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
Presentation of urinary calculus ranges from painful urination to acute retention. Diagnosed by x-ray pelvis and non-contrast CT and removal of stone by various methods is the management. Variety in symptoms, sometimes make clinical diagnosis difficult until radiological investigations confirm it. In this case presentation, initial diagnosis was made of Urethrocutaneous fistula may be due to distal stricture, but on investigating, he was diagnosed as urethral calculus in urethral diverticulum , as the reason for his symptoms
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This study attempts to address the importance of communicative digitization in the field of various arts for the sake of continuity of shopping and aesthetic, artistic and intellectual appreciation of artistic achievements by the recipient on various places of their residence in light of the COVID 19 crisis, and to highlight the importance of the plastic arts of the Iraqi painter exclusively and how it expresses in a contemporary way the environment or life reality in Iraq in light of this crisis. With all its implications affecting the life reality from various aspects and methods of its negative and positive employment. As for the research procedures, the researcher reviewed the research methodology represented by the descriptive ana
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The study aimed at identifying the mental capacity of the research sample and classifying them for the purposes of the study, preparing the scale of cognitive control of the subject of teaching methods of sports education, preparing educational units by establishing the question network for the subject of the teaching methods of sports education, and adopting the experimental method by experimental design workers (2×2) for the two groups The limits of the research community are represented by third-stage students of the Department of Physical Education and Sports Science in the morning study of the College of Knowledge, the Community University, which continues in the regular working hours of the year (2019-2020) adult Their number
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Background: Bone regeneration in dehiscence and fenestration defect can be improved with the use of platelet rich fibrin (PRF) that provides a scaffold for new bone regeneration. This study was conducted to assess the effectiveness of PRF as a graft material and membrane in dehiscence and fenestration defects. Materials and Methods: This prospective clinical study included patients who received dental implants that demonstrated peri-implant defects which were augmented using Leukocyte- PRF (L-PRF) or Advanced-PRF (A-PRF). Twenty four weeks postoperatively the defect resolution and the density of regenerated bone were assessed by CBCT and re-entry surgery. The assessment also included measurement of primary and secondary implant stability
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Abstract:
This Research aims to define role of the system of evaluating the performance for higher leadership in determining the level of institutional work quality in the Ministry of Agriculture, by measuring system efficiency of evaluating the performance for higher leadership and its effect in institutional work quality, the searcher reached through the theoretical framing and involved studies to build default plan define the relation between Research variables formed from system of evaluating leadership performance as independent variable contains six subsidiary dimensions: (Polarization, evaluating the performance of personnel, training, motivation, se
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This research aims to analyse the problem of organizations in general and universities in particular, in dealing with �quality subjects� in a world where these organizations face the risks of becoming side lined and possibly vanished without looking for solutions that allow them to move in an open arena where change becomes the key to those solutions. Change here must be strategic and planning must adopts a way for organizations to develop mechanisms to manage change itself. Management leaders play a central role in achieving the principle required to chart new trends for universities in dealing with quality as a strategy that allows excellence and competition in light of the success of the processes of change. Change through reengineer
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