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%).
Abstract
The research has discussed the public relations as dependent variable of its branch dimensions( confidence , commitment, control and satisfaction ) and the governmental service quality as independent variable of its branch dimensions (response, dependency, emphasis, tangibility and sympathy), and the research problem has represented by weakness of service quality presented to the customers dealing with company, which is observed via field co-existence of the researcher, where he observe that the quality presented in the company services, are inappropriate with the customers expectations level, also there is weakness of attention and recognition by the
Teaching through the system of personal learning, known as (Clare's plan) is amongst the most prominent plans which depend on self-education, as it received worldwide recognition. The plan lets the learner achieve learning by depending on himself after being familiar with the educational goals given to him, then he starts to solve the exercises and the drills accompanying the unit. After that, he checks his achievement by answering the self-evaluation tests. This method offers more opportunities for personal interaction than do the traditional systems, and individual leaning is a methodical expression aims at taking care of the learner and making him the locus of the processes of teaching and learning.
Aims of the study
... Show MoreThis research introduces a developed analytical method to determine the nominal and maximum tensile stress and investigate the stress concentration factor. The required tooth fillets parametric equations and gears dimensions have been reformulated to take into account the asymmetric fillets radiuses, asymmetric pressure angle, and profile shifting non-standard modifications. An analytical technique has been developed for the determination of tooth weakest section location for standard, asymmetric fillet radiuses, asymmetric pressure angle and profile shifted involute helical and spur gears. Moreover, an analytical equation to evaluate gear tooth-loading angle at any radial distance on the involute profile of spur and hel
... Show MoreAmong Persian poets and literary works, Ferdowsi and Shahnameh have a distinctive and prominent place. Since the 5th C. AH , they took the interest of all Persian language and literature scholars and were one of the first books to be translated into different languages including Arabic by Al Fatih Bin Ali Bin Mohammed Al-Bandari in the year of (620)AH .Because it was completed in the early 7th C. AH and in terms of antiquity, there is no older copy than of Al-Bandari’s version which holds great value in the analysis of Shahnameh other different copies.
To find out the how far analogy goes, the present paper makes a general comparisons of Bijan and Manijeh in Shahnameh Fer
... Show MoreThin films of (CuO)x(ZnO)1-x composite were prepared by pulsed laser deposition technique and x ratio of 0≤ x ≤ 0.8 on clean corning glass substrate at room temperatures (RT) and annealed at 373 and 473K. The X-ray diffraction (XRD) analysis indicated that all prepared films have polycrystalline nature and the phase change from ZnO hexagonal wurtzite to CuO monoclinic structure with increasing x ratio. The deposited films were optically characterized by UV-VIS spectroscopy. The optical measurements showed that (CuO)x(ZnO)1-x films have direct energy gap. The energy band gaps of prepared thin films
The Reasons behind the decadence of the studies concerning the evening school in Salah al Deen A field study
Monetary sterilization policies are one of the modern trends of monetary policy in rentier countries, specifically to confront the positive shocks in foreign assets flowing into the national economy and the impact of these shocks on monetary and real variables. And that the Central Bank contains these emergency increases in foreign exchange with the aim of avoiding the impact of this increase on the official local currency through its three main monetary tools, which are the rediscount rate, the legal reserve, and open market operations. As well as the relationship between the central bank and the objective of external balance, which is reflected in the balance of payments balance, the central bank resorts to managing the exchange rate
... Show MoreThe beginning of COVID-19 in Wuhan, China in late December 2019 and its worldwide transmission has led the World Health Organization to formally address the pandemic. The pandemic has imposed influential impacts on different environmental, economic, social, health, and living aspects. Publishing in scholastic journals was not immune from these impacts.
This work has been done with using of epoxy resin mixed with Granite powder were weighted by percent volume (5,10,15, and 20)%and then mixed with epoxy polymer to compose polymer composite. Hand lay-up technique is used in fabrication of the composite samples. Hardness test was carried out for the proper samples in both normal condition and after immersion in HCL (1 M and 2 M) solutions for periods ranging up to 10 weeks. After comparing the results between the polymer and their composite, the hardness increased with increasing Granite weight percent, it was found that Hardness were greater for the composites before immersion compared with their values after immersion.