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
Sildenafil, tadalafil, and vardenafil are phosphodiesterase type 5 enzyme (PDE-5) inhibitors used for the treatment of male erectile dysfunction. This present study aims to investigate 55 herbal products indicated for men’s sexual health from the Malaysian market for adulteration of PDE-5 inhibitors and analogues. The screening and identification of 20 PDE-5 inhibitors and analogues in herbal products of various forms (powder, capsules, tablets, and pastels) were conducted using gas chromatography–electron impact-mass spectrometer (GC-EI-MS). The analysis has shown that 19 herbal products were adulterated with PDE-5 inhibitors and analogues. Unique ion fragmentations and the presence of molecular
... Show MoreThe importance of the research lies in preparing an experimental curriculum according to a scientific method that will contribute to the development of the special strength(endurance the strength of arms) in order to contribute to the attempt to develop the basic skills of the national team players with the goal ball for the blind As for the research problem, it lies in the weakness of the strength endurance of the national team players with the goal ball for the blind, as the research problem is clearly evident in the last minutes of the match, as well as the former studies in the field of goal ball game for the blind at the country level The research aims to prepare special exercises for endurance of strength as well as t
... Show MoreThis research aims to demonstrate the impact of the going concern assumption in different accounting applications to provide a realistic look and more accurate result of activity and financial situation, as well as determining the responsibility of the Company's administration in compliance with the going concern assumption during the preparation for their financial statements, and to clarify the concept of integration between internal audit and external audit about going concern assumption, besides its importance and usefulness on the work of both of the internal auditor and the external auditor, as well as on the company under auditing process.This research purports preparing an internal audit program, including a set of auditing actio
... Show MoreBackground: Economic Globalization affects work condition by increasing work stress. Chronic work stress ended with burnout syndrome.
Objectives: To estimate the prevalence of burnout syndrome and the association of job title, and violence with it among physicians in Baghdad, and to assess the burnout syndrome at patient and work levels by structured interviews.
Subjects and Methods: A cross section study was conducted on Physicians in Baghdad. Sampling was a multistage, stratified sampling to control the confounders in the design phase. A mixed qualitative and quantitative
... Show MoreBackground: The bond strength of root canal sealers to dentin and gutta-percha seems to be an important property for maintaining the stability of root canal filling, which potentially influences both leakage and root strength. The objective of this, in vitro, study was to evaluate the shear bond strength of three different endodontic sealers (Gutta-Flow, AH Plus, Apexit Plus) to dentin, in the presence and absence of the smear layer and gutta percha. Material and Methods: After slicing off the occlusal 2mm of 60 extracted human maxillary premolar teeth, the exposed dentin served as the tested surfaces; the teeth were fixed with cold cure acrylic, and were divided into two groups according to the smear layer presence, group A without smear
... Show MoreThis study is planned to find relationship between interleukin-33 (IL-33) with its receptor interleukin-1 receptor 4 (IL-1R4), and assurance IL-33/IL-1R4 proportion as biomarker to atherosclerosisin rheumatoid arthritis (RA) Iraqi female’s patients with and without dyslipidemia. This study was attempted at Baghdad Teaching Hospital included 60 female’s patients with RA that were isolated into: 30 patients with dyslipidemia(G2), 30 patients without dyslipidemia(G3) and 30 individuals as control group (G1). Patients were experiencing treatment by methortexiene medication, analyzed by rheumatoid factor (RF) and erythrocyte sedimentation rate (ESR) tests. All patients and control groups age ranged from (30-55) years. The results show an inc
... Show MoreBackground: All diseases concerning bone destruction such as osteoporosis and periodontal diseases share common pattern in which the osteoclast cells are absolutely responsible for bone resorption that occurred when osteoclast activity exceeds osteoblast activity. Osteoprotegrin (OPG) considered as novel soluble decoy receptor known as “bone protector†since it prevents extreme bone resorption through inhibition of differentiation and activity of osteoclast by competing for binding site. It binds to receptor activator of nuclear factor kappa-B ligand (RANKL) and prevent its interaction with receptor activator of nuclear factor kappa-B (RANK), thus inhibits osteoclast formation. TNF-α is a pro-inflammatory cytokines having
... Show MoreBackground: Economic Globalization affects work condition by increasing work stress. Chronic work stress ended with burnout syndrome. Objectives: To estimate the prevalence of burnout syndrome and the association of job title, and violence with it among physicians in Baghdad, and to assess the burnout syndrome at patient and work levels by structured interviews. Subjects and Methods: A cross section study was conducted on Physicians in Baghdad. Sampling was a multistage, stratified sampling to control the confounders in the design phase. A mixed qualitative and quantitative approach (triangulation) was used. Quantitative method used self-administered questionnaires of Maslach Burn out Inventory. Qualitative approach used an open-end
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