive oxidase result, the isolated bacteria were identified as Burkhold
... Show MoreHaruki Murakami (1949-present) is a contemporary Japanese writer whose works have been translated into fifty languages and won him plenty of Japanese and international awards. His short stories are well constructed in a weird realistic manner and are mixed with elements of surrealism. His novels and short stories fall under the genre of magical realism. One of the major revolving themes that Murakami wrote about was the haunting feeling of emptiness and disconnectedness in a world which seems to care much for materialism and self-interests.
The paper explores two of Murakami’s short stories in his book After the Quake (2000) and the relevance of their themes and characters to Iraq after the q
... Show MoreConstruction projects have a special nature and affect them many factors making them exposed to multiple risks as a result of the length of the implementation period and the multiplicity of stages, starting from the decision stage through implementation until the final delivery, which leads to increased uncertainty and the likelihood of risk.
The process of analysis and risk management is one of the effective and productive methods that are used in managing the construction projects for the purpose of increasing the chances of ending the project successfully in terms of cost, time and quality and at the lowest possible problems.
The research aims first to the effective planning for analysis and risk managemen
... Show MoreCongenital distal vaginal obstruction is usually asymptomatic in a newborn female. On rare occasions, it may present as an acute emergency with life threatening complications.This paper is reporting the rare condition of two newborn females presenting urgently with abdominal distension and acute urinary retention as a result of congenital distal vaginal Obstruction. The case history and urgent management shall be presented and both conditions shall be discussed.
Recent studies agree that the democratic system in a country can only be established in an atmosphere of political and religious freedom. However, the term democracy and the term freedom have become controversial because their concepts remain multiple and different. Karl Popper is one of the most prominent philosophers in modern Western political thought, and one of the defenders of democracy as opposite to dictatorship. It has defined its function by its ability to restrain the ruling elite and to enforce it to prevent their tendency to tyranny. This can be achieved only in the context of the close relationship between democracy and freedom, so, if there is democracy in the absence of absolute freedom, democracy is a gateway to expandin
... Show MoreAlice Walker's novel The Color Purple1983, whose events take place in the rural Georgia and addresses the most important issues in the early 20thcentury; like male dominant society and women submission to men, weaves a mosaic picture of male-female relationships. Black men like Alphonso, Albert and Harpo are portrayed as oppressors, cruel and they exercise power and violence over their wives and daughters. Through the negative portrayal of black male characters, Walker is accused to be a men hating writer because she ''Views oppression as an essentially masculine activity which springs from the male's aggressive need to dominate. In the novel, man is the premium mobile, the one by whom and t
... Show MoreThe genus Latrodectus Walckenaer, 1805 (Araneae: Theridiidae) is a worldwide distribute genus (Graudins et al., 2001), it includes a group of species commonly referred to as widow spiders. It's considered a taxonomically complex genus as the status of several forms had not been properly evaluated and specific boundaries are not well defined or understood (Levi, 1959; 1967; Garb et al., 2001), therefore, in multiple cases, populations has been uncritically referred to as different taxa. Discriminating between Latrodectus species using morphology has always been problematic (Levi, 1983), it is difficult taxonomically and readily separated from members of other Theridiid genera (Mirshamsi, 2005). The Genus Asagena Sundevall, 1833 was revalidat
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