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.
Background :The incidence of bile ducts injuries( BDI )has risen from) 0.1 to 0.2%( to) 0.4 to 0.6% ( between the era of open cholecystectomy( O C) and the age of laoaroscopic cholycystectomy( LC.) The aim of the study is to review the management and surgical outcome of the bile duct injuries in gastroenterology and hepatology teaching hospital .Methods: This study is Prospective, done in G.I.T hospital ,From January 2008 –to –February 2011, patients included in this study had prevouse history of cholecystectomy which followed by sign and symptoms of bile duct injures .Most patients have been reffered from other hospitals,supprting therapy were given to them and investigations performed to evaluate the the type of injureis ,minor inj
... Show MoreAfrican-American writers during the 19th century wrote in the shadow of the prominent romance, sentimental, and domestic fiction. Harriet Wilson’s Our Nig (1859) reflects an “alternative social character”, for the female protagonist suffers racism in the free North, because she is a mulatto child. Through depicting the life of free blacks, who supposedly lives a better life than Southern slaves, Wilson exposes how she has actually lived and sensed life in antebellum America. According to Raymond Williams (2011), there are two kinds of literary writings. The first represents the general tendency of the age, and he calls it “dominant social character”; representing the majority content of both the public writing and speaking. But, a
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Abstract
Oil is the most important natural resources in Iraq and represents the goal to others as well as Iraqi people. It is gift from God to all Iraqi people now and future. So we must maintain it and invest its revenue that achieve development in country and ensure the next generations' rights in it without external costs or negative externalities from extracted and invested it.
The most problems that we attempt to solve by this research are the exhausted, environmental degradation and theft from next generation that produced with oil contracts between Iraq and foreign companies. From here was th
... Show MoreBackground: Obesity is becoming the healthcare epidemic world wide.Obesity is associated with reduced life expectancy, increased morbidity and mortality, and greater healthcare costs.Bariatric surgery is the only effective treatment for morbid obesity and is gaining increasing popularity. There has been a steady rise in the numbers and types of bariatric operations done worldwide in recent years butnon of prove to be ideal .Animal studies and use of animal models are significant element in the evolution of medical knowledge and the use of animals as a model for bariatric surgery is of importance to study the mechanisms of these operationsa and also help to develop new technique in management of obesity.Objectives:Study of effects of slee
... Show MoreThis study aims to identify the amount of the effect of the ability to learn the individuals within the organization on the accumulation of intellectual capital and the role it plays in improving the performance of the organization, and to achieve that, the researcher designed a questionnaire to collect data and information from the surveyed respondents and analyzed using SPSS software, the study concluded after testing hypotheses to have a direct impact between the capacity for organizational learning and the accumulation of intellectual capital, which in turn affects the accumulation of intellectual capital as a positive and direct impact on the performance of the organization, al
... Show MoreThe quality of groundwater is just as important as its quantity. The kinds and concentration of salts in groundwater depend on the environment, movement, and the source of the groundwater. During the field work, 20 samples have been collected from water wells from Al-Salman basin for two seasons represent wet and dry seasons in November 2017 and April 2018. After water well samples have been analyzed the Electrical conductivity values range from (2260 to 5500) μS/cm for dry season and range from (2540 to 5630) μS/cm for wet season, the Total dissolved solids values range from (1289 to 3582) ppm for dry season and range from (1710 to 3960) ppm for wet season, and pH values range from (7.11 to 7.3) for dry and wet seasons. The Hydroc
... Show MoreBackground: Adults with Acute Myelogenous Leukemia (AML) have the lowest survival rate of all leukemias. Complete remission (CR) rate after induction therapy is about 55-85%, however 30% of patients fail to achieve remission and they remain alive only for about a year. Consolidation chemotherapy results in 5-year overall survival (OS) of about 30%.
Objectives: To study characteristics of adult patients with AML who attended Baghdad Teaching Hospital, their response to induction therapy and then to consolidation therapy, and their 5-year (OS) and disease free survival (DFS).
Results: Eleven patients who received attenuated induction therapy had a median survival of 6-8 mon
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