Acute decompensated heart failure (ADHF) is a leading cause of hospital admission and many factors are known to precipitate decompensation. We aimed to assess the decompensating factors of heart failure and the management of patients admitted to the emergency department (ED). A total of 107 patients were examined, all diagnosed with ADHF in the ED of the Baghdad Teaching Hospital, from June 2017 to December 2017, and presenting with decom¬pensation (pulmonary oedema, peripheral oedema, and fatigue). The mean patient age was 62.5 ± 9.8 years (range: 43–85 years); the majority of them were in their 7th decade (37.4%), and men were slightly more than women. Hy¬pertension was the most commonly associated comorbidity (68.2%), followed by diabetes mellitus (57.9%), coronary artery disease (51.4%), dyslipidaemia (37.4%), arrhythmia (28%), and chronic obstructive pulmonary disease / asthma (23.4%). The most common presentation was pulmonary oedema (88.8%) followed by peripheral oedema (61.7%), and fatigue (26.2%). Uncontrolled hypertension was the most common precipitating condition for decompen¬sation (58.9%), followed by infection (39.3%), acute coronary syndrome (31.8%), arrhythmia (27.1%), non-compliance (11.2%), and anaemia (2.8%). The majority of the admitted patients were managed with intravenously-administered (i.v.) diuretics (92.5%) that may have been combined with oxygen therapy (63.6%), antibiotics (58.9%), β-blockers (50.5%), nitroglycerin (40.2%), i.v. fluids (38.3%), and/or digoxin (19.6%).
Image segmentation using bi-level thresholds works well for straightforward scenarios; however, dealing with complex images that contain multiple objects or colors presents considerable computational difficulties. Multi-level thresholding is crucial for these situations, but it also introduces a challenging optimization problem. This paper presents an improved Reptile Search Algorithm (RSA) that includes a Gbest operator to enhance its performance. The proposed method determines optimal threshold values for both grayscale and color images, utilizing entropy-based objective functions derived from the Otsu and Kapur techniques. Experiments were carried out on 16 benchmark images, which inclu
Th paper scientifically deals with the Syrian crisis events erupted in 2011 using the historical descriptive and analytical approaches. The importance of the paper comes from the serious crisis that occurred in a region rich of historical crises, and natural resources attracting the attention of the major countries. The paper aims to show the Syrian crisis, its importance to Russia, the United States, and the regional countries, its impact on Russia economically and politically after the intervention, and Russia’s achievements on a global level holding the influential power on international decisions and other global events. The new Russian strategy has proven its worth in preserving its strategic interests as it could help the Syrian
... Show MoreIn front of the serious deterioration of the elements of the environment, new convictions arose the need to integrate into the global environmental concerns as being one and the issue of shared responsibility and the impact of this conviction, the evolution of the environment protection law in many countries, including Algeria. Due to the multiplicity of perceptions about the environmental result of multiple scientific disciplines, the legislative concept emerged to protect the environment, which includes prevention and rational management and conservation and restoration and repair.
Environmental planning for the various governments and countries aims to avert disasters and achieve the
... Show MoreThe topic of the research tagged (narrative structure and its impact on building open and closed endings in the fictional film) is summarized by studying the mechanism of employing closed and open endings in the fictional film. novelist, then the need for it, as well as the objectives of the research and clarifying its limits as well as its importance. Then moving to the theoretical framework, which included three topics, where the first topic was entitled (the cinematic construction of the film narrative), either the second topic (the structure of complexity and narrative solutions), or the third topic dealt with the subject (the structure of the end and its relationship to the construction of the narrative). After completing the theore
... Show MoreThe demand for expatriate labor to Iraq increased after 2003 as a result of the openness that Iraq experienced, but this expatriate labor, which was requested at an increasing rate, has had economic, social, and political effects on the Iraqi economy in general, and the Iraqi labor market in particular. This is due to the high rates of unemployment, as most of these expatriate workers cause competition to local labor, and thus cause repercussions on the Iraqi economy as a whole, except for those expatriate workers coming with companies working in the oil sector. Iraq's GDP
Economic analysis plays a pivotal role in managerial decision-making processes. This analysis is predicated on deeply understanding economic forces and market factors influencing corporate strategies and decisions. This paper delves into the role of economic data analysis in managing small and medium-sized enterprises (SMEs) to make strategic decisions and enhance performance. The study underscores the significance of this approach and its impact on corporate outcomes. The research analyzes annual reports from three companies: Al-Mahfaza for Mobile and Internet Financial Payment and Settlement Services Company Limited, Al-Arab for Electronic Payment Company, and Iraq Electronic Gateway for Financial Services Company. The paper concl
... Show MoreBackground: Diagnosis and treatment planning can be difficult with conventional radiographic methods as the orthodontic-surgical management of impacted canines requires accurate diagnosis and precise localization of the impacted canine and the surrounding structures. This study was aimed to localize and evaluate weather there is any differences in the diagnostic information provided by multi-slice computed tomography three dimensional volumetric CT images and two dimensional reconstructed panorama images (derived from CT) in subjects with impacted maxillary canines. Materials and Methods: Thirty patients including 24 female and 6 male with mean age of 18 years with suspected unilaterally or bilaterally impacted maxillary canines were evalu
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