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
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Dylan Thomas (1914-1953) is a modern poet belongs to the apocalyptic movement of the 1940's.This movement is influenced by the doctrines and techniques of surrealism. Poetry for him should not be primarily concerned with man in society, but with the celebration of spiritual truth. It should bring to light the hidden causes, hence his personal interest is to strip darkness and explore the inward motives. To do this he uses a cluster of images: a constant building up and breaking down of images. His poetry depends on the romantic spontaneity, suggestiveness of the Symbolists and the the surrealists' mysterious liberation of the unconsciousness and the emotional involvement in the dynamics of life. In "Light Breaks
... Show MoreConsuming of by-product or waste materials in highway engineering is significant in the construction of new roads and/or in renovations of the existing ones. Pulverised Fuel ash (PFA), which is a by-product material of burning coal in power stations, is one of these materials that might be incorporated instead of mineral filler in hot asphalt mixtures.
Two types of surface course mixtures have been prepared one with conventional mineral filler i.e. ordinary Portland cement (OPC) while the second was with PFA. Several testings have been conducted to indicate the mechanical properties which were Marshall Stability and Indirect Tensile Strength tests. On the other hand, moisture damage and ageing have been evaluated
... Show MoreThis work has been accomplished through a dense field work on the Sawa Lake. The aim of this work is to highlight on characteristics that are consistent with outstanding universal values to be a new Iraqi site belongs to the World Natural Heritage. This study sorted many unique characteristics might ensure that Sawa Lake as a world natural heritage sites. This study shows that the lake had met four natural criteria of the outstanding universal values: (1) the seventh criterion which states to contain superlative natural phenomena or areas of exceptional natural beauty and aesthetic importance. (2) The eighth criterion which stated to be outstanding example representing major stages of earth's history, including the rec
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The advertising mail is considered as one of potential tools that followed to transfer the printed messages to the consumers and public customers whom are located at homes or works. This type of advertising is preferable due to the zero expense to receive the announcements of products, which became recently one of the successful procedures to create new customers and keep them in touch with direct communication. It is also possible to send them to specific group of people who can be classified by the advertisers to select even by name their own clients to give the personality to the clients for a long term of communication.
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The tourism industry has become, currently, an art, an industry and a science. It is also one of the components that make up touristic regions. Tourist attractions are no longer the exclusive visits of museums and archeological sites, but also involve other service facilities. It is, therefore, imperative that the authorities should become aware of the degradation of tourist resorts and prevent them from getting worse. Moreover, the authorities should take a set of decisions concerning the protection of the urban aspect with its historical, social, and environmental dimensions, as well as, adapting it to the modern requirements that can bring comfort to the citizens and tourists at physical and psychological levels.
The research explores the confessional aspect in Audre Lorde's poem" Who Said It Was Simple ". Lorde depicts her personality under the stress of race, sex and sexuality. She discloses her own bitter experience concerning racism, sexism and sexuality in her poem to revive the retrospective truth of the Afro-Americans' life in the USA. This publicly manifestation of her personality and tribulation throughthe language ofpoetry has been regarded as the hallmark of confessional poetry.
Metoclopramide HCl (MTB) is a potent antiemetic drug used for the treatment of nausea and vomiting. Many trials were made to prepare a satisfactory MTB orodispersible tablet using direct compression method.Various super disintegrants were used in this study which are croscarmellose sodium (CCS), sodium starch glycolate (SSG) and crospovidone (CP). The latter was the best in terms of showing the fastest disintegration time in the mouth.Among the different diluents utilized, it was found that a combination of microcrystalline cellulose PH101 (MCC 101), mannitol, dicalcium phosphate dihydrate (DPD) and Glycine was the best in preparing MTB orodispersible tablet with fastest disintegration time in the mouth.The physical parameters of the pre
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Recently, several concepts and expressions have emerged that have often preoccupied the world . around the concept of environment and sustainability. This is due to the negative and irresponsible impact of man and his innovations in various industrial and technological fieldsthat have damaged the natural environment. Architecture and cities at the broader level are some of the man made components that caused these negative impacts and in the same time affected by them. What distinguishes architectural and urban projects is the consumption of large . quantities of natural resources and production larger amounts of waste and pollution, along the life of these projects. At the end of the twentieth century and the beginning of the twenty-fir
... Show MoreThe aim of the current research is to study a topic from the Qur’anic topics, few have researched it and realized its content, so people knew it in one name in the Qur’an in another name, and due to the ancientity of the topic and its contemporaneity, I wanted to write about it. The research has an introduction, three demands, and a conclusion with the most important results of the research:
As for the introduction: It was to indicate the importance of the topic and an optional reason for it.
As for the first requirement: it included the definition of reasoning, its divisions, and its characteristics.
As for the second requirement, it was to indicate the meaning, types, and methods of labeling it.
As for the third require