ABSTRACT: BACKGROUND: Left ventricular hypertrophy is a significant risk factor for cardiovascular complications such as ischemic heart disease, heart failure, sudden death, atrial fibrillation, and stroke. A proper non-expensive tool is required for detection of this pathology. Different electrocardiographic (ECG) criteria were investigated; however, the results were conflicting regarding the accuracy of these criteria. OBJECTIVE: To assess the accuracy of three electrocardiographic criteria in diagnosis of left ventricular hypertrophy in adult patients with hypertension using echocardiography as a reference test. PATIENTS AND METHODS: This is a hospital-based cross sectional observational study which included 340 adult patients with a history of hypertension (240 patients with left ventricular hypertrophy and 100 patients without depending on Echocardiographic results). Three electrocardiographic criteria including Sokolow Lyon Voltage, Cornell voltage, and Cornell voltage duration were evaluated for their sensitivity and specificity in detection of left ventricular hypertrophy in those patients. RESULTS: Each of older ages (over 50 years) (OR= (OR=6.25, 95%CI=3.75-10.39, p<0.001), male gender (OR=0.58, 95% CI= 0.36-0.93, p= 0.018) and type 2 diabetes mellitus (OR=8.14, 95%CI= 4.04-16.41, p<0.001) were significantly associated with development of left ventricular hypertrophy in patients with hypertension. The sensitivity and specificity of Sokolow Lyon Voltage, Cornell voltage, and Cornell voltage duration were 17.5% and 96%; 13.33% and 97%; and 10% and 98%, respectively. CONCLUSION: Older ages, male gender, and type 2 diabetes mellitus can increase the risk of left ventricular hypertrophy in hypertensive patients. All the studied criteria have low sensitivity and high specificity in recognition of the left ventricular hypertrophy in patients with hypertension, with no advantage of definite criterion over the others.
هناك دائما حاجة إلى طريقة فعالة لتوليد حل عددي أكثر دقة للمعادلات التكاملية ذات النواة المفردة أو المفردة الضعيفة لأن الطرق العددية لها محدودة. في هذه الدراسة ، تم حل المعادلات التكاملية ذات النواة المفردة أو المفردة الضعيفة باستخدام طريقة متعددة حدود برنولي. الهدف الرئيسي من هذه الدراسة هو ايجاد حل تقريبي لمثل هذه المشاكل في شكل متعددة الحدود في سلسلة من الخطوات المباشرة. أيضا ، تم افتراض أن مقام النواة
... Show MoreIn this paper, an exact stiffness matrix and fixed-end load vector for nonprismatic beams having parabolic varying depth are derived. The principle of strain energy is used in the derivation of the stiffness matrix.
The effect of both shear deformation and the coupling between axial force and the bending moment are considered in the derivation of stiffness matrix. The fixed-end load vector for elements under uniformly distributed or concentrated loads is also derived. The correctness of the derived matrices is verified by numerical examples. It is found that the coupling effect between axial force and bending moment is significant for elements having axial end restraint. It was found that the decrease in bending moment was
in the
Among the metaheuristic algorithms, population-based algorithms are an explorative search algorithm superior to the local search algorithm in terms of exploring the search space to find globally optimal solutions. However, the primary downside of such algorithms is their low exploitative capability, which prevents the expansion of the search space neighborhood for more optimal solutions. The firefly algorithm (FA) is a population-based algorithm that has been widely used in clustering problems. However, FA is limited in terms of its premature convergence when no neighborhood search strategies are employed to improve the quality of clustering solutions in the neighborhood region and exploring the global regions in the search space. On the
... Show MoreThis paper addresses the use of adaptive sliding mode control for the servo actuator system with friction. The adaptive sliding mode control has several advantages over traditional sliding mode control method. Firstly, the magnitude of control effort is reduced to the minimal admissible level defined by the conditions for the sliding mode to exist. Secondly, the upper bounds of uncertainties are not required to be known in advance. Therefore, adaptive sliding mode control method can be effectively implemented. The numerical simulation via MATLAB 2014a for servo actuator system with friction is investigated to confirm the effectiveness of the proposed robust adaptive sliding mode control scheme. The results clarify, after
... Show MoreThe reason behind choosing this topic " internal marketing (IM) of human resource management (HRM)" is to highlight the advantages of using IM in the organization framework. The problem of the research paper lies in not paying enough attention to employees genuine needs as they interact with each other in the sake of organization prosper. This research paper can be used as indictor to expose the weaknesses that the organization encounters daily. The current research paper attempts at examining the possibility of developing philosophy of internal marketing of human resources and its most practices, empowering staff, training courses, motivations and recognitions, and within departments communication, in order to reach targeted res
... Show MorePrevious data indicated the effectiveness of silibinin as intraocular pressure (IOP) - lowering agent. The present study was performed to evaluate the interaction of silibinin with pilocarpine or cyclopentolate in lowering IOP in normotensive rabbits. The effects of topically instilled silibinin hemisuccinate solution (0.75%) alone or adjunctly combined with 2% pilocarpine or 1% cyclopentolate on the IOP of normotensive rabbits were evaluated using indentation tonometry. The results showed that 0.75% solution of silibinin was found more potent than pilocarpine (2% drops) in lowering IOP of normotensive rabbits, while their combination results in longer duration of action. Moreover, the elevated IOP values produced by cyclopentolate
... Show MorePrevious data indicated the effectiveness of silibinin as intraocular pressure (IOP) - lowering agent. The present study was performed to evaluate the interaction of silibinin with pilocarpine or cyclopentolate in lowering IOP in normotensive rabbits. The effects of topically instilled silibinin hemisuccinate solution (0.75%) alone or adjunctly combined with 2% pilocarpine or 1% cyclopentolate on the IOP of normotensive rabbits were evaluated using indentation tonometry. The results showed that 0.75% solution of silibinin was found more potent than pilocarpine (2% drops) in lowering IOP of normotensive rabbits, while their combination results in longer duration of action. Moreover, the elevated IOP values produced by cyclopentolate (1%drops
... Show More