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
With the development of communication technologies for mobile devices and electronic communications, and went to the world of e-government, e-commerce and e-banking. It became necessary to control these activities from exposure to intrusion or misuse and to provide protection to them, so it's important to design powerful and efficient systems-do-this-purpose. It this paper it has been used several varieties of algorithm selection passive immune algorithm selection passive with real values, algorithm selection with passive detectors with a radius fixed, algorithm selection with passive detectors, variable- sized intrusion detection network type misuse where the algorithm generates a set of detectors to distinguish the self-samples. Practica
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This study was conducted with the aim to extract and purify a polyphenolic compound “ Resveratrol†from the skin of black grapes Vitis vinifera cultivated in Iraq. The purified resveratrol is obtained after ethanolic extraction with 80% v/v solution for fresh grape skin, followed by acid hydrolysis with 10% HCl solution then the aglycon moiety was taken with organic solvent
( chloroform). Using silica gel G60 packed glass column chromatography with mobile phase benzene: methanol: acetic acid 20:4:1 a
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The public budget is on the same time an art and a science .As an accountable science it seeks balance between public income and public expenditure for an accountable year. And as an accountable art it seeks to achieve economic balance by distributing equitable income in order to reach sustainable development .This is the optimal use of all natural and human resources to address scarcity of natural resources facing the increase need of human resources by spending on education, health, environment, housing, agriculture and industry to achieve social justice for the current generation and future generations. Since the first budget in Iraq on 1921 an accounting budget, is balancing the sections and items has been adopted and since the publi
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Native speakers of English from different parts of the world have different accents,but the differences of accents are mainly the result of differences in the sound of vowels and consonants . The actual use of all these sounds in combination leads the speaker to produce a number of segments which only appear on the production level and realized on the perceptual one . RP pronunciation represents the teachable variety in all Iraqi universities because it is the most acceptable and understandable accent all over the world and not only in South East London ..The structure of the English syllable in RP pronunciation is influenced by the appearance of certain allophones especially aspiration and glottalization which ch
... Show MoreThe research aims to study and assess the effectiveness of preventive measures banking for the reduction of money laundering based on the checklist (Check list), which have been prepared based on the paragraphs of some of the principles and recommendations of international and Money Laundering Act No. 93 of 2004 and the instructions thereto, to examine and assess the application of these measures by Gulf Commercial Bank, which was chosen to perform the search.
I've been a statement the concept of money laundering in terms of the definition and characteristics, stages and effects of political, economic and social as well as the nature of banking supervision in terms of the definition and the most important
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