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.
Abstract
Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through eviden
... Show MoreAbstract Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through evidence-based pricing decisions. O
... Show MoreBackground: Oxidative stress may contribute to the etiology of hypertension in humans. Oxidative stress is an imbalance between reactive oxygen species (ROS) and antioxidant defense mechanisms, causing damage to biological macromolecules and dysregulation of normal metabolism and physiology. Amlodipine as an antihypertensive agent is a long-acting calcium channel blocker that dilates blood vessels and improves blood flow. The aim of this study was to assess the oxidative stress in hypertensive patients on Amlodipine treatment through the assessment of salivary Malondialdehyde (MDA) and superoxide dismutase (SOD) as a marker of oxidative stress.
Mat
... Show MoreBackground: It has been well known that the success of mandibular implant- retained overdenture heavily depends on initial stability, retention and long term osseointegration this is might be due to optimal stresses distribution in surrounding bones. Types of mandibular implant- retained overdenture anchorage system and number of dental implants play an important role in stresses distribution at the implant-bone interface. It is necessary to keep the stresses below the physiologic tolerance level of the bone .since. And it is difficult to measure these stresses around bone in vivo. In the present study, finite element analysis used to study the stresses distribution around dental implant supporting Mandible implant retained overdenture Mate
... Show MoreSummary:
This research revolves around the probing of those whom Ibn Hajar said, "He has a vision", its significance, and the ruling on the connection and transmission to it. The number of narrators reached fifty-one (51) narrators, among whom it was said, “He has a vision, whether it is definite or possibly. Some of them had a vision and companionship.”They are eleven (11) narrators, And among them were those who had visions and had no company, and their number was twenty-one (21) narrators, and among them were those who had no vision and nor company, and their number is nineteen (19) narrators.
As a result , whoever said about him “has a vision” and has companions, his hadith is connected, even i
From 1979 to 1999 several theatricl groups had produced (Mackbeth) by shakespear which were directed by different director and the role being played by different actors. So the questions are: How did those a Iraqi actors approach that character by their performance? Did they interpret the character Truelly as the poet wanted to be. The researcher aims to find out the true performance by the actor who impersonate (mackbeth) as a wicked personality, who had un rational ambition. The researcher also aims to expose the style of acting fallowed by the Iraqi actors in that play. In chapter of review of literature, The researcher discusses the weaning and procedure of the actor performance which include characterization and transformation. He a
... Show MoreThis work presents a five-period chaotic system called the Duffing system, in which the effect of changing the initial conditions and system parameters d, g and w, on the behavior of the chaotic system, is studied. This work provides a complete analysis of system properties such as time series, attractors, and Fast Fourier Transformation Spectrum (FFT). The system shows periodic behavior when the initial conditions xi and yi equal 0.8 and 0, respectively, then the system becomes quasi-chaotic when the initial conditions xi and yi equal 0 and 0, and when the system parameters d, g and w equal 0.02, 8 and 0.09. Finally, the system exhibits hyperchaotic behavior at the first two conditions, 0 and 0, and the bandwidth of the chaotic
... Show MoreThe mechanical design of elevator elements is always performed by international standards. The engineer selects the appropriate elements of elevator according to catalogues without knowing scientific details. Therefore, a theoretical analysis is achieved at two operating conditions for guide rails (1) safety gear operation, and (2) running condition with the loads unevenly distributed on the elevator car. The guide rail is considered a continuous beam with variable supports. Then the British code is listed showing the equations used in it.
The theoretical equations showed that guide rails are never subjected to stress in simultaneous combined buckling and bending in the plane, where the bending moment is exerted. It is always a c
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