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%).
World War II has brought suffering for all people; it has led people to have a nostalgic feeling. The war has many faces all of them are ugly, like death, separation, loneliness, violence, crime, betrayal, and disconnection and many other meanings. Michael Ondaatje in his novel The English Patient (1992) portrays a picture of the effect of World War II on four different characters; Hana a Canadian nurse, The English patient who is Hungarian, Caravaggio a Canadian-Italitan thief, and Kip an Indian sapper. They live together in one house, share their secrets and memories about World War II. Ondaatje brings them together to reveal their secrets and to heal their wounds of the war experience.
Abstract
The current research aims to identify the level of organizational relaxation among the employees of educational directorates in the Sultanate of Oman. The descriptive approach was used, as well as a questionnaire of two parts to collect data. The questionnaire consists of (15) items divided into three themes about the relaxing level. It was applied on a sample of (406) male & female employees of the educational directorates who were randomly selected. The results of the study showed that the level of organizational relaxation was low. The study results also found that there were no statistically significant differences at the level of significance (α ≤ 0.05) of the study sample in the level of org
... Show MoreThis paper presents a computer simulation model of a thermally activated roof (TAR) to cool a room using cool water from a wet cooling tower. Modeling was achieved using a simplified 1-D resistance-capacitance thermal network (RC model) for an infinite slab. Heat transfer from the cooling pipe network was treated as 2-D heat flow. Only a limited number of nodes were required to obtain reliable results. The use of 6th order RC-thermal model produced a set of ordinary differential equations that were solved using MATLAB - R2012a. The computer program was written to cover all possible initial conditions, material properties, TAR system geometry and hourly solar radiation. The cool water supply was considered time
... Show MoreAbstract:
This tribe had lived in Iraq since the first century A.D. Persia tried to
keep this tribe away from Iraq, but without result. The tribe managed to get
victory against Persia in the battle of Dhyqar.
When the Muslims had come to conquer Iraq, Rabi’a welcomed them
and takes part in that action.
That tribe helped the caliph Ali in the Jammal and Sifffen wars in order
to remain Iraq the center of the Islamic caliphates this tribe had felt very sad
and sorrowful when the caliphate become to the Umayyad . This tribe did not
give up, so this tribe did what could be done to help those who had revolted
against the Umayyad. Rabi’a did that in order to get ride of the Mudriat alsham,
and favored Rabi
Satire is genre of the literary arts that has always been the source of human interest. Because it is difficult to accept direct criticism, Satire appears as a literary tool in which vices, follies, abuses and shortcomings are held up to ridicule, with the intent of shaming individuals, corporations, government, or society itself into improvement. A satirical critic usually employs irony to attain this goal. Although satire is usually meant to be humorous, its greater purpose is often profitable social criticism, using wit to draw at
... Show MoreThis study tackles the contribution of the environmental audit in achieving the sustainability of the environmental balance in the Sudanese business environment. The study aimed at clarifying the role of environmental auditing in supporting sustainable development, and to recognize the role of environmental audit in urging businesses to abide by environmental protection. It also shows how effective the environmental audit reports are, in providing the reliable data for the concerned authorities, in order to use it in making the decisions that would help in the sustainability of the environmental balance. To achieve the goals of the study, a questionnaire was developed and distributed to the registered chartered accountants in Sud
... Show MoreThis research aims to examine the relationship between learning organization and behavior of work teams. The variable of the learning organization took four dimensions depending on the study (sudhartna & Li, 2004): Common cultural values , communication, knowledge transfer and the characteristics of workers. The behavior of teams was identified on the basis of realizing of the respondents of their organization to work as a team where the research relied concepts applied in the study (Hakim , 2005) , and chose to research the case of a service organization for the study and relied on four dimensions of coordination , cooperation , sharing of information , the performance of the team, and was a curriculum approach and des
... Show MoreThis is a brief research in which I tried to briefly explain the care that the Holy Qur’an received during the era of the Prophet, may God bless him and grant him peace, from the Prophet, may God bless him and grant him peace, and all of his honorable companions, may God bless him and grant him peace. I made this research in an introduction and two chapters, the first chapter I made it entitled: About the Holy Qur’an, in which I talked about general investigations about the Holy Qur’an, such as the definition of the Holy Qur’an and the difference between it and the hadith Qudsi and the hadith of the Prophet, then I mentioned a part of the virtues of the Holy Qur’an in general and the virtues of some surahs in particular, and th
... Show More