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
In-situ gelation is a process of gel formation at the site of application, in which a drug product formulation that exists as a liquid has been transformed into a gel upon contact with body fluids. As a drug delivery agent, the in-situ gel has an advantage of providing sustained release of the drug agent. In-situ gelling liquid suppositories using poloxamer 188 (26-30% W/W) as a suppository base with 10% W/W naproxen were prepared, the gelation temperature of these preparations were measured and they were all above the physiological temperature. Additives such as polyvinylpyrrolidin "PVP" ,hydroxylpropylmethylcellulose "HPMC", sodium alginate and sodium chloride were used in concentration ranging from (0.25-1
... Show MoreThe present study aimed to identify the extent to which the content of social and national studies courses was included in interactive thinking maps in the educational stages in the Kingdom of Saudi Arabia, and to achieve the goal of the study, the researcher used the descriptive and analytical approach, and the study tool used consisted of a content analysis card; Where it included a list of the types of thinking maps, where the study sample consisted of all social and national studies courses at the elementary and intermediate levels, and it is (12) books for the student in its first and second parts, and after verifying the validity and reliability of the tool, it was applied to the study sample, and the study reached conclusions, inc
... Show MoreThe challenges facing today's multi-customer and this is due to the multiplicity of products and speed in launching new products so search came to reveal the reveal the of the new product classification standards through a relationship (good products, low interest products, useful products and products desired) and the customer emotionally blackmail through deportation (fear, obligation and guilt). dentified the problem of the research in several questions focused on the nature of the relationship between the variables of research, and for that outline supposedly to search it expresses the head of one hypothesis and branched out of which four hypotheses subset, but in order to ensure the validity of the ass
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This research deals with the two item namely, the monetary policy central Bank of Iraqi and money supply . that contribute in up the problem of the paper that is concerned with the fact that to what extent the effectiveness of monetary policy conducted by the central Bank of Iraqi is valid in controlling money supply as well as the possibility of applying it in practical environment restricted to the scope of financial in stitiutions particularly in research population represented by central Bank of Iraqi .
For the purpose of a practical contribution for monetary and financial institutions . To achieve this , A hypothesis has been carried out and it suggested that the mon
... Show MoreThe research aims to; identify the management of conflict as perceived by secondary school managers toward the directors of directorates of education in wassat province, identify functional performance as perceived by secondary school managers toward the directors of directorates of education in wassat province. Besides, explore the relationship between Conflict management and functional performance among the directors of directorates of education in wassat province. A descriptive approach deemed more appropriate with study design. As a tool to collect the data of current research, the author used a questionnaire. Spss tools were used for data analysis
The research aims to evaluate the selected projects from the water Department of Baghdad, according to a standard for total quality management and to achieve this goal , adopted the case study method to get to know how close or turn away those projects in the management of Standard Malcolm Baldrige Award for Excellence in Quality Management its comprehensive one scales the world's most famous in this area , in order to draw a general framework to evaluate how project management can benefit from this approach to modern management , input from the entrances of the comprehensive management reform and development.
Be standard Malcolm Baldrige Award of several elements: - leadership , strategic planning , foc
... Show MoreBackground: Crohn's disease (CD) is an immunological disorder associated with chronic inflammatory process of several unspecific regions of gastrointestinal tract but frequently detected in the terminal Ilium and proximal colon or both. This disease frequently presented with various oral manifestations as a consequence of inflammatory process of the disease, nutritional deficiency or medications side effects. Several therapeutic approaches have been developed for CD management that are targeting the inflammatory process and directed at controlling the host immune response. Immunosuppressants such as Azathioprine and anti-TNF α agents as well as the combination of them have been widely used as an effective therapeutic modality with a bett
... Show MoreAround 65 million individuals suffer from epilepsy worldwide, and when it is not properly treated, it is linked to higher rates of physical harm and mortality. Due to the requirement for long‐term therapy and the side effects of many medications, medication compliance is a significant issue. The purpose of this review was to summarize the findings of previous studies examining the quality of life (QOL), adherence, patient education, and medication knowledge, as well as the impact of a pharmacist‐led educational intervention. Additionally, to find out if these studies benefit epileptic patients, to find the appropriate method used to help them in all aspects of their lives, and to use these in future studies. A systematic and comprehensi
... Show MoreAPDBN Rashid, Review of International Geographical Education Online (RIGEO), 2021
Two-dimensional unsteady mixed convection in a porous cavity with heated bottom wall is numerically studied in the present paper. The forced flow conditions are imposed by providing a hydrostatic pressure head at the inlet port that is located at the bottom of one of the vertical side walls and an open vent at the top of the other vertical side wall. The Darcy model is adopted to model the fluid flow in the porous medium and the combination effects of hydrostatic pressure head and the heat flux quantity parameters are carefully investigated. These governing parameters are varied over wide ranges and their effect on the heat transfer characteristics is studied in detail. It is found that the time required to reach a desired temperature at th
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