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
This study aims to explore the potential mediation role of person-centeredness between the effects of the work environment and nurse reported quality and patient safety. A quantitative cross-sectional survey collected data from 1055 nurses, working in medical and surgical units, in twelve Malaysian private hospitals. The data collection used structured questionnaires. The Hayes macro explored the mediation effect of person-centeredness between the associations of work environment dimensions and care outcomes, controlling nurses’ demographics and practice characteristics. A total of 652 nurses responded completely to the survey (61.8% response rate). About 47.7% of nurses worked 7-h shifts, and 37.0% were assigned more than 15 pati
... Show MoreIn this article, the casting method was used to prepare poly(methyl methacrylate)/hydroxyapatite (PMMA/HA) nanocomposite films incorporated with different contents (0.5, 1, and 1.5 wt%) of graphene nanoplatelets (Gnp). The chemical properties and surface morphology of the PMMA/HA blend and PMMA/HA/Gnp nanocomposite were characterized using FTIR, and SEM analysis. Besides, the thermal conductivity, dielectric and electrical properties at (1–107 Hz) of the PMMA/HA blend and PMMA/HA/Gnp composites were investigated. The structural analysis showed that the synthesized composites had a low agglomerated state, with multiple wrinkles of graphene flakes in the PMMA/HA blend. The thermal conductivity was improved by more than 35-fold its value for
... Show MoreThis contribution provides an atomistic understanding into the impact of W, Nb, and Mo co-substitution at Hf-site of cubic HfO2 lattice to produce Hf1−xTMxO2 system at x = 25%. The calculations have been performed under the framework of density functional theory supported by Habbured parameter (DFT+U). Structural analysis demonstrates that the recorded lattice constants is in good coherence with the previously published results. For the lattice parameters, contraction by 1.33% comparing with the host system has been reported. Furthermore, the doping effect of TM on the band gap leads to its reduction in the resulting Hf0.75TM0.25O2 configurations. The partial density of states (PDOS) indicate that hybridization through localized electroni
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Praise be to Allah and prayers and peace be upon our Prophet, Muhammad, his family and all of his companions,
This research addresses the issue of judge's preaching to the litigants and witnesses; it is a very significant issue since the judge cannot know the insides and facts, but it issues judgments based on the hearings. Since people are originally wrong-doing and ignorant, they, therefore, commit injustice, oppression, false adversarial, and false testimony. However, some people can possibly retreat and return to the right, after being inattentive or recalcitrant, by preaching. This fact led scholars to talk about the judge's preaching to litigant and witnesses and this research is conducted
... Show MoreIn this paper the process of metal ions extraction (Zn(II) and Cu(II)) was studied in PEG-KCl aqueous two phase system was investigated without using an extracting agent. The experimental runs were performance at constant temperature (25 oC), constant mixing time (30 min), and constant PH of the solution (about 3). The effect of KCl salt concentration (from 10% to 25%), volumetric phase ratio of PEG solution to KCl solution (from 0.5 to 2), and the initial metal ion concentration (from 0.25 ml to 2 ml of 1 gm/L solution) were investigated on the percent extraction of Zn(II) and Cu(II). The results indicated that the percent extraction of metal ions increase with increasing of salt concentration and phase ratio, and slightly de
... Show MoreSummary The aim of this study is the evaluation the resistance of S. marcescence obtained from soil and water to metals chlorides (Zn+2, Hg+2, Fe+2, Al+3, and Pb+2). Four isolates, identified as Serratia marcescence and S. marcescena (S4) were selected for this study according to their resistance to five heavy metals. The ability of S. marcescena (S4) to grow in different concentrations of metals chloride (200-1200 µg/ml) was tested, the highest concentration that S. marcescence (S4) tolerate was 1000 µg/ml for Zn+2, Hg+2, Fe+2, AL+3, pb+2 and 300 µg/ml for Hg+2 through 24 hrs incubation at 37 Co. The effects of temperature and pH on bacteria growth during 72 hrs were also studied. S. marcescence (S4) was affected by ZnCl2, PbCl2, FeC12
... Show More4-amino-3-(4-(((4-hydroxy-3, 5dimethoxybenzyl) oxy) methyl) phenyl)-1, 2, 4-triazole-5-thione was synthesized by to method the first one from melt reaction of 4-(((4-hydroxy-3, 5-dimethoxybenzyl) oxy) methyl) benzoic acid with Thiocarbonyldihydrazide, the second method from convert the corresponded acid hydrazide to potassium 2-(4-(((4-hydroxy-3, 5-dimethoxybenzyl) oxy) methyl) benzoyl) hydrazinecarbodithioate salt then react with hydrazine hydrate. Newly Schiff base (7a-7f) were synthesized from reaction the 4-amino-1, 2, 4-triazol with substituted hydroxybenzaldehyde. The resulting compounds were characterized by IR, 1H-NMR, 13C-NMR, and HRMS data. 2, 2-Diphenyl-1-picrylhydrazide (DPPH) and ferric reducing antioxidant power (FRAP) assays
... Show MoreBrainstorming has been a common approach in many industries where the result is not always accurate, especially when procuring automobile spare parts. This approach was replaced with a scientific and optimized method that is highly reliable, hence the decision to optimize the inventory inflation budget based on spare parts and miscellaneous costs of the typical automobile industry. Some factors required to achieve this goal were investigated. Through this investigation, spare parts (consumables and non-consumables) were found to be mostly used in Innoson Vehicle Manufacturing (IVM), Nigeria but incorporated miscellaneous costs to augment the cost of spare parts. The inflation rate was considered first due to the market's
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