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 know the role of transformational leadership in the organizational success of the College of Education at Samarra University. The researcher adopted the analytical descriptive method in analyzing the research problem. The research included two main hypotheses that resulted in four hypotheses that were subjected to statistical tests. A sample of (54) The researcher used the survey method as a main tool for collecting data and information as well as visits and structured interviews that took place during the period of application. The research reached a set of conclusions and recommendations among the conclusions that there is an art relationship There is a strong and moral impact between transformational lead
... Show MoreThe great importance of training made it as an investment for the organization, and assert the Quality of performance which support it by prepare the employee to the Current and future Jobs . The Research problem a rounded about How to measure the impact of training based on (ISO 10015) and its effect on the Quality of performance , How to evaluation the results of training to attained the training goals . The Research aims to find out the effects of application of international standard guidelines (ISO 10015) to attained the quality of audit work achieved in the Federal Board of Supreme Audit. The Research sought to achieve a number of objectives cognitive and applied on the basis of four key assumptions, and other su
... Show MorePolish Academy of Sciences
The first chapter the importance of research and need for education scientists see that the roots of the use of a specimen Wheatley in learning and teaching back to Grayson Wheatley, one of the largest supporters of a modern construction, which lay the groundwork for the specimen stage and the form in which it is. That was attributed to him, often called his name called while some educators based learning strategy on the issue. He sees the learner in this model make him a meaningful understanding of problems during his progress, thereby acting with his colleagues to find solutions to them in small groups. He
Borders Search: Search by students is determined by th
... Show MoreActual and effective organizational dynamic capabilities in the work environment contribute to a number of factors that contribute to the organization's ability to manage its human talents. Thus, the study sought to identify the level of contribution of organizational dynamic capabilities to human talent management based on their dimensions in the investigated organization by determining the level of relationship and impact between these variables. The presidency of Mosul University was chosen as a field for the current study, and data were collected by adopting the questionnaire form as the main tool for the study. The study used a deliberate sample of (42) administrative leaders in the investigated organization and adopte
... Show MoreThe recognition of the dynamic organizational capabilities in their actual and influential extent in the work environment achieves a set of positive data that can fall under the addition axes, particularly with regard to the organization's ability to manage human talents in them, so the researchers sought to identify the level of contribution of dynamic organizational capabilities in the management of human talents in terms of Keep them away in the research organization by indicating the level of relationship and impact between them. The presidency of Mosul University was chosen as a field for the current study, and data were collected by adopting the questionnaire form as the main tool for the study. The study used a deliberate
... Show MoreBackground: Thyroid nodules are very common in clinical practice. Although most of thyroid nodules are benign, it is crucial to checkout which nodules are more likely to be malignant. Ultrasound is a major diagnostic tool for screening and evaluating thyroid diseases because it is safe, non-invasive, non-radioactive and effective.
Objective: The aim is to identify the role of ultrasound in assessing thyroid nodules and to review various ultrasound criteria predicting malignancy.
Patients and methods: A case series study conducted during the period from January 2015 to February 2016 at the First Surgical Unit, Department of Surgery, Baghdad Teaching Hospital by a team of surgeons. One hundred eighty Patients who underwent surgical i
Abstract The League of Arab States took many procedures against the Syrian political system, like suspended Syria's membership in the League of Arab States and sent a team of Arab observers headed by Dabi to discuss the situation there and issued some decisions and statements that called the Syrian regime to stop the use of violence and repression against the Syrian opposition.Through these steps, the Arab League has tried to help the Syrian parties to resolve the crisis. However, the role of the league in the Syrian crisis was characterized by weakness in general, and lack of seriousness, which contributed in the aggravation of the situation in Syria, and the intervention of major powers in the internal affairs of Syria.
Background : The hepatopulmonary syndrome (HPS) is defined as the triad of liver disease, arterial deoxygenation, and pulmonary vascular dilatation. The reported prevalence of HPS in cirrhotic patients varies between 5% -17.5%.Objective : To estimate the prevalence of hepatopulmonary syndrome among patients with chronic liver disease and portal hypertension and to study the correlation between HPS and the severity of liver disease.Patients and methods : Thirty patients were studied for the presence of HPS using transthoracic contrast echocardiography for detection of pulmonary vasodilatation. Arterial oxygen saturation (SaO2) was determined in erect and supine position using a pulse oximeter , (SaO2 ≤ 92 % in supine position and/or a d
... Show MoreAcute lung injury (ALI) is a state of inflammation that breaks down the lung endothelial and epithelial cell barriers. In the current study, we investigated the role of resveratrol (RES) in regulating the expression and functions of tight junction proteins (TJP) in epithelial cell responses following exposure to this superantigen. To this end, C3H mice were given resveratrol orally twice prior to intranasal challenge with lethal SEB doses. 16S rRNA results showed that there were microbes transported in the blood in addition to the lung and colonic tissues. For this purpose, we used a reporter E. coli-GFP labeled bacterium to monitor and examine the viability of this bacterium in case