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
Arabic calligraphy has great importance in the printing designs that are often on the written character-based to perform functional goals and to achieve some of the aesthetic values in design work, has led major developments in the field of computer manufacturing and design software for the design and layout to increase to deal with the programmed character for the purposes of typesetting has confronted this Find the Arab character programmed for the purposes of typesetting for the detection of the most important design interventions that underwent the Arabic letter written to turn it into a programmed image intended for the purposes of the printing and typesetting has been addressed in the context of which the theoretical types of
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It has become necessary to change from a traditional system to an automated system in production processes, because it has high advantages. The most important of them is improving and increasing production. But there is still a need to improve and develop the work of these systems. The objective of this work is to study time reduction by combining multiple sequences of operations into one process. To carry out this work, the pneumatic system is designed to decrease\ increase the time of the sequence that performs a pick and place process through optimizing the sequences based on the obstacle dimensions. Three axes are represented using pneumatic cylinders that move according to the sequence used. The system is implemented and
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In this paper the modified trapezoidal rule is presented for solving Volterra linear Integral Equations (V.I.E) of the second kind and we noticed that this procedure is effective in solving the equations. Two examples are given with their comparison tables to answer the validity of the procedure.
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In this work we investigate and calculate theoretically the variation in a number of optoelectronic properties of AlGaAs/GaAs quantum wire laser, with emphasis on the effect of wire radius on the confinement factor, density of states and gain factor have been calculated. It is found that there exist a critical wire radius (rc) under which the confinement of carriers are very weak. Whereas, above rc the confinement factor and hence the gain increase with increasing the wire radius.
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This study was designed to look for certain biochemical markers(serum uric acid and serum peroxynitrite) in women presented with obesity and to compare the level of these markers with non-obese women. A total number of 63 women were recruited from outpatients and private clinics to admit in this study. The patients were grouped into non obese women (Group I) and obese women (Group II). The anthropometric and blood pressure were determined and venous blood was obtained from each patient for determination of C-reactive protein, uric acid and peroxynitrite. The results showed that there were no significant differences in age or in concomitant or associated diseases in both groups except rheumatoid arthritis which account 80% of group I and 25%
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