Background: Clinical classification of patients with acute coronary syndrome is essential step in identifying severe cases before referring them, fairly quickly, for the ultimate investigation of coronary angiography .Hence it is important to find out the extent at which the severity of the disease, based on clinical classification, agrees with its severity at angiography and to see whether traditional Risk factors or pas ischaemia played a role.
Patients and Methods : The angiographer data of 178 consecutive pts with Acute Coronary Syndrome (ACS) were retrospectively analyzed. The pts consisted of 114 with Unstable Angina (UA) and 64 pts with Non-ST-Segment Elevation Myocardial Infarction (NSTEMI). Patients were classified depending upon the predominating clinical assessment during hospitalization into four groups of progressively worsening ischaemia. They were; group 1; New onset Angina; 27 pts, group 2; Deteriorating Chronic Angina, 33 pts, group 3; Rest Angina 54 pts, and, group 4; Non-ST-Elevation Myocardial Infarction (NSTEMI), 64 pts.
Results : Coronary Angiography revealed that the frequency of multi-vessel coronary Disease (MVD) in group 1, 2, 3, and 4 were 48%, 73%, 72%, and 56% respectively which meant that worsening of ischaemia was not accompanied by commiserate increase of the frequency of MVD in Rest angina and NSTEMI. To explain that we calculated the average number of Five traditional Risk Factors; Hyperlipidaemia (HL), Diabetes Mellitus (DM), Hypertension (HTN), Smoking (SM), and Positive Received March 2006 Family History (PFH) in the four groups ofACS (R.F. score) and they were 1.72, 1.87, 2.13, 2.51 in Accepted May 2006 groups 1,2,3, and 4 respectively. Then we studied the relation of having one, two, three, and four orfive Risk Factors and the frequencies of Multi-vessel disease and they were; 43%, 67%, 76%, and 84% respectively which meant that the frequency of MVD ought to increase from group 1 to group 4 supporting the clinical classification. This prompted us to look into the individual Risk factors. The clinical data showed that the incidence of HL had risen
significantly in Ch. D. angina and Rest Angina (P: 0.03) and that the incidence of SM had risen significantly in NSTEMI (P.• 0.001). Since the angiographic data had demonstrated a significant association of HL with MVD and SM with SVD we may understand why the rate of MVD was not higher in NSTEMI than UA. To explain why the frequency of MVD in Rest Angina (g. 1) was not higher than Ch. D. Angina (g. 2) despite having worse ischaemia and higher R.F. Score we scrutinized the data and noticed that the main difference between group 1 and group 2 that chronic stable angina had preceded the onset of UA in Group 2 while it did not do in group 1. On the other hand Rest Angina and NSTEMI pis were a mixture of those with and without prior ischaemia. To follow this point further we divided both groups into two subgroups: one with history of prior ischaemia and one without it. The frequency
of MVD in Rest Angina and NSTEMI with prior ischaemia were 83%% and 81 %% compared to 54% and 39% respectively in pts without it.
Conclusion this study has shown that clinical classification in Acute Coronary Syndrome may predict severity of the underlying CAD to some extent however considering the no. Of risk factors and which Risk factor and whether there was antecedent ischaemia would improve the prediction a great deal.
This research aims to identify the role that forensic accounting plays on the transparency and quality of the financial statements in trade bank of Iraq and the Gulf Commercial Bank in Babylon. This research came to address the problem that most financial institutions suffer from, which is represented by the lack of transparency and the quality of the financial statements issued in a manner. Annual also the manipulation and fraud in the financial data, which causes a big gap between that institutions and organizational stakeholders. According to the implementation of the research hypothesis and the objectives of the research, a questionnaire was prepared consisting of three axes, the first axis dealing with the demographic distri
... Show MoreThis paper examines the impact of the organizational culture prevailing at the university center, Ali KafiTindouf, on the quality of the educational service provided by the university center Ali KafiTindouf from the point of view of the teachers of the center. The questionnaire method was used to determine the effect between the variables studied, by the distribution of 33 questionnaires on a random sample of the study community.
The study found that the organizational culture prevailing at the university center of Ali KafiTindouf contributed to reaching higher levels in the awareness and quality of the educational service provided by the teachers of the center.<
... Show Moreان الازمة الصحية العالمية الناشئة عن انتشار فيروس كورونا (والذي وصفته منظمة الصحة العالمية في 30/كانون الثاني/2020 بانه حالة طواريء صحية عامة مُثيرة للقلق الدولي، ثم عادت لتُسبغ عليه وصف الجائحة pandemic في 11/آذار/2020) وما أتخذته السطات الحكومية في دول العالم المختلفة من تدابير وأجراءات متفاوته (سواء بمستواها الاعلى من فرض حظر التجوال الشامل او ما اطلق عليه عالميا بالحجر المنزلي وبالتالي تعطيل كافة القطاع
... Show MoreThe global health crisis resulting from the spread of the Corona virus, which the World Health Organization described on January 30, 2020 as a public health emergency of international concern, then returned to describe it as a pandemic on March 11, 2020, and the measures and procedures taken by government authorities in different countries of the world, whether at the highest level of imposing a comprehensive curfew or what is called globally home quarantine and thus disrupting all sectors and activities in the state, whether public or private (with the exception of some sectors such as the health, media and security sectors), or at a lower level than that, such as reducing work rates in different sectors by rates that vary from one country
... Show MoreThis thesis aims to show the effects of the development of the traditional manual system of the tax accounting process to the electronic system by the activation of the tax identification numbers (TINs) mechanism. The impact of this development is facilitating the tax accounting process, tax fraudand thus increasing the tax outcome.To prove the research hypothesis, an electronic system was designed based on income tax report, estimation note of individuals, in additional to using Adobe Dreamweaver application to write PHP, HTML, Javascript, and CSS web languages to implement the proposed system. The research reached a set of conclusions, the most important of which is; not enough the communication methods between the Genera
... Show MoreThe aim of the research is to identify to what extent to which Malcolm Baldrige standards of total quality are applied in the after-sales services of a private sector company for electrical appliances, from the point of view of administrative leaders, in it. To achieve this aim a questionnaire has been used to measure the degree of application of Malcolm’s seven criteria for total quality, namely: (leadership, strategic planning, focus on the customer, measurement and analysis and knowledge management, focus in human resource and operation management and results of the company’s management), the research found that the company achieved a good level of the standard from the de
... Show MoreBackground: Visfatin is a novel adipokine that mainly secreted by visceral adipose tissue, had an important role in inflammation and immune system. Creatine Kinase (CK) which is an enzyme that is involved in energy metabolism, found in large amounts in myocardium, brain and skeletal tissues. This study is carried out To evaluate the periodontal health status of the study groups (chronic periodontitis and chronic periodontitis with coronary atherosclerosis) and control groups, to measure the salivary levels of visfatin and Creatine Kinase in these groups and compare between them, and to determine the correlations between salivary visfatin and Creatine Kinase levels with the periodontal parameters in the three groups. Materials and Methods: e
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The research the impact of the application of some of the production system tools in the specified time, which can be adapted in the service sectors (banking sector) over the improvement and increase the quality of banking services, and highlights the research problem in the low quality of banking services provided to customers because of the reliance on traditional banking systems in the provision of services Because of the lack keep pace with global developments in the banking industry, and the goal of research is to clarify the applicability of the production system in the time specified in the service sector and th
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