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.
Significant advancements in nanoscale material efficiency optimization have made it feasible to substantially adjust the thermoelectric transport characteristics of materials. Motivated by the prediction and enhanced understanding of the behavior of two-dimensional (2D) bilayers (BL) of zirconium diselenide (ZrSe2), hafnium diselenide (HfSe2), molybdenum diselenide (MoSe2), and tungsten diselenide (WSe2), we investigated the thermoelectric transport properties using information generated from experimental measurements to provide inputs to work with the functions of these materials and to determine the
International responsibility rises against the United Nations Organization for the actions of the Security Council according to the theory of risks, in the event that ships, submarines and aircraft carriers that operate with nuclear energy are launched against countries that violate the provisions of Chapter VII the Charter of the United Nations, considering that the Council's actions here are considered as internationally legitimate acts of exceptional risks that the Council may resort to it in order to ensure the speed and effectiveness referred to in Article (11 / Paragraph 2) of the charter and to keep pace with developments in modern technology.
This paper presents a hierarchical model of localized company effective when is used in a university campus or site. To highlight the standard criteria for each layer of the model and to prove the positive aspects of this model is the best in use and make the Dell Network as case of study. Through the case of study it has been shown that the expansion of the on-site network does not affect services or bandwidth.
Artificial pancreas is simulated to handle Type I diabetic patients under intensive care by automatically controlling the insulin infusion rate. A Backstepping technique is used to apply the effect of PID controller to blood glucose level since there is no direct relation between insulin infusion (the manipulated variable) and glucose level in Bergman’s system model subjected to an oral glucose tolerance test by applying a meal translated into a disturbance. Backstepping technique is usually recommended to stabilize and control the states of Bergman's class of nonlinear systems. The results showed a very satisfactory behavior of glucose deviation to a sudden rise represented by the meal that increase the blood glucose
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The question about the existence of correlation between the parameters A and m of the Paris function is re-examined theoretically for brittle material such as alumina ceramic (Al2O3) with different grain size. Investigation about existence of the exponential function which fit a good approximation to the majority of experimental data of crack velocity versus stress intensity factor diagram. The rate theory of crack growth was applied for data of alumina ceramics samples in region I and making use of the values of the exponential function parameters the crack growth rate theory parameters were estimated.
The petroleum industry, which is one of the pillars of the national economy, has the potential to generate vast wealth and employment possibilities. The transportation of petroleum products is complicated and changeable because of the hazards caused by the corrosion consequences. Hazardous chemical leaks caused by natural disasters may harm the environment, resulting in significant economic losses. It significantly threatens the aim for sustainable development. When a result, determining the likelihood of leakage and the potential for environmental harm, it becomes a top priority for decision-makers as they develop maintenance plans. This study aims to provide an in-depth understanding of the risks associated with oil and gas pipeli
... Show MoreDue to the continuing demand for larger bandwidth, the optical transport becoming general in the access network. Using optical fiber technologies, the communications infrastructure becomes powerful, providing very high speeds to transfer a high capacity of data. Existing telecommunications infrastructures is currently widely used Passive Optical Network that apply Wavelength Division Multiplexing (WDM) and is awaited to play an important role in the future Internet supporting a large diversity of services and next generation networks. This paper presents a design of WDM-PON network, the simulation and analysis of transmission parameters in the Optisystem 7.0 environment for bidirectional traffic. The simulation shows the behavior of optical
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Due to the continuing demand for larger bandwidth, the optical transport becoming general in the access network. Using optical fiber technologies, the communications infrastructure becomes powerful, providing very high speeds to transfer a high capacity of data. Existing telecommunications infrastructures is currently widely used Passive Optical Network that apply Wavelength Division Multiplexing (WDM) and is awaited to play an important role in the future Internet supporting a large diversity of services and next generation networks. This paper presents a design of WDM-PON network, the simulation and analysis of transmission parameters in the Optisystem 7.0 environment for bidirectional traffic. The sim
... Show MoreThe ground state proton, neutron, and matter density distributions and corresponding root-mean-square (rms) of P19PC exotic nucleus are studied in terms of two-frequency shell model (TFSM) approach. The single-particle wave functions of harmonic-oscillator (HO) potential are used with two different oscillator parameters bRcoreR and bRhaloR. According to this model, the core nucleons of P18PC nucleus are assumed to move in the model space of spsdpf. The shell model calculations are carried out for core nucleons with w)20(+ truncations using the realistic WBP
interaction. The outer (halo) neutron in P
19
PC is assumed to move in the pure 2sR1/2R-
orbit. The halo structure in P
19
PC is confirmed with 2sR1/2R-dominant c
The growth curves of the children are the most commonly used tools to assess the general welfare of society. Particularity child being one of the pillars to develop society; through these tools, we can path a child's growth physiology. The Centile line is of the important tools to build these curves, which give an accurate interpretation of the information society, also respond with illustration variable age. To build standard growth curves for BMI, we use BMI as an index. LMSP method used for finding the Centile line which depends on four curves represents Median, Coefficient of Variation, Skews, and Kurtosis. These can be obtained by modeling four parameters as nonparametric Smoothing functions for the illustration variable. Ma
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