Background: Mitral stenosis (MS) is the most common valve disease in developing countries and there are many ways to deal with this condition. The aim of this study was to evaluate the immediate results of percutaneous transvenous mitral commissurotomy (PTMC) in patients with severe symptomatic rheumatic mitral stenosis.
Patients and Methods: From May 2006 to August 2007, 58 patients (17 male, 41 female) with age range (16-57) years, underwent PTMC in Ibn AL- Bitar Hospital for Cardiac Surgery. All the patients were symptomatic, their MVA 1.5 cm2 with NYHA class II-IV. Clinical evaluation and echocardiographic examination were carried out before and after PTMC, mitral valve structures were assessed using Wilkins score. The procedure was performed under local anesthesia, using the step-wise Inoue balloon technique with the antegrade transvenous approach.
Results: The procedure was successful in 51(88%) of the patients and unsuccessful in the remaining 7(12%) patients. Successful result was defined as post procedure mitral valve area ( MVA) 1.5 cm² as assessed by echocardiography and no mitral regurgitation (MR)>2 according to sellers classification. Mitral valve area increased from 0.93 ±0.2 to 1.84±0.2 cm² after the procedure (P<0.001) as measured by echocardiography. Severe MR was observed in 1(1.7%) patients, while new mild - moderate MR have been detected in 9(17.6%) patients. Symptomatic improvement was seen in all patients who underwent successful PTMC .There where no procedure related deaths, temponade or the need for emergent mitral valve replacement.
Conclusion: percutaneous transvenous mitral commissurotomy by Inoue balloon technique is safe and effective procedure for patients with severe and symptomatic rheumatic MS. The ideal candidate are those patients with pliable valve ,but still most of patients with relatively high Wilkins echo score can get considerable benefit.
The main purpose of this research is to diagnose the role of the Knowledge Accumulation of Human Resources KAHR in Strategic Performance SP, and for that, the research was applied to the represented sample by the administrative leaders consisting of (108) individuals distributed according to their positions and the organizational structure of the ministry. Correlations, effects, and benefits from generalizing the results in the field of research. The research involved a mixed-methods approach through two stages. During the first stage, the researcher gathered quantitative data from a questionnaire. The second stage gathered qualitative data to explore the survey results more deeply by conducting individual interviews with a sub-sample of
... Show MoreFor the premature termination of the contract is the creditor’s ability to request the termination of the contract due to the debtor’s breach of the execution date based on the debtor’s explicitness not to perform upon the occurrence of this date or because of a presumption proving that breach. Or return it to the extent of the creditor’s ability to prove what he claims, and thus the burden of proof falls on the creditor.
There is no difficulty in proving the debtor's declaration of non-performance, but the difficulty lies in proving the perceived breach in the future, that is, the creditor concludes earlier on the date of implementation that the debtor will breach his obligation and therefore the creditor does not obtain
... Show MoreSome responses to ancient grammarians
And contemporary researchers
In monograms
This paper presents results about the existence of best approximations via nonexpansive type maps defined on modular spaces.
The objective of this paper was to study the laser spot welding process of low carbon steel sheet. The investigations were based on analytical and finite element analyses. The analytical analysis was focused on a consistent set of equations representing interaction of the laser beam with materials. The numerical analysis based on 3-D finite element analysis of heat flow during laser spot welding taken into account the temperature dependence of the physical properties and latent heat of transformations using ANSYS code V.10.0 to simulate the laser welding process. The effect of laser operating parameters on the results of the temperature profile were studied in addition to the effect on thermal stresses and dimensions of the laser w
... Show MoreIn this study four cheese samples were randomly collected from local markets. These cheese samples were Ishaqi, Danone, Arab white cheese and Agricultural college cheese.
Results obtained revealed that all these cheese samples were contaminated by fungi in addition to the presence of same heavy metals under study which were Fe, Pb, Ni and Cr. All fungal contaminat were identified which were contaminated them in winter (January). However, fungal pollution in summer was 100% while in winter was 50% Aspergillus niger was polluted chees samples100% in summer while it was 75% in winter. Aspergillus fumigatus was polled cheese samples under study 50% in summer and 0% in winter .Results for heavy metals determination revealed that Fe was con
The sound effects in TV dramas achievements have become very important not only in terms of function and implementation, but at a greater and wider level in terms of artistic and aesthetic values, which are produced and employed in the most important world artistic achievements of drama, using the latest and most prominent technologies and equipment and according to the expressive and dramatic values expressed by these modern digital sound effects. Therefore, the researcher chose the aesthetic effect of digital sound effects in television drama to identify the aesthetic aspects provided by digital sound effects by employing them and their accompaniment for the image.
The researcher, therefor, divided this study into the methodolo
... Show MoreBackground:
Trichomonas vaginalis is a pear shaped parasite, with a short undulating membrane, lined with a flagellum and four anterior flagella. It is one of the most
common organisms causing infection in the female genital tract, which is normally limited to vulva, vagina and cervix. It doesn't usually extend to the uterus. The
mucosal surface may be tender, inflamed and covered with a frothy yellow or cream colored discharge.
Aim:
To evaluate the infection rate of Trichomonas vaginalis among females complaining of vaginal discharge with or without pruritis vulvae, and to isolate the
parasite by different laboratory methods, such as wet mount method, culture on special media and staining by sp