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The Rate of Discordance between Syntax Score II and Cardiologist Decision as a Guide for Mode of Revascularization in Patients with Complex Coronary Artery Disease
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treatment decisions for percutaneous coronary intervention (PCI) and/or coronary artery bypass graft (CABG) in patients with complex coronary artery disease (CAD) and/or unprotected left main stem disease (ULMSD).
Objectives: To assess the agreement between the clinical decisions of the cardiologist and the SS II recommendation regarding the revascularization strategies in patients with complex CAD and/or ULMSD.
Patients and Methods: Prospective data from patients who presented to Baghdad Medical City Catheterization Labs for coronary angiography and were followed up between January 2014 and November 2015 were analyzed. For these patients, SS II was assessed by the two anatomical variables (SS and presence of ULMSD) and six clinical variables (age, creatinine clearance, left ventricular ejection fraction, sex, chronic obstructive pulmonary disease, and peripheral vascular disease) to predict 4-year mortality after revascularization with PCI and/or CABG. These scores were then compared with the clinical decisions of cardiologists. After 1 year of data collection, we followed up the patients by phone to assess their mortality status. Patients were categorized into three groups according the interventional procedures: Group 1 (for PCI), Group 2 (for CABG), and Group 3 (for PCI vs. CABG).
Results: Two hundred patients were enrolled. Their mean age was 60.23 ± 9.836 years, and 157 (78.5%) were men. Depending on the clinical judgment of the cardiologist, 71 (35.5%) patients were referred for PCI (Group 1), 119 (59.5%) patients for CABG (Group 2), and the remaining 10 (5%) patients for PCI vs. CABG (Group 3). Based on an assessment of 4-year mortality by the SS II, CABG would have been the treatment of choice in 67 (33.5%) patients, PCI in 30 (15%) patients, and both the treatments in 103 (51.5%) patients. There was a concordance between the clinical decision of the cardiologist and SS II in 67 (33.5%) patients and discordance in 133 (66.5%) patients. Six patients died within 1 year, most of whom were from the discordant group.
Conclusion: There was a statistically significant discordance between the SS II recommendation and clinical judgment of the interventional cardiologist. SS II proved to be a useful objective tool to assist experienced clinical judgment in determining appropriate revascularization strategy for CAD patients.

المقدمة:درجة السنتاكس ٢ تعد طريقة ارشادية لاختيار طريقة العلاج في المرضى اللذين يعانون من امراض شرايين القلب التاجية المعقدة مع او بدون امراض الشريان الايسر الرئيسي غير المحمي.

الهدف: لتقييم نسبة عدم التوافق بين القرار السريري لاختصاصي القلبية وتوصيات درجة السنتاكس ٢ بالنسبة لخطة العلاج في المرضى المصابين بآمراض شرايين القلب التاجية المعقدة مع او بدون امراض الشريان الايسر الرئيسي غير المحمي.                       

طرائق البحث: يتم جمع معلومات المرضى اللذين يخضعون لاجراء القسطرة التشخيصية لشرايين القلب في صالات القسطرة في مدينة الطب وتتم متابعة المرضى ايضا وتكون مدة الدراسة للفترة من شهر كانون الثاني لسنة ٢٠١٤م الى شهر تشرين الثاني لسنة ٢٠١٥م وخلال هذه الفترة يتم تقييم المرضى عن طريق درجة السنتاكس ٢ وست متغيرات سريرية للتنبؤ بآحتمالية حدوث الوفاة خلال الاربع سنوات بعد عودة التوعي ومقارنتها مع القرار السريري لاختصاصي القلبية. ثم بعد مرور سنة على جمع الداتا، نقوم بمتابعة حالة المرضى عن طريق الاتصال الهاتفي لمعرفة إذا حدثت حالات الوفاة. يتم تقسيم المرضى الى ٣ مجاميع، المجموعة الاولى والتي تخضع للتداخل القسطاري، المجموعة الثانية والتي تخضع لعملية جراحية لزرع شرايين القلب، والمجموعة الثالثة والتي لديها احتمالية للخضوع للقسطرة او للعملية الجراحية.    

