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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
Fri Jan 01 2010
Journal Name
Ibn Al- Haitham J. Fo R Pure & Appl. Sci
Multipole Mixing Ratios of Gamma Rays From Fe(n,ny Reaction Using Constant Statistical Tensor Method (CST).
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The - M ultiple mixing ratios of -transitions from levels of 56Fe populated in 56 56 Fe n n Fe ( , )  reactions are calculated by using const. S.T.M. This method has been used in other works [3,7] but with pure transition or with transitions that can be considered as pure transitions، in our work we used This method for mixed  - transitions in addition to pure  - transitions. The experimental angular distribution coefficients a2 was used from previous works [1] in order to calculet - values. It is clear from the results that the - values are in good agreement or consistent, within associated errors, with those reported previously [1]. The discrepancies that occur are due to inaccuracies existing in the expe

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Publication Date
Sun Mar 17 2019
Journal Name
Baghdad Science Journal
Toxic Effects of Purified Microcystins from Soil Blue-Green Alga Oscillatoria pseudogeminata on Tomato Plant Lycopersicon esculentum
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The current study included the isolation, purification and cultivation of blue-green alga Oscillatoria pseudogeminata G.Schmidle from soil using the BG-11liquid culture medium for 60 days of cultivation. The growth constant (k) and generation time (G) were measured which (K=0.144) and (G=2.09 days).

Microcystins were purified and determined qualitatively and quantitatively from this alga by using the technique of enzyme linked immunosorbent assay (Elisa Kits). The alga showed the ability to produce microcystins in concentration reached 1.47 µg/L for each 50 mg DW. Tomato plants (Lycopersicon esculentum) aged two months were irrigated with three concentrations of purified microcystins 0.5 , 3.0 and 6.0

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Publication Date
Wed Jun 01 2022
Journal Name
Journal Of Engineering
Extraction of Manganese Element from Electric Arc Furnace Steel Slag (EAFS) by Liquid-liquid extraction (LLE) method
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This research investigates manganese (Mn) extraction from Electric Arc Furnace Steel Slag (EAFS) by using the Liquid-liquid extraction (LLE) method. The chemical analysis was done on the slag using X-ray fluorescence, X-ray diffraction, and atomic absorption spectroscopy. This work consisted of two parts: the first was an extensive study of the effect of variables that can affect the leaching process rate for Mn element from slag (reaction time, nitric acid concentration, solid to liquid ratio, and stirring speed), and the second part evaluates the extraction of Mn element from leached solution. The results showed the possibility of leaching  83.5 % of  Mn element from the slag at a temperature of 25°C, nitric acid co

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
Operational assessment of biological wastewater treatment using advanced return-mass reactors based on principal component cluster analysis
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Abstract<p>In this study, field results data were conducted, implemented in 64 biofilm reactors to analyses extract organic matter nutrients from wastewater through a laboratory level nutrient removal process, biofilm layer moving process using anaerobic aerobic units. The kinetic layer biofilm reactors were continuously operating in Turbo 4BIO for BOD COD with nitrogen phosphorous. The Barakia plant is designed to serve 200,000 resident works on biological treatment through merge two process (activated sludge process, moving bed bio reactio MBBR) with an average wastewater flow of 50,000 m3/day the data were collected annually from 2017-2020. The water samples were analysis in the central labor</p> ... Show More
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Publication Date
Wed Jun 24 2020
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
NEW RECORD OF PLEUROBRACHIA PILEUS (O. F. MÜLLER, 1776) (CTENOPHORA, CYDIPPIDA) FROM CORAL REEF, IRAQI MARINE WATERS
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   The aim of this paper is to present the first record of ctenophore species Pleurobrachia pileus (O. F. Müller, 1776) in the coral reef as was recently found in Iraqi marine waters. The specimens were collected from two sites, the first was in Khor Abdullah during May 2015, and the second site was located in the pelagic water of the coral reef area, near the Al-Basrah deep sea crude oil marine loading terminal. Three samples were collected at this site during May 2015, February and March 2018 which showed that P. pileus were present at a densities of 3.0, 2.2 and 0.55 ind./ m3 respectively. The species can affect on the abundance of other zooplankton community through predation.

 

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Publication Date
Sat Jan 20 2024
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
First Record of Phoretic Mite from Red Palm Weevil Rhynchophorus ferrugiuneus (Olivier,1790) from Basrah, Southern Iraq
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The red palm weevil Rhynchophorus ferrugineus (Olivier, 1790), which belongs to the family Curculionidae, order Coleoptera, is one of the most important palm pests, which leads to heavy losses in date palms. In the last few years, it has been recorded in Iraq, from Safwan city south of Iraq, where it was detected on date palm trees (Phoenix dactylifera L, Arecales: Arecaceae). In the current study, specimens of adult weevils were collected from infested date palms (Phoenix dactylifera), that showed signs of infection in Safwan district, south of Basra province. The results of the investigation showed the presence of phoretic mites associated with the red palm weevil Rhynchophorus ferrugineus (Olivier,

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Wed May 01 2019
Journal Name
Journal Of Engineering
Optimization of Friction Stir Welding Process Parameters to joint 7075-T6 Aluminium Alloy by Utilizing Taguchi Technique
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In this study, a 3 mm thickness 7075-T6 aluminium alloy sheet was used in the friction stir welding process. Using the design of experiment to reduce the number of experiments and to obtain the optimum friction stir welding parameters by utilizing Taguchi technique based on the ultimate tensile test results. Orthogonal array of L9 (33) was used based on three numbers of the parameters and three levels for each parameter, where shoulder-workpiece interference depth (0.20, 0.25, and 0.3) mm, pin geometry (cylindrical thread flat end, cylindrical thread with 3 flat round end, cylindrical thread round end), and thread pitch (0.8, 1, and 1.2) mm) this technique executed by Minitab 17 software. The results showed th

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Tue Sep 01 2020
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Development of Bridges Maintenance Management System based on Geographic Information System Techniques (Case study: Al-Muthanna \ 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 visualization

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Publication Date
Tue Jun 21 2022
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Performance evaluation of frequency division duplex (FDD) massive multiple input multiple output (MIMO) under different correlation models
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Massive multiple-input multiple-output (massive-MIMO) is considered as the key technology to meet the huge demands of data rates in the future wireless communications networks. However, for massive-MIMO systems to realize their maximum potential gain, sufficiently accurate downlink (DL) channel state information (CSI) with low overhead to meet the short coherence time (CT) is required. Therefore, this article aims to overcome the technical challenge of DL CSI estimation in a frequency-division-duplex (FDD) massive-MIMO with short CT considering five different physical correlation models. To this end, the statistical structure of the massive-MIMO channel, which is captured by the physical correlation is exploited to find sufficiently

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Tue Sep 30 2014
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Microwave Assisted Demulsification of Iraqi Crude Oil Emulsions Using Tri-octyl Methyl Ammonium Chloride (TOMAC) Ionic Liquid
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In the present work, the efficiency of Tri-octyl Methyl Ammonium Chloride (TOMAC) ionic liquid was investigated as new and green demulsifier for three types of Iraqi crude oil emulsions (Nafut Khana (NK), Kirkuk and Basrah). The separation efficiency was studied at room temperature and by using microwave heating technique. Several batch experiments were done to specify the suitable conditions for the emulsification and demulsification which were specified as 45 minutes and 3000 rpm for crude oil emulsification while the ionic liquid doses were (500,300,150,50) ppm and the conditions of microwave heating were 1000 watt and 50 second as irradiation time. The results were very encouraging especially for NK and Kirkuk crude oil emulsions whe

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