Background: Dobutamine stress echocardiography (DSE) is a well established non invasive test for the diagnosis and risk stratification of patients with coronary artery disease. Aim of the study was to conduct a pilot study in order to establish the basis for the future routine practice of DSE in our center (Ibn Al- Bitar Hospital for Cardiac Surgery).
Patients and Methods: Fifty consecutive patients who were referred from the outpatient of our center, from August 2007 to July 2008, were included. The age range was 39 – 70 years with an average of 57.18 years. Fifty-eight percent were males. Patients were enrolled in the study in accordance with the American Heart Association/ American College of Cardiology guidelines, including mainly those who are unable to exercise due to an orthopedic problem (26%) or limited functional capacity (30%). Some Patients with resting electrocardiographic changes (20%) and non diagnostic exercise test (14%) were also included as well as five patients (10%) for the assessment of myocardial viability. The baseline echocardiogram was normal in 44 % of cases. Others had resting wall motion abnormalities due to previous myocardial infarction (50%) or left bundle branch block (6%). Dobutamine was given by a syringe or an infusion pump at incremental doses (every three minutes) of 5,10,20,30, and finally 40 μg/kg/min. Atropine was needed at peak test in 36% of cases to increase the proportion of patients who reach the target heart rate.
Results: The test was positive in 5 patients (10%); negative in 34(68%), non diagnostic in 2(4%), aborted due to intolerable symptoms in 3(6%) and stopped due to arrhythmias in 3(6%) patients. Side effects included chest tightness and irritability in 40%, headache in 12%, nausea and vomiting in 10%, and postural hypotension in 4%. Infrequent ventricular/atrial ectopics occurred in 13%, supraventricular tachycardia in one patient, and complex multiple ventricular ectopics in 3 patients; no incidence of sustained ventricular tachycardia or ventricular fibrillation occurred. There was no incidence of myocardial infarction or death.
Conclusions: DSE is a safe and practical test provided it is used according to the recommendedprotocols. A special unit for DSE in our centre is recommended.
The systems of governance in Europe are characterized by ancient democratic systems that have developed and developed through a long history of political conflicts that have emerged from a social reality that feeds them and receives the resulting effects. This is an achievement that has been achieved after the sacrifices and great efforts in formulating models of good governance through which to realize the aspirations of their peoples. . The democratic system operates within a balanced mechanism of two competing parties to manage and direct the work of the government and the parliament. The parties that achieve the majority in the elections carry out the functions of the government supported by their parliamentary base belonging to one
... Show MoreAbstract: E2F6 is a member of the E2F family of transcription factors involved in regulation of a wide variety of genes through both activation and repression. E2F6 has been reported as overexpressed in breast cancers but whether or not this is important for tumor development is unclear. We first checked E2F6 expression in tumor cDNAs and the protein level in a range of breast cancer cell lines. RNA interference-mediated depletion was then used to assess the importance of E2F6 expression in cell lines with regard to cell cycle profile using fluorescence-activated cell sorting and a cell survival assay using (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT). The overexpression of E2F6 was confirmed in breast tumor cDNA samp
... Show MoreBackground: Pyogenic discitis most frequently occurs
after home delivery, hemorridectomy, and dilatation and
curettage. Discitis is generally due to blood borne bacterial
invasion of the disc from adjacent end-plate via
communicating vessels. Infective discitis remains an
uncommon, but potentially serious cause for back pain.
Delayed diagnosis can occur and a high index of suspicion
may occur.
Methods: The study included 30 patients suffering from
localized low back pain with limitation of movement.
Diagnosis was made by history, physical examination and
investigation mainly E.S.R and MRI.
Results: 50.3% of patient with discitis had a history of
vaginal delivery, 15% had a history of hemorridectomy
Despite recent advances in both suture welding and knotless anchor technology, knot tying will remain a necessary skill which the surgeon must master when performing suture
anchor in laparoscopic surgery. There are an endless number of combinations of knots (sliding versus static, simple versus complex, etc.) and suture types (monofilament versus
braided) to accomplish this task. Surgeons are familiar with knotting but seem not to be aware of the possibilities and impact of the techniques of capsizing, flipping, and flyping
knots. (1) Capsizing refers to changing or perverting a flat knot’s geometry under asymmetric stress. The simplest examples of this is the change
Background: intestinal anastomosis is one of the most commonly performed procedures it required to reestablish gastrointestinal continuity after surgical resection, traumatic disruption or bypass procedures. In last decade, advances in intestinal stapling devices have led to an increased frequency of stapled anastomosis. There are varieties of proposed benefit from a stapled technique: better blood supply, reduced tissue manipulation, less edema, uniformity of suture, adequate or perhaps wider lumen at the site of anastomosis, ease and rapidity.
Patient and methods: a prospective study was conducted on 103 patients who suffered from benign and malignant diseases in addition to trauma patients. They were d
Background: (ABO) Blood type have an effect on general health including oral health as salivary physicochemical characteristics differ among different type of blood and as consequence these affect the severity of dental caries. The aim of the present study is an assessment of the prevalence of caries experience among different blood type in relation to salivary physicochemical characteristic. Materials and Methods: Two hundred and fifty females' college students in Al-Qadisyia University aged 18 years old were selected on random basis; they were divided to four groups according to their blood type, Dental experience was diagnosed and recorded according to DMFs (Mülemman, 1976) Index, this allows recording decayed lesion by severity. A su
... Show MoreBecome organizations today can not withstand the competitive challenges and constant change in the business environment , as well as the pressures witnessed by the Iraqi environment , especially in recent years such as the opening of the market which increased ambitious organizations and desire to secure the experiences superior to the survival and expansion of the competitive environment , prompting attention to the subject of vital contemporary is emotional Marketing and measure its impact on the customer experience in the sector of the economy is important and is the financial sector , so there is a need to study this term in the Iraqi organizations and try to diagnose the extent of implementation of the study sample emo
... Show MorePredicting vertical stress was indeed useful for controlling geomechanical issues since it allowed for the computation of pore pressure for the formation and the classification of fault regimes. This study provides an in-depth observation of vertical stress prediction utilizing numerous approaches using the Techlog 2015 software. Gardner's method results in incorrect vertical stress values with a problem that this method doesn't start from the surface and instead relies only on sound log data. Whereas the Amoco, Wendt non-acoustic, Traugott, average technique simply needed density log as input and used a straight line as the observed density, this was incorrect for vertical computing stress. The results of these methods
... Show MoreBackground: Data on the impact of neonatal and total pediatric admissions volume on neonatal mortality are sparse. Objectives: This study is done to estimate the neonatal mortality in relation to neonatal admissions and to total hospital admissions in Al-Alwyia Pediatric Teaching Hospital through years 2005-2012 Type of the study: A retrospective study.Methods: statistical records of all cases admitted to APTH were studied during 2005-2012.Results: Neonatal mortality decreased to the nadir at last year of study period (2012) and reached 6.1% of neonatal admissions compared to 2005 level which was 9.7 %. Mortality rate among premature and low birth weight (LBW) infants decreased also. The study also reveals that neonatal mortality constit
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