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 includes the study of the harsh environment areas in which engineers and workers operate in drilling oil wells, and their own characteristics in terms of nature and the climate and other surrounding factors, that negatively large amount affect on all the staff, present in comparison with other lands, so the study showed the preparations administrative and methodology that must be taken to confront the problems that may arise or for the purpose of avoiding. One of these things should be addressed is the process of adaptation of the staff live in the remote desert land and under difficult living conditions. The study also demonstrated all kinds of diseases and ill health which afflict the staff due to climatic conditions that
... Show MoreThe influx of Arab Qahtani and Nizari tribes continued to the countries of Baluchistan and the Levant in pre-Islamic times until the Levant became open to the Arab-Islamic tide during the first century AH. The Islamic Orient until the early Islamic Arab Army reached the western borders of China. What we will see in the folds of the search.
Background: Carpal tunnel syndrome (CTS) is one of common peripheral nerve disorder which involves an entrapment neuropathy of the median nerve at the wrist which occurs either due to primary idiopathic cause or secondary to systemic causes. The diagnosis of CTS is clinical and supported by neurophysiological analysis. Surgical intervention is the main treatment modality.
Objective: The aim of the present study is to evaluate the effectiveness of low level laser therapy (LLLT) to treat mild – moderate CTS cases.
Pateients and methods: The study involves 60 symptomatic patients complaining of CTS were divided into two groups. Group A was subjected to real LLLT by Gallium – Arsenide (Ga-As) laser (904 nm), whereas group B was sub
The international humanitarian intervention regardless its legitimacy and illegitimacy aims at using the armed and unarmed force to Protect the rights of the human being and his/ her fundamental freedom when heavy violations may occur for these rights and the interferences features and their development appeared during the period that happened after the cold war as well as the establishment of the new international system the is based on the respect of the human rights to achieve the global peace and security.
The international practices proved that the international humanitarian intervention which have been practiced do not rely on any legal justification and sometimes it forms assault against the states' rights and their intern
... Show MoreCommunication is one of the main elements of culture, it is the source of its formation and a factor of its development and spread. Communication is a 'dynamic' cultural process and is an integral part of the political, social, economic and cultural aspects of people. Therefore, mass communication means help in the course and movement of individuals and cultural communities. The relationship between media and culture according to this perspective is one of many key factors and influential forces that make it coherent and sometimes intertwined. It is a problematic relationship that leads to research and study in order to lay the right foundations in the orientation towards the audience.
Mass communication has many basic functions.
... Show MoreThe research aims to identify the impact of managing performance's employees in building intellectual capital, Because employing the practice of managing the performance of employees may acquire familiar skills to improve their performance and reflect on the construction of intellectual capital in the surveyed area, Especially that the independent dimension represented by the management of the performance of employees is one of the important topics that has received attention in the world of management in general and human resource management in particular. While the adopted dimension was represented by Intellectual capital in the important practice of human resource management in the increasing of their knowledge, to
... Show MoreAfter the internal audit as a tool of internal control in any organization, and helps in the evaluation of all internal control activities, as a tool to ensure compliance with the plans and policies to achieve the goals of the institution as much as possible of the efficiency, effectiveness, and should have the Internal Audit full independence and is linked to senior management, and aims to get the credibility and accuracy of information and data, and keep abreast of modern developments.
The practical side includes the preparation of the questionnaire, which included a set of questions that fit the hypothesis of the research, was Tozeiha the research sample consisting of employees of the Internal Audit Department an
... Show MoreThe research in the variables of the political process and government stability tried to show the impact of the political process on political stability first, and then on government stability second, given that the political process that was established in 2005 was aimed at achieving legitimacy, and its most prominent tools are elections, leading to achieving political stability, including government stability. The issue of governmental stability is one of the important issues in Iraq, but it has not been achieved, as a result of several factors, including problems in political action, as the political process has not succeeded in leading Iraq to stability.