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
هناك دائما حاجة إلى طريقة فعالة لتوليد حل عددي أكثر دقة للمعادلات التكاملية ذات النواة المفردة أو المفردة الضعيفة لأن الطرق العددية لها محدودة. في هذه الدراسة ، تم حل المعادلات التكاملية ذات النواة المفردة أو المفردة الضعيفة باستخدام طريقة متعددة حدود برنولي. الهدف الرئيسي من هذه الدراسة هو ايجاد حل تقريبي لمثل هذه المشاكل في شكل متعددة الحدود في سلسلة من الخطوات المباشرة. أيضا ، تم افتراض أن مقام النواة
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Among the metaheuristic algorithms, population-based algorithms are an explorative search algorithm superior to the local search algorithm in terms of exploring the search space to find globally optimal solutions. However, the primary downside of such algorithms is their low exploitative capability, which prevents the expansion of the search space neighborhood for more optimal solutions. The firefly algorithm (FA) is a population-based algorithm that has been widely used in clustering problems. However, FA is limited in terms of its premature convergence when no neighborhood search strategies are employed to improve the quality of clustering solutions in the neighborhood region and exploring the global regions in the search space. On the
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Moisture damage is one of the most significant troubles that destroy asphaltic pavement and reduces road serviceability. Recently, academics have noticed a trend to utilize fibers to enhance the efficiency of asphalt pavement. This research explores the effect of low-cost ceramic fiber, which has high tensile strength and a very high thermal insulation coefficient, on the asphalt mixture's characteristics by adding three different proportions (0.75%, 1.5%, and 2.25%). The Marshall test and the Tensile Strength Ratio Test (TSR) were utilized to describe the impact of ceramic fiber on the characteristics of Marshall and the moisture susceptibility of the hot mix asphalt mixture. The Field Emission Scanning Electron Microsc
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In this paper we proposed a new method for selecting a smoothing parameter in kernel estimator to estimate a nonparametric regression function in the presence of missing values. The proposed method is based on work on the golden ratio and Surah AL-E-Imran in the Qur'an. Simulation experiments were conducted to study a small sample behavior. The results proved the superiority the proposed on the competition method for selecting smoothing parameter.
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in this paper the collocation method will be solve ordinary differential equations of retarted arguments also some examples are presented in order to illustrate this approach
In this paper, an exact stiffness matrix and fixed-end load vector for nonprismatic beams having parabolic varying depth are derived. The principle of strain energy is used in the derivation of the stiffness matrix.
The effect of both shear deformation and the coupling between axial force and the bending moment are considered in the derivation of stiffness matrix. The fixed-end load vector for elements under uniformly distributed or concentrated loads is also derived. The correctness of the derived matrices is verified by numerical examples. It is found that the coupling effect between axial force and bending moment is significant for elements having axial end restraint. It was found that the decrease in bending moment was
in the
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Aim: To determine the expression of tissue inhibitors of metalloproteinases (TIMP-2) in oral squamous cell carcinoma (OSCC) and the difference in its expression level between positive and negative HPV-16 (human papilloma virus- 16) OSCC patients. Methods: This study was conducted on 33 biopsies obtained from patients with OSCC and 10 normal oral mucosa as controls. In situ hybridization (ISH) was used to investigate the presence of HPV-16, while immunohistochemistry (IHC) was used to estimate the expression level of TIMP-2. Results: The TIMP-2 was expressed in 27 (81.8%) of OSCC sections with no significant difference between its expression level in HPV-16 positive and HPV-16 negative OSCC cases (p=0.058). TIMP-2 was found to be hig
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This research includes the study of dual data models with mixed random parameters, which contain two types of parameters, the first is random and the other is fixed. For the random parameter, it is obtained as a result of differences in the marginal tendencies of the cross sections, and for the fixed parameter, it is obtained as a result of differences in fixed limits, and random errors for each section. Accidental bearing the characteristic of heterogeneity of variance in addition to the presence of serial correlation of the first degree, and the main objective in this research is the use of efficient methods commensurate with the paired data in the case of small samples, and to achieve this goal, the feasible general least squa
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