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%).
Laryngoscopy and tracheal intubation are considered the most invasive stimuli in anesthesia. They provoked cardiovascular responses that include hypertension, tachycardia and dysrhythmias. Various pharmacological approaches have been used to blunt or attenuate such pressor responses. The present study was designed to evaluate the effect of medazolom, lignocaine and propranolol as a valuable adjuvant to fentanyl in attenuating hemodynamic responses to endotracheal intubation in normotensive patients. Thirty two patient with physical status I or II according to the score of American Society of Anesthesiologist (ASA), scheduled for elective surgery under standard general anesthesia, were randomly allocated into four groups (8 patients in ea
... Show MoreThis paper examined accounting information systems (AIS) as a mediator between small and medium-sized enterprises (SMEs) strategies, including (finance source, administrative innovation, organizational culture, developing capabilities levels of SMEs, information source, development of business managers, and technological innovation) and organizational performance. In this quantitative study, 450 self-administered questionnaires were distributed to the managers and owners of SMEs using purposive sampling. Data were analyzed using the structural equation modeling (SEM) method via SmartPLS3 Software. The study offers empirical findings on the importance of AIS as a mediator, considers various factors, a
Nuclear structure of 29-34Mg isotopes toward neutron dripline have been investigated using shell model with Skyrme-Hartree–Fock calculations. In particular nuclear densities for proton, neutron, mass and charge densities with their corresponding rms radii, neutron skin thicknesses and inelastic electron scattering form factors are calculated for positive low-lying states. The deduced results are discussed for the transverse form factor and compared with the available experimental data. It has been confirmed that the combining shell model with Hartree-Fock mean field method with Skyrme interaction can accommodate very well the nuclear excitation properties and can reach a highly descriptive and predictive power when investiga
... Show MoreContemporary arts have achieved, in accordance with the transition of concepts, a new logic in presentation and expression in general, and specifically in the field of ceramic art. The shift towards the logic of rejection and subversion of prevailing methods, which have been almost a constant foundation for a long period, has directly influenced the direction of visual arts in the contemporary world.
The growth and cultural transformations that the world has witnessed after the two World Wars have produced cognitive shifts based on strategies that diverge from the dominant culture. These approaches vary according to existential needs, as the language of art has become conceptual and a medium for contemporary culture with its rapid an
Aim: The current study was aimed to determine the relationship between the orthodontic force applied by monobloc and the salivary level of alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) enzymes, considering the time factor after insertion of the appliance and whether there is a correlation between these enzymes. Materials and methods: A sample of 28 growing patients requiring orthodontic treatment with myofunctional appliance (Monoblock) was taken for the current study with an age range 9 to 12 years,all patients had Angle's class II division 1 malocclusion with no or mild crowding, the sample was selected using simple random sampling. Only 16 subjects (10 males and 6 females) were included who follow certain inclusion criteria.
... Show MoreAbstract
Performance evaluation is of great importance in all countries of the world, because it has a prominent and effective role in determining the efficiency and effectiveness of the optimal use of available resources, which are rare and important in achieving the desired objectives. With the continued growth of public spending and the limited resources, the State seeks to achieve its objectives through its units with minimal expenditure or deficit, rationality and wastefulness in the spending. In many countries, particularly developing countries, reforms are made in the public sector to achieve that goal through the adoption of IPSAS, which is reflected in the developmen
... Show MoreIn this study, high quality ZnO/Ag-NPs thin transparent and conductive film coatings were fabricated
The aim of the present research is to know the following : What are the Science and technology, society and environment issues (S.T.S.E) which included in the content of thechemistry Book second grade intermediate ? And to achieve the objective of search The two researchers has prepares a list of science and technology, society and environment issues (STSE) consisted of (9) key issues namely (Air quality and the atmosphere, sustainable development, water security, health and preventive security, mineral resources investment, pollution of various kinds, energy, food industry, production of weapons technology) and from which (70) sub-issues emerge,Arbitrators competent agreement has been received . Then, thetwo researchers analyzed the con
... Show MoreThe research aims to learn spatial disparities tracts of agricultural crops in the
province of Maysan and their relationship (the salinity of the soil and the degree of chemical
interaction (PH)) The research is divided into an introduction and three Investigation eat first
section spatial disparities agricultural crops (cereals, vegetables, legumes and forage). The
comparison between the years of production in the province where the province has seen
varied spatial by hand and taking second section degrees of soil salinity and its impact on
agriculture, as well as the chemical reaction (PH) and its impact on agriculture The third
section has been used three technical techniques first linkage and the second simple an