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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 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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Publication Date
Wed May 25 2022
Journal Name
Iraqi Journal Of Science
Stopping power of Hetero nuclear di-cluster ions from partial-wave analysis based on semi classical phase shifts
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We apply a semi classical partial-wave scattering method based on the induced density approach (IDA) model. For ion electron scattering, the transport cross section is used to calculate the energy loss. This method yields a non-perturbative exemplification of energy loss, bridging the difference among classical and quantal representations. The focus of this work is the interaction of hetero nuclear di-cluster (He-H) ions with a free gas. The results show three kinds of stopping power in (a.u) (cluster stopping power, self-stopping power and correlated stopping power) of hetero nuclear di-cluster ions (He-H) with velocity at different atomic di-cluster distances at different densities and temperatures. We find that Bragg’

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Publication Date
Sun Oct 22 2023
Journal Name
Iraqi Journal Of Science
Extraction of Staphyloxanthin from Staphylococcus aureus Isolated from Clinical Sources to Determine its Antibacterial Activity Against other Bacteria
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Fourty three isolates ( 20.7%) characterized as Staphylococcus aureus , were isolated from 207 different clinical sources (blood , nose, , wound , urine , vaginal, ear and eye) in different percentages (30.23, 18.60, 16.28, 13.95, 15.15, 6.96 and 2.33 %), respectively. The staphyloxanthin (STX) production of S. aureus isolate was estimated 72.1% .The optimal conditions for pigment production by S. aureus AE36 , were detected and was noticed that the milk agar medium revealed the highest production of pigment which was estimated to be 165.21unit/cell, at pH 8 for 72 hr at 370C. The Staphyloxanthin pigment was extracted using methanol and was purified partially by organic solvents and Thin Layer Chromatography (TLC). The results revealed t

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Publication Date
Mon Jul 01 2013
Journal Name
Political Sciences Journal
Towards Promoting Political Participation of Female - University Students - Field Study on Al-Quds Open University Female - Students - Rafah
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نحو تعزيز المشاركة السياسية للطالبات الجامعيات الفلسطينيات

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Publication Date
Tue May 11 2021
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Pulmonary Sequestration Second case series from Iraq
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Background:

Pulmonary sequestration is a lung tissue (out of function), that received its blood supply from anomalous artery and not continuous with the tracheobronchial tree.

Aim:

To report a personal experience in dealing with five patients with pulmonary sequestration, due to anomalous arterial supply from the descending Thoracic Aorta ,ways of diagnosis and proper surgical management.

Patients and Methods:

Five patients with pulmonary sequestration, admitted, investigated and surgically managed at the department of Thoracic and Vascular surgery, in the surgical sub specialties hospital of the Medical City Teaching Complex d

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Publication Date
Thu May 11 2017
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Object Reconstruction From Fourier Magnitude Information Only
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Reconstruction an object from its Fourier magnitude has taken a great deal in the literature and there is still no obvious solution for the failure of this algorithm. In this paper, the frequent failure of the phase retrieval is discussed in details and it has been shown that when the object is cento-symmetric, the object support is vital element to ensure uniqueness while for asymmetric object; the asymmetric support of the object is not enough to ensure uniqueness but the reconstruction appear to include most of the information of the original object. This is also true for the reconstruction of a complex function.

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Publication Date
Tue Nov 01 2022
Journal Name
Inorganic Chemistry Communications
Sustainable adsorptive removal of high concentration organic contaminants from water using biodegradable Gum-Acacia integrated magnetite nanoparticles hydrogel adsorbent
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Release of industrial effluents comprising dyes in water bodies is one of the foremost causes of water pollution. Therefore, the proper and proficient treatment of these dyes contaminated left-over material before their release is crucial. Herein, an eco-friendly biological macromolecule Gum-Acacia (GA) integrated Fe3O4 nanoparticles composite hydrogel was manufactured via co-precipitation technique for effective adsorption of Congo red (CR) dye existing in water bodies. The as-prepared magnetic GA/Fe3O4 composite hydrogel was characterized by FTIR, XRD, EDX, VