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%).
Over the course of two centuries, Portugal emerged as one of the most powerful European empires, with colonies stretching from Asia and Africa to Brazil. A significant factor in this expansion was the role of winds, which carried one of Cabral’s ships westward, landing unexpectedly on unknown shores—the Brazilian coasts. These territories later became some of Portugal’s richest and most important colonies. Therefore, the study begins in the 16th century and concludes at the end of the 17th century. The study was divided into four sections. The first section addressed Portugal's discovery 0022 of Brazil and its naming before it gained economic importance. The second section discussed the Portuguese occupation of Brazil in 1530 and its
... Show MoreThis study aims to reach the right of governorates that are not organized in a region to impose local legislation, including tax legislation, and the extent of the constitutionality of this legislation and its consistency with constitutional texts and legal rules. The imposition of local taxes finds its constitutional and legal basis in the Iraqi constitution for the year 2005 and the law of governorates not organized in a region.The imposition of local taxes corresponds to the principle of tax legality, which is reflected in the necessity of issuing tax laws from a competent authority, whether this authority is federal, regional or local. Rather, it is sufficient that it be competent
The Symbolic Interaction of the Kindergarten
The costume is a language that has carved itself into a path that is transformed over time in line with the development of human thought. The child theater is a form of communication between the individual and his society. The costume in the child's theater is seen as a sign of personality and identity. It is a model of communication that uses many of the world systems to which it belongs. Directed to the child by invoking the creative and creative energies of the designer in the formation of the children's theater. The second topic was the communicative function of secondary signs of uniforms and patterns of their transformations. The theoretical framework of the indicators included the on the research community. And his tools in the an
... Show MoreThis research deals with the most important grammatical views of the science of the media of the Arab and Andalusian grammar is: Abu Ali al-Shloubini, who filled his name the pages of important grammatical books such as: (singer Al-Labib) Ibn Ibn Hisham, and the book (like and analogues), and (Hama Alhwama) for Suyuti, and other books The task, I have divided my research into the topics: I talked in the first section on his life and his biography and his works, and the second topic: it included his independent opinions and the third section contained the most prominent views selected The fourth and final topic, was his responses to grammarians, and concluded my research with the most prominent findings Research to them, which was the mos
... Show MoreSince the law is the tool for implementing the state’s public policies, it is natural that its provisions (or at least some of them) seek to preserve human dignity as the source on which all rights and freedoms are based. One of the examples of humanizing the provisions of the law in France is what is known as the winter truce. What is this truce, what are the justifications for granting it, what is its historical origin, how did the legislative treatment of it develop, what are the similarities and differences between it and other legal periods included in French law, what is the scope of its application, and what are the effects resulting from it. These questions and others are what we will try to answer through this research.
This research attempts to evaluate the role of the information system by highlighting its importance in providing date and information to the tax administration the process of tax accounting for those who are subject to income tax whether they are individuals or companies where the effective information system provides accurate and reliable information in a timely manner.
At the theoretical part of the research, the research approaches the problem of the research represented in that whether the information system, applied in the General Commission for Taxes, is capable of achieving its role in reducing the phenomenon of tax evasion. The existence of a set of things which in the Commission may lead to increase tax evasion by taxpa
... Show MoreIn the construction of buildings usually, problems occur because of the causes of change orders. The main causer of change orders is the owners, consultants, and contractors. These changes lead to conflicts among them which result in influencing building projects. Therefore, it is necessary to analyze the causes of change orders to reduce them and facilitate management. This paper determines the most critical factors that cause change orders from a different point of view, a consulting owner and a contractor, and a study of the reality of the management of change orders when constructing public buildings. The method employed in this research is a field survey using interviews with experts working in the construction of p
... Show MoreThe research deals with A very important two subjects, computer aided process planning (CAPP) and Quality of product with its dimintions which identified by the producer organization, the goal of the research is to Highlight and know the role of the CAPP technology to improve quality of the product of (rotor) in the engines factory in the general company for electrical industries, The research depends case study style by the direct visits of researcher to the work location to apply the operational paths generated by specialized computer program designed by researcher, and research divides into four axes, the first regard to the general structure of the research, the second to the theoretical review, the t
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