النتائج: تم اشراك مئتا مريض في الدراسة، معدل العمر ٦٠.٢٣ ± ٩.٨٣٦سنة، ١٥٧ (٧٨.٥٪) من المرضى ذكور. بالاعتماد على القرار السريري لاختصاصي القلبية تم تحديد ٧١ (٣٥.٥٪) من المرضى للخضوع للتداخل القسطاري (المجموعة الاولى)، ١١٩ (٥٩.٥٪) من المرضى تم ارسالهم لاجراء عملية جراحية (المجموعة الثانية) وبقية المرضى ١٠ (٥٪) تم ادراجهم تحت احتمالية خضوعهم للتداخل القسطاري او العملية الجراحية. بالنسبة لتققيم حالة الوفاة للاربع سنوات بالاعتماد على درجة السنتاكس ٢، كانت النتيجة ان العلاج المفضل هو العمليات الجراحية وبنسبة ٣٣.٥٪، في حين ان نسبة المرضى الخاضعين للتداخل القسطاري كانت ١٥٪، وكانت النسبة متوازية بالنسبة للمرضى الخاضعين للعمليات الجراحية او التداخل القسطاري ٥١.٥٪. كان هنالك توافق بين القرار السريري لاختصاصي القلبية ودرجة السنتاكس ٢ وبنسبة ٣٣.٥٪، في حين ان نسبة عدم التوافق للمرضى كانت ٦٦.٥٪. خلال سنة واحدة توفي ستة مرضى ومعضمهم كانوا من مجموعة عدم التوافق.                 

الاستنتاج: هذه الدراسة اظهرت عدم توافق هام بين توصيات درجة السنتاكس ٢ والقرار السريري لاختصاصي القلبية.

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Publication Date
Sun Mar 02 2008
Journal Name
Baghdad Science Journal
Pre-column dervatization of amino acids from nigella sativa L seed hydrolysates by reversed phase HPLC
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A rapid and sensitive method for analysis of amino acid hydrolysates of nigella sativa L seed has been developed using O-phthaldialehyde(OPA ) as a pre-column derivatizing agent. OPA reagents in the presence of mercaptoethanol react rapidly with primary amino acids ( less than 60 sec.) to form isindole derivatives which easily separated with good selectivity on ODS column. Resolution of amino acid derivatives is carried out with a methanol gradient in 0.01 maqueous sodium acetate. pH 7.1 . The quantitation of amino acid derivatives is reproducible within an average relative deviation of + 1.4% the linearity for most amino acids were more than 0.9993 with detection limit of 0.2 ppm. 15 amino acid were detected in the analysis of

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Publication Date
Thu Jun 08 2023
Journal Name
Iraqi Journal Of Laser
PDF Performance Study of Polarization Beam Splitters Based on Horizontal Slot Waveguide Operating at 700nm Wavelength
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Abstract: Polarization beam splitter (PBS) integrated waveguides are the key components in the receiver of quantum key distribution (QKD) systems. Their function is to analyze the polarization of polarized light and separate the transverse-electric (TE) and transverse-magnetic (TM) polarizations into different waveguides. In this paper, a performance study of polarization beam splitters based on horizontal slot waveguide has been investigated for a wavelength of . PBS based on horizontal slot waveguide structure shows a polarization extinction ratio for quasi-TE and quasi-TM modes larger than  with insertion loss below  and a bandwidth of . Also, the fabrication tolerance of the structure is analyzed.<

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Publication Date
Fri Nov 24 2023
Journal Name
Iraqi Journal Of Science
Neotectonics of Al-Thirthar, Al-Habbaniya , Al-Razzazah Depressions, Central Iraq, by using Remote Sensing Data.
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The object of this research is to reveal the neotectonics of Al-Thirthar, Al-Habbaniya, and Al-Razzazah depressions by using remote sensing data. The age of the exposed rocks ranges from Early Miocene to Holocene. The depressions represent the west margin of the Mesopotamia Zone along its boundary with Al-Salman Zone. The lineament map contains three major groups of lineaments. Two of them are trending east-west and northeast-southwest parallel to the transversal fault systems of Iraq territory. The third group is trending northwest-southeast. The lineament groups reveal the tectonic and structural effects to the extension and the shape of the depressions. The intersection of the lineaments divided the area into small fragments which con

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Publication Date
Wed Dec 30 2020
Journal Name
Iraqi Journal Of Science
Assessment of Rock Slope Stability along Sulaimaniyah -Qaradagh Main Road, Near Dararash Village, Sulaimaniyah, NE-Iraq
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The road network in the Baranan mountain, near Dararash village, connecting Sulaymaniyah city with Qaradagh town, plays a major role in socio- economic activities of Qaradagh town and its surrounding villages. Any type of slope failure in the area may cause breaking up in traffic, loss of lives, and injuries.

      For assessing the stability of rock slopes in the area, seven stations (rock-cut slopes) were selected along the road and evaluated by kinematic analysis, using DIPS v6.008 software and slope mass rating system (SMRTool - v205 software).

      The kinematic analysis revealed that planar and wedge sliding may occur in stations no.2, 5, 6, and 7, flexural toppling

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Publication Date
Sun Jul 01 2012
Journal Name
Ieee Transactions On Geoscience And Remote Sensing
Echo Amplitude Normalization of Full-Waveform Airborne Laser Scanning Data Based on Robust Incidence Angle Estimation
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Publication Date
Mon Jul 01 2019
Journal Name
Journal Of Engineering
Development of Bridges Maintenance Management System based on Geographic Information System Techniques (Case study: AlMuthanna \ Iraq)
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A Geographic Information System (GIS) is a computerized database management system for accumulating, storage, retrieval, analysis, and display spatial data. In general, GIS contains two broad categories of information, geo-referenced spatial data and attribute data. Geo-referenced spatial data define objects that have an orientation and relationship in two or three-dimensional space, while attribute data is qualitative data that can be counted for recording and analysis. The main aim of this research is to reveal the role of GIS technology in the enhancement of bridge maintenance management system components such as the output results, and make it more interpretable through dynamic colour coding and more sophisticated vi

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Publication Date
Tue Sep 25 2018
Journal Name
Iraqi Journal Of Science
Hysterothylacium Persicum (Nematoda: Raphidascarididae) Parasite of Orangespotted Grouper Epinephelus coioides (Forsskål, 1775) Iraqi Marine Water Fishes
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Hysterothylacium  is one of the most important nematode parasites parasitizing fish, and it's the most diverse species nematodes of marine parasites, these species attach to the intestinal wall via their mouth lips adaptation. In the present study, seven out of 56 fish specimens (12.5 %) were found to be infected by the adult worms of Greasy grouper fishes Orangespotted  grouper Epinephelus coioides (Forsskål, 1775)from locations of marine coastal water, Arabian Gulf, Iraq. A new recorded of Hysterothylacium spp. collected are morphologically described, genetically and  Sccaning Electron Microscope (SEM)  images for new systematic observations, on dorsal labium, su

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Publication Date
Wed May 10 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Adsorption of Thymol From Aqueous Solution Using Granulated Surfactant Initiated Modified Bentonite via Packed Column Method
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    The adsorption study of thymol, was carried out at (25±0.1) °C, using granulated surfactant modified Iraqi Na – montmorillonite clay (initiated modified bentonite); in a down-flow packed column, the modified mineral was characterized by FT-IR spectroscopy.  A linear calibration graph for thymol was obtained, which obey Beer's law in the concentration range of 5-50 mg/L at 274 nm against reagent blank. Single-factor-at-a-time approach; showed that the equilibrium time required for complete adsorption was 45 minute with flow rate (4.0drop/ mint). The adsorption of thymol increased with rising pH of the adsorbate solution, increase of solute uptake when  the initial adsor

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Publication Date
Thu Mar 30 2023
Journal Name
Iraqi Journal Of Science
Enhancement of prodigiosin production by Serratia marcescens S23 via introducing microbial elicitor cells into culture medium
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The present study was designed to investigate the possibility of exploiting the interspecies interaction of microbial cells in order to enhance the production of prodigiosin by local isolate S. marcescens S23. Prodigiosin is a promising drug owing to its characteristics of antibacterial, antifungal, immunosuppressive and anticancer activities. S. marcescens S23 was isolated from soil sample and already recognized via morphological, biochemical and molecular identification process. The first step was to detect the optimal conditions for maximum prodigiosin production using chemically defined liquid medium. The results revealed that the optimal conditions for prodigiosin production were sucrose as carbon source; peptone as nitrogen source;

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Publication Date
Wed May 16 2018
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Kinetic Study of Methyl Green Dye Adsorption from Aqueous Solution by Bauxite Clay at Different Temperatures
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    Kinetic experiments were performed to induce of the green methyl dye adsorption from aqueous solution on the bauxite clay. This study includes  determination of  the adsorption capacity of  bauxite clay to methyl green dye adsorption and study the effect of some parameters  ( temperature , time ) on the kinetic of the adsorption process of the dye were studied. Quantity of dye adsorbed was increased when the temperature increases from 298 to 318K which indicates that methyl green adsorption processes are endothermic nature . In order to describe the kinetic data and the rate adsorption constants of the pseudo-first-order and  second-order kinetics were used . The kinetics data were applied well

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