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.
The study aims to provide a Suggested model for the application of Virtual Private Network is a tool that used to protect the transmitted data through the Web-based information system, and the research included using case study methodology in order to collect the data about the research area ( Al-Rasheed Bank) by using Visio to design and draw the diagrams of the suggested models and adopting the data that have been collected by the interviews with the bank's employees, and the research used the modulation of data in order to find solutions for the research's problem.
The importance of the study Lies in dealing with one of the vital topics at the moment, namely, how to make the information transmitted via
... Show MoreModern French novel has gained a distinctive status in the history of French literature during the first half of the twentieth century. This is due to many factors including the new literary descriptive objective style adopted by novelists like Alain Robbe – Grillet that has long been regarded as the outstanding writer of the nouveau roman, as well as its major spokesman, a representative writer and a leading theoretician of the new novel that has broken the classical rules of the one hero and evolved, through questioning the relationship of man and the world and reevaluating the limits of contemporary fiction , into creating a new form of narrative.
Résumé:
En vue de résu
... Show MoreBackground: The optimal timing of surgery for Wilms' tumor has been debated for many years. It appears dubious whether surgical ease or per operative complications consistently improved after preoperative chemotherapy.
Materials and Methods: This is a cross section study ,the sample collected from January 2009 to November 2012 .Thirty four patients were selected after informed consent . Patients aged between 10 months and 5 years who were newly diagnosed with Wilms' tumors. including (17) patients with unilateral wilms tumors received immediate nephrectomy without preoperative chemotherapy according to the National Wilms' Tumor Study Group protocol and (1
... Show MoreBackground: To find an operation that can be effectively carried out in both adults and children, equally applicable in the elective as well as in the emergency situation and for the good – risk as well as the poor – risk patients. Done by expert and junior surgeons in a short time.
Patients and Methods: Twenty patients with portal hypertension and bleeding varices aged 9-45 years were treated with shunting procedures (group 1, n=10), or a modified Sugiura operation (group 2, n=10) in accordance with the following therapeutic protocol: after resuscitation and diagnostic endoscopy, an emergency modified Sugiura operation was carried out if bleeding could not be controlled over 24 hours. When blee
Background:
Pulmonary sequestration is a lung tissue (out of function), that received its blood supply from anomalous artery and not continuous with the tracheobronchial tree.
Aim:
To report a personal experience in dealing with five patients with pulmonary sequestration, due to anomalous arterial supply from the descending Thoracic Aorta ,ways of diagnosis and proper surgical management.
Patients and Methods:
Five patients with pulmonary sequestration, admitted, investigated and surgically managed at the department of Thoracic and Vascular surgery, in the surgical sub specialties hospital of the Medical City Teaching Complex d
... Show MoreAutism is considered as one of the most developmental problems in the world that interfere with children growth and affect their social ,emotional and cognitive development child with autism used to be normal in his growth but in his development parents started to notice that their child characterize by loneliness and withdrawal himself from the surrounding world with some mannerism behaviors these characteristics used to be manifested children during the 1st three year of their life . It appears, one in every 500 birth (The American International Institution for child health 1997. and it would be less in females than makes at 1/4 percent .
Aim is to b
... Show MorePraise be to God, Lord of the Worlds, and the best blessings and peace be upon our master Muhammad and all his family and companions, and those who follow them with goodness until the Day of Judgment. . And after:
God created man in the best manner, and subjugated the universe to him and favored him over the rest of creation when he gave him a mind to contemplate and know how to distinguish between the harmful and the beneficial, the bad and the good, in order to exploit him in achieving the meaning of worship, because it is the highest goal of his creation. God Almighty said (And I did not create the jinn and mankind. Except that they worship them.” [Al-Dhariyat: 56]
If knowing what is harmful from what is beneficial a
... Show MoreBackground: Type 1 diabetes mellitus is one of the most common chronic endocrine disorders of childhood, growth impairment is one of its long−term consequences
Objective: To study the anthropometric indices among children with type 1diabetes.
Results: A total of 253 children with type 1diabetes were studied, 51.8% were females, 47.9% developed the disease at 5-9 years of age, and 52.6% presented with classical signs and symptoms. Stunting /sever stunting was 15% with male predominance, higher among older age group (10-20 y), wasting/ sever wasting was 19.4% with male predominance, higher among older age group (10-20 y), over weight/ obese was 3.6% with females predominant an
Background: - Recurrent breast cancer is cancer that comes back following initial treatment. Risk factors of recurrence are lymph node involvement, larger tumor size, positive or close tumor margins, and lack of radiation treatment following lumpectomy, younger age and inflammatory breast cancer.
Objective: Asses the rate of recurrence for early breast cancer in Iraqi female patients, in relation to certain risk factors.
Patients and methods: A prospective study was conducted on 100 consecutive female patients, with stage I and stage II breast cancer treated by mastectomy and axillary dissection by the same team. Patients were assessed postoperatively every three months and recurrences were detected by physical examination and ultr
Background: Birth trauma is defined as injury to neonates resulting from mechanical forces (such as compression or traction) during the process of birth. Birth injury is used to denote avoidable and unavoidable mechanical and hypoxic- ischemic injury incurred by neonates during labor and delivery. Maternal, labor and infant factors can predispose to birth traumas. Many types of birth traumas can be found including intra and extra cranial, spinal, peripheral nerves, fractures and visceral.
Patients and methods: A cross sectional study was done on 200 babies (100 babies for the study group and 100 babies for the control group), admitted to special care baby unit of Baghdad Teaching Hospital, during the peri