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
Banks face many of the various risks: which are of dangerous phenomena that cause the state achieved a waste of money and a threat to future development plans to be applied to reach the goals set by: prompting banks and departments to find appropriate solutions and fast: and it was within these solutions rely on Banking risk management and effective role in defining and identifying: measuring and monitoring risk and trying to control and take risks is expected to occur in order to encircle and make it in within acceptable limits: and try to avoid them in the future to reduce the losses that are likely to be exposed to the bank: and it began to emerge and dominate a lot of legislation that seeks to structure the year risk management and t
... Show MoreThe majority of the environmental outputs from gas refineries are oily wastewater. This research reveals a novel combination of response surface methodology and artificial neural network to optimize and model oil content concentration in the oily wastewater. Response surface methodology based on central composite design shows a highly significant linear model with P value <0.0001 and determination coefficient R2 equal to 0.747, R adjusted was 0.706, and R predicted 0.643. In addition from analysis of variance flow highly effective parameters from other and optimization results verification revealed minimum oily content with 8.5 ± 0.7 ppm when initial oil content 991 ppm, tempe
The important factor in the success of construction projects is its ability to objective estimate of the cost of the project and adapt to the changes of the external environment, which is affected by a lot of elements and the requirements of the competitive environment. The faces of those projects are several problems in order to achieve particular goals. To overcome these difficulties has been the development of research in the last two decades and turn the focus on the role of the cost of project management, by providing information and assist management in planning and control of the budget among the main elements of the project, namely, (time-cost-quality),The research aims at the possibility of developing and implementing mechanisms
... Show MoreObjectives: The study aims to (1) Assess the parents' efficacy for child healthy weight behavior. (2) Identify the difference in parents’ efficacy for child healthy weight behavior between the groups of parent’s gender, family’s socioeconomic status, child’s gender, and child’s birth order, (3) Find out the relationship between parents’ age, child’s age, child’s body mass index, family’s socioeconomic status, the number of children in the family and parents’ efficacy for child healthy weight behavior.
Methodology: A descriptive correlational study is conducted for the period from November 11th, 2018 to March 25th, 2019 to assess the parents' efficacy for child healthy weight behavior. The study was carried-out in (
Background: This study was aimed to investigate the effect of three lingual button (Nickel free / rectangular base, Nickel free / round base and Composite) and bonding environment, wet and dry enamel surface, on: the shear bond strength (SBS) of light and self-cured Resin Modified Glass Ionomer Cements, and the debonding failure sites. Materials and method: One hundred twenty no-carious, free of cracks maxillary first premolar teeth were selected. Three types of orthodontic lingual buttons were used in this study: Nickel free / rectangular base, Nickel free / round base and Composite buttons. The teeth were divided into two groups of sixty teeth each. One group was used for testing the chemically cured GC Fuji Ortho Resin modified Glass Io
... Show MoreA (k,n)-arc is a set of k points of PG(2,q) for some n, but not n + 1 of them, are collinear. A (k,n)-arc is complete if it is not contained in a (k + 1,n)-arc. In this paper we construct complete (kn,n)-arcs in PG(2,5), n = 2,3,4,5, by geometric method, with the related blocking sets and projective codes.