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
Aromaticity reversals between the electronic ground (S0) and low-lying singlet (S1, S2) and triplet (T1, T2, T3) states of naphthalene and anthracene are investigated by calculating the respective off-nucleus isotropic magnetic shielding distributions using complete-active-space self-consistent field (CASSCF) wavefunctions involving gauge-including atomic orbitals (GIAOs). The shielding distributions around the aromatic S0, antiaromatic S1 (1Lb), and aromatic S2 (1La) states in naphthalene are found to resemble the outcomes of fusing together the respective S0, S1, and S2 shielding distributions of two benzene rings. In anthracene, 1La is lower in energy than 1Lb, and as a result, the S1 state becomes aromatic, and the S2 state becomes anti
... Show MoreThe primary focus of the study factor reverse polymerization styrene polymer kinetics and distribution weight Aljaia in Blma Aldhur free reverse The study was conducted wi Mamahakah and using the Monte Carlo method
There is a real problem when adding micro elements to the soil as a result of fixation, sedimentation, washing or toxicity, and thus economic loss. The plant needs micro elements in very small quantities that do not burn the leaves or cause poisoning to plants, including iron, zinc and boron, as they are essential elements for growth and completing the plant's life cycle, and increase the plant's resistance to diseases and insects, activate enzymes, and form the chlorophyll molecule, in addition to their role in oxidation and reduction processes and vital processes. The use of fertilizers with their modern technology has made the process of activating seeds or foliar nutrition a matter of interest to researchers as a complementary process t
... Show MoreSince I live in a society in which violence has become widespread, and killing among its own people flared up till they began to kill under the excuse of taking shelter, in these pages I would like to explain the status of taking shelter in the light of Islamic Law (Sharia), exploring scholars’ opinions in the legitimacy or illegitimacy of this issue according to the legal standards.
And, to acquaint people, and myself in the first place, with the true nature and the gravity of this issue; to expose it to those who are unaware of it; to remind those who are already aware of it. I would refute the fabrications, remove the suspicions which surround it untill it made the forbidden permissible; the wrong right. I would explain to those
The Civil Rights era has been an era of struggle for the African American in the
Unites states. Thus, many writers devoted their writing to reflect the racism and
discrimination that many have suffered from, among them is Ralph Ellison.
Ralph Ellison is a 20th century African-American writer and scholar best known for
his renowned, award-winning novel Invisible Man. He illustrates the powerful
social and political forces that conspire to keep black Americans in their place,
denying them the right to life, liberty, and the pursuit of happiness guaranteed to all
Americans. Invisible Man is a 1952 novel that addresses many of the social and intellectual
issues facing African-Americans in the twentieth century. It exa
Background: Pregnancy is considered a major risk factor for development and progression of periodontal disease. There are hormonal changes in both estrogen and progesterone hormones in addition to bacterial effect and poor oral hygiene that will enhance development of periodontal disease in pregnant women. Materials and methods: Seventy subjects were enrolled in the study, the subjects with an age range (20-35) years old without any history of systemic disease. The subjects were divided into 20 non-pregnant women they represent the control group (G I), 30 pregnant women with gingivitis (GII) and 20 pregnant women with periodontitis (GIII).All periodontal parameters (plaque index, gingival index, bleeding on probing, probing pocket depth an
... Show MoreWe presented here a 25years old lady with a multiple hatdtid cysts in lung and liver and spleen in large number in each organ. Which regarded inoperable and difficult to treared.We use medical treatment with antihelimenthes drugs in new regime and follow-up over 1year clinically, laboratory investigations, U/s and CT.scan. There was good disappearance of liver and spleen cysts with very good response in lungs.
Discourse markers are expressions used to connect sentences to what comes before or after and indicate a speaker's attitude to what he is saying.As linguistic items, they have important functions in discourses of various styles or registers. And being connective elements, discourse markers relate sentences, clauses and paragraphs to each other. "One of the most prominent function of discourse markers, however, is to signal the kinds of relations a speaker perceives between different parts of the discourse". (Lenk 1997: 2) Through political discourse, different types of discourse markers are used. This paper deals with the importance and functions of discourse markers and tries to shed light on the kinds of discourse markers used in polit
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