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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
Sat Sep 30 2017
Journal Name
College Of Islamic Sciences
Book of Musaka (by Imam Abu al-Qasim Abdul-Karim Muhammad ibn Abd al-Karim al-Rafii)
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Al-Aziz's book was chosen as a subject for research as it is one of the important books in the Islamic world in general and the Shafi'i school in particular and its author Imam Abdul Karim bin Mohammed bin Abdul Karim Al-Rafi's, who in the doctrine of the jurisprudence has made prominent lines and left behind invaluable scientific treasures in the service of religion. Its importance is summarized as follows:
1. Being an explanation of the book (brief) of the argument of Islam Imam Ghazali (God's mercy), one of the five books adopted in Shafi'i jurisprudence.
2. His work is Imam Abu al-Qasim al-Rafii known for the brilliance of the investigation and the power of weighting in the doctrine.
3. It is considered an encyclopedia in Sh

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Publication Date
Thu Jan 01 2009
Journal Name
Ibn Al- Haitham J. Fo R Pure & Appl. Sci
Multiple Mixing Ratios of Gamma Rays Erγ)nEr(n, From 168 168 Reaction  Using a2 – Ratio Method
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The -mixing of  - transition in Er 168 populated in Er)n,n(Er 168168  reaction is calculated in the present work by using a2- ratio method. This method has used in previou studies [4, 5, 6, 7] in case that the second transition is pure or for that transition which can be considered as pure only, but in one work we applied this method for two cases, in the first one for pure transition and in the 2nd one for non pure transitions. We take into accunt the experimental a2- coefficient for p revious works and -values for one transition only [1]. The results obtained are, in general, in agood agreement within associated errors, with those reported previously [1], the discrepancies that occur are due to inaccuracies existing

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Publication Date
Wed Feb 01 2023
Journal Name
Chemical Data Collections
Removal of diclofenac from aqueous solution on apricot seeds activated carbon synthesized by pyro carbonic acid microwave
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Pharmaceuticals have been widely remaining contaminants in wastewater, and diclofenac is the most common pharmaceutical pollutant. Therefore, the removal of diclofenac from aqueous solutions using activated carbon produced by pyrocarbonic acid and microwaves was investigated in this research. Apricot seed powder and pyrophosphoric acid (45 wt%) were selected as raw material and activator respectively, and microwave irradiation technique was used to prepare the activated carbon. The raw material was impregnated in pyrophosphoric acid at 80◦C with an impregnation ratio of 1: 3 (apricot seeds to phosphoric acid), the impregnation time was 4 h, whereas the power of the microwave was 700 watts with a radiation time of 20 min. A series o

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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Removal of Dissolved Trivalent Chromium Ions from Contaminated Wastewater using Locally Available Raw Scrap Iron-Aluminum Waste
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The present study is to investigate the possibility of using wastes in the form of scrap iron (ZVI) and/ or aluminum ZVAI for the detention and immobilization of the chromium ions in simulated wastewater. Different batch equilibrium parameters such as contact time (0-250) min, sorbent dose (2-8 g ZVI/100 mL and 0.2-1 g ZVAI/100 mL), initial pH (3-6), initial pollutant concentration of 50 mg/L, and speed of agitation (0-250) rpm were investigated. Maximum contaminant removal efficiency corresponding to (96 %) at 250 min contact time, 1g ZVAI/ 6g ZVI sorbent mass ratio, pH 5.5, pollutant concentration of 50 mg/L initially, and 250 rpm agitation speed were obtained.

The best isotherm model for the batch single Cr(III) uptake by ZVI

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Publication Date
Sat Dec 30 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Oxidative Desulfurization of Simulated Diesel Fuel by Synthesized Tin Oxide Nano-Catalysts Support on Reduced Graphene Oxide
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   The modified Hummers method was applied to prepare graphene oxide (GO) from the graphite powder. Tin oxide nanoparticles with different loading (10-20 wt.%) supported on reduced graphene oxide were synthesized to evaluate the oxidative desulfurization efficiency. The catalyst was synthesized by the incipient wetness impregnation (IWI) technique. Different analysis methods like FT-IR, XRD, FESEM, AFM, and Brunauer-Emmett-Teller (BET) were utilized to characterize graphene oxide and catalysts. The XRD analysis showed that the average crystal size of graphene oxide was 6.05 nm. In addition, the FESEM results showed high metal oxide dispersions on the rGO. The EDX analysis shows the weight ratio of Sn is close to its theoretical weight.

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Publication Date
Wed Jun 26 2019
Journal Name
Iraqi Journal Of Science
Well-Controlled Generation Process of Bimetallic Ag//Au Colloidal Nanoparticles by Non-Thermal Plasma DC Glow Discharge
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In this paper, an inexpensive, simple and well-accurate process of the generation of bimetallic silver Ag//gold Au core//shell is colloidal metal nanoparticles (MNPs). This is achieved via an atmospheric pressure non-thermal plasma glow discharge between two electrodes. One of these electrodes is a capillary tube placing over solution about (1 cm) that acts as the cathode, while the other electrode is a metal disk immersed in the solution and acts as an anode. Glow discharge process carried out at room temperature using a home-made cell with (6 KV) applied voltage and direct current (DC) about (1.8 mA) for different discharge periods. A wide range of bimetallic Ag//Au colloidal MNPs was rapidly synthesized as a result of non-thermal plas

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Publication Date
Mon Aug 16 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
Statistic Assessment of Spreading Cases (Total Confirmed, Recovered, Death) From Different AreasContain Novel Coronavirus (2019-n Cov)
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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Cytotoxic Assay of Nigella sativa Leaf Callus Extract (Thymol) on Hep-2 Cell Line Using ELISA Assay
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Extract from cell culture of medicinal plant like Nigella sativa have been assessed for its cytotoxic properties. Thymol is likely responsible for the theraputic effects of  Nigella sativa leaf callus extract. In this short study the inhibitory effect of Nigella sativa leaf callus extract (Thymol) has been studied on Human Lorgnx Epidrmoid Carcinoma (Hep-2) cell line during different exposure period of time (24, 48 and 72 hrs.) using different concentration of the extract (1000, 500, 400, 300, 200 and 100 µg/ml). The optical density of the Hep-2 cells has been readed on 492 nm wave length. Thymol –induced cytotoxicity was (500 µg/ml) which inhibit cell growing compared to the control and this

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Publication Date
Fri Dec 29 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Efficacy of Some Insect Growth Regulators (IGR) Against Jasmine White Fly Alearoclava Jasimini ( Homoptera: Aleyrodidae) on Citrus Tree
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The efficacy of five insect growth regulators has been tested against white fly larva Alearoclava jasimini on citrus tree orchards. Data from field tl'ia ls con finned that percent mortalities were 43.7, 33.9, 23.7, 20.8 and     12.3  for  Admiral ( I miL)  pyriproxefen, Nomol t  1 5 SC  (!milL) Teflubenzuren , Match 050 EC (  I milL ) Lufenuren , cascade I 0 F.C (

0.9mi/L) flufenoxaron, and Dimiline 10 EC ( I milL)  Difluben- zuron. The result indicated that Admiral and Nomolt have a continuous  effect for one month , so the treatment needs to be repeated for each four weeks. Also, Admiral and Nomolt effect against eggs hatching by 41. 3 % and

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    Publication Date
    Sun Oct 22 2023
    Journal Name
    Iraqi Journal Of Science
    Assessment of Genetic Distance Among Some Iraqi Date Palm Cultivares )Phoenix Dactylifera L.) Using Randomly Amplified Polymorphic DNA
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    The aim of this study to determine the genetic distance and relationship among some Iraqi date palm cultivars by using the Random Amplified Polymorphic DNA (RAPD) technique. Molecular analysis was performed by using 10 random primers. These primers produced 176 fragment lines across 14 cultivars, Of these, 166 or 94.3% were polymorphic. The size of the amplified bands ranged between 200-2250 bp. The genetic polymorphism value of each primer was determined and ranged between 7.5-16.9%. In terms of unique banding patterns, the most characteristic banding pattern was for the Barhee cultivar with primer OP-M06 and for the Khadhrawy Mandily cultivar with primer OP-C02. Genetic distance values ranged from 0.868 to 0.125 among studied date palm

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