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 inner wasteland can be observed in Samuel Beckett’s early and later plays. His characters suffer from loss of identity, emotions, and sense of time. They lead a life of failure, repetition, inaction, loneliness, doubt, suffering, and nothingness. The inner wasteland includes many aspects, such as the multi and split identity, the habitual repetitive element of life, the dark sorrowful life the characters lead, lack of communication and relations among them, their unfree, inactive condition, their foggy terrible recollections, loneliness, dryness of love, and uncertainty. The analysis and the illustration of each aspect will show how the inner wasteland is intensified in the selected later plays of Beckett.
This research deals with deliberative intentionality in its two dimensions, deliberative intent, direct, and indirect deliberative intent, and deliberative intentionality assumed great importance to ancient and contemporary scholars. The text, relying on deliberative intent as a methodology concerned with the study of language in usage, and the research focuses on direct deliberative intent through (the intent of acceptability, the intent of the presumption, the intent of the informational, the intent of interaction), and the indirect deliberative intent through (the intentionality of the case, the intent of the metaphor, The intent of the communicative impulse, the intent of the allusion,), and these deliberative elements activate and c
... Show MoreBackground: This study is to evaluate the necessity of prescribing prophylactic antibiotics for nasal packing in spontaneous epistaxis. There are few published papers of infective complications in such patients.
Methods: This prospective study analysed 149 consecutive patients admitted to AL-Kindy teaching hospital with spontaneous, epistaxis, who underwent nasal packing over 2 years period . in the first year, 78 patients received prophylactic antibiotics , In the second year 71 patients were not given prophylatic antibiotics. Exclusion criteria included antibiotics prescribed for unrelated pathology and post-operative epistaxis. Signs and symptoms of acute otitis m
... Show MoreThe theatrical performance has an aesthetic, artistic, technical and intellectual vision presented by the theatrical director according to the dualities of theatrical form and content, which depend on the uniformity and interconnection of theatrical elements, as the vision is integrated through the harmony and fusion of these elements and the flow of their coordination with an aesthetic system within the framework of the aesthetic space of the theatrical performance, and when the heritage is presented in the performance, as there will certainly be different readings of that heritage and moving away from the iconization of the event and highlighting it in a manner that is in line with the spirit of the age.
the (researcher) tries, t
Background: Sub-clinical hypothyroidism (SCTD) is most commonly an early stage of hypothyroidism. Although the condition may resolve or remain unchanged, within a few years in some patients, overt hypothyroidism may develop, with low free T4 levels as well as a raised thyroid stimulating hormone(TSH) level. In general thyroid dysfunction is a condition known to reduce the likelihood of pregnancy and to adversely affect pregnancy outcome. As screening for thyroid disease becomes more common, SCTD is being diagnosed more frequently in clinical practice. The aim of the study is to find out the effect of treating SCTD with thyroxin on the fertility status of the female patient.
Patients and methods: Forty thr
In our world, technological development has become inherent in all walks of life and is characterized by its speed in performance and uses. This development required the emergence of new technologies that represent a future revolution for a fourth industrial revolution in various fields, which contributed to finding many alternatives and innovative technical solutions that shortened time and space in terms of making Machines are smarter, more accurate, and faster in accomplishing the tasks intended for them, and we find the emergence of what is called artificial intelligence (artificial intelligence), which is the technology of the future, which is one of the most important outputs of the fourth industrial revolution, and artificial inte
... Show Moreان الرأسمالية ليست بناءً هندسياً يتم انتظامه وفقاً للنظريات الهندسية والمعادلات الرياضية والفنون المعمارية، لأنها ببساطة نظاماً اجتماعياً يقوم على تشكيلة اقتصادية معينة، والأخيرة تقوم على مستوى معين لتطور قوى الانتاج (التكنولوجيا) والذي يقوم عليه مستوىً معين لعلاقات الإنتاج، ويقوم على التشكيلة الاقتصادية/ نمط الإنتاج نظاماً سياسياً، هو جزء من البناء الفوقي، ولأنها نظاماً اجتماعياً بالمواصفات انفة
... Show MoreA potentiostatic study of the behaviour of Inconel (600) in molar sulphuric acid has been carried out over the temperature range 293-313 K. Values have been established for the potentials and current densities of the corrosion, active-passive transition, passivity and transpassive states. For corrosion, the current density (ic) and potential (Ec) have been determined from well-defined Tafel lines. The potential and current density prior to the commencement of passivity have been obtained corresponding respectively to the critical potential (Ecr( and to the current density (icr) for the active-passive transition state. The passive range was defined by the respective potentials and current densities for passive film formation and dissolutio
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The great scientific progress has led to widespread Information as information accumulates in large databases is important in trying to revise and compile this vast amount of data and, where its purpose to extract hidden information or classified data under their relations with each other in order to take advantage of them for technical purposes.
And work with data mining (DM) is appropriate in this area because of the importance of research in the (K-Means) algorithm for clustering data in fact applied with effect can be observed in variables by changing the sample size (n) and the number of clusters (K)
... Show MoreThis study aimed to knowledge of the effects of the Traditional ore upon the structure of sculpture form, as well as to knowledge of new materials that was used for the contemporary sculpture. This study included four chapter: first chapter was specialized for methodical frame. such as problem of research. that it was abstracted by question about the reason that lead the sculptor to search from new raw to carry out his sculpture works? As well as the important of research and its limits was that define between year 1950 up to 2000. The second chapter included the theoretical field and previous studies, that formed from three researches, such as the fist about the materials, as it was considered master element at the sculpture formal. the
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