BACKGROUND: Acute coronary syndrome (ACS) is the clinical manifestation of acutely diminished coronary arterial blood supply. The rate of increase of intraventricular pressure during isovolumetric contraction (left ventricular dP/dt) represents the rate of change of pressure during ejection. OBJECTIVE: The aim of this study is to evaluate the usefulness of the rate of increase of intraventricular pressure during isovolumetric contraction (dP/dt) in assessment of left ventricular function in patients with acute coronary syndrome and its relation to certain clinical and echocardiographic features. PATIENTS AND METHODS: The study is a cross sectional study including 50 patients with an established diagnosis of acute coronary syndrome. The study was performed in Baghdad Teaching Hospital during the period between 2/2/2013 and 5/3/2014. History was taken from all patients and recoded using a specially prepared questionnaire paper. Left ventricular internal dimensions at end diastole (LVIDd) and end systole (LVIDs) were measured using M-mode echocardiography to asses left ventricular systolic function (ejection fraction). Pulse Doppler tracing of the transmitral flow velocities and tissue Doppler image (TDI) mitral annular velocities were obtained from the apical four-chamber view to assess left ventricular diastolic function. Doppler-derived dP/dt was determined from mitral regurgitation (MR) spectral flow RESULTS: The study included 50 patients (31 males and 19 females, mean age of 65.26 ± 5 years). Low dP/dt values were found in 42 patients (84%). Low dP/dt values were found more in the age group (51-60 yrs) (p value < 0.05). The mean age of patients with low dP/dt (<1000) was (65.62 ± 5yrs) and that of patients with normal dP/dt (≥ 1000) was (63.38 ± 5 yrs) with no significant difference (p value > 0.05). Low dP/dt value was significantly associated with smoking and positive family history and not significantly associated with male sex, hypertension, and diabetes mellitus. No significant association was found between low dP/dt value and type of presentation of acute coronary syndrome (p value > 0.05) or ejection fraction (p value > 0.05). It was significantly associated with LV diastolic dysfunction, left atrial size, left atrial pressure, and left ventricular size (p value < 0.05). CONCLUSION: The use of dP/dt is useful for evaluating left ventricular function in patients with acute coronary syndrome.
Galway Kinnell (1927-) is considered as one of the most important contemporary American poets who brought about a drastic change in the American poetry of the nineteen sixties. Kinnell's poetry is characterized by being simple in style and deep in content. Poetry for him is a means through which he perceives the inner levels of consciousness in an attempt to comprehend the depths of the American self. Therefore, he writes narrative poems in which the emphasis is not on the rhetorical effects, but on the inner transformations through which the poet goes.
"The Bear" (1968) is typical of Kinnell's introspective poetry. It takes the form of a journey in which the rituals of hunting are used allegorically to embody the state of the sp
... Show MoreGalway Kinnell (1927-) is considered as one of the most important contemporary American poets who brought about a drastic change in the American poetry of the nineteen sixties. Kinnell's poetry is characterized by being simple in style and deep in content. Poetry for him is a means through which he perceives the inner levels of consciousness in an attempt to comprehend the depths of the American self. Therefore, he writes narrative poems in which the emphasis is not on the rhetorical effects, but on the inner transformations through which the poet goes.
"The Bear" (1968) is typical of Kinnell's introspective poetry. It takes the form of a journey in which the rituals of hunting are used allegorically to embody the state of the sp
... Show MoreIntroduction The pathophysiology of appendicitis likely stems from obstruction of the appendiceal orifice leading to an increase in intraluminal and intramural pressure, resulting in small vessel occlusion and lymphatic stasis. Organ supplied by an end artery, such as the appendix, are more prone to the deleterious effects of arterial occlusion. The continuous cigarette smoking might be associated with a greater risk for developing atherosclerosis.
Objectives The aim is to evaluate the effect of cigarette smoking on the incidence of complications of acute appendicitis.
Methods Patients suffered from symptoms and signs suggesting a
BACKGROUND: Acute appendicitis (AA) remains a complex case even for experienced surgeons. Rate of negative appendectomy is 5–40% and delayed intervention result in perforated appendicitis in 5–30% of cases. AIM: The aim of the study was to evaluate NPT as a marker for the diagnosis of AA concerning its severity. And compare the diagnostic value of it with the ALV scoring system. METHODS: One hundred twenty patients presented with signs and symptoms of AA and underwent appendectomy, only 84 patients proved to be AA by histopathological examination, were included in the study. Blood samples for neopterin (NPT) estimation and Alvarado (ALV) score was calculated. Control group consists of 45 healthy individual. RESULTS: NPT levels were s
... Show MoreBackground: The problem of difficult gallbladder is not clearly defined and associated with real missing of therapeutic approaches that decreased morbidity. Moreover, the difficult gallbladder was reported as a contributing risk factor for biliary injury due to raised difficulty in surgical dissection within Calot’s triangle. The aim of this study is to determine the surgical outcomes of the open fundus-first cholecystectomy in lowering the rate of lethal intraoperative risks.
Subjects and Methods: Our prospective study conducted during the period of January 2019 to December 2022 at Ibn Sina specialized hospital, Khartoum, Sudan, for two hundred and fifty-three patients underw
... Show MorePrevious data indicated the effectiveness of silibinin as intraocular pressure (IOP) - lowering agent. The present study was performed to evaluate the interaction of silibinin with pilocarpine or cyclopentolate in lowering IOP in normotensive rabbits. The effects of topically instilled silibinin hemisuccinate solution (0.75%) alone or adjunctly combined with 2% pilocarpine or 1% cyclopentolate on the IOP of normotensive rabbits were evaluated using indentation tonometry. The results showed that 0.75% solution of silibinin was found more potent than pilocarpine (2% drops) in lowering IOP of normotensive rabbits, while their combination results in longer duration of action. Moreover, the elevated IOP values produced by cyclopentolate (1%drops
... Show MorePrevious data indicated the effectiveness of silibinin as intraocular pressure (IOP) - lowering agent. The present study was performed to evaluate the interaction of silibinin with pilocarpine or cyclopentolate in lowering IOP in normotensive rabbits. The effects of topically instilled silibinin hemisuccinate solution (0.75%) alone or adjunctly combined with 2% pilocarpine or 1% cyclopentolate on the IOP of normotensive rabbits were evaluated using indentation tonometry. The results showed that 0.75% solution of silibinin was found more potent than pilocarpine (2% drops) in lowering IOP of normotensive rabbits, while their combination results in longer duration of action. Moreover, the elevated IOP values produced by cyclopentolate
... Show MoreTheoretical and experimental investigations of the transient heat transfer parameters of constant heat flux source subjected to water flowing in the downward direction in closed channel are conducted. The power increase transient is ensured by step change increase in the heat source power. The theoretical investigation involved a mathematical modeling for axially symmetric, simultaneously developing laminar water flow in a vertical annulus. The mathematical model is based on one dimensional downward flow. The boundary conditions of the studied case are based on adiabatic outer wall, while the inner wall is subjected to a constant heat flux. The heat & mass balance equation derived for specified element of bulk water within the annulu
... Show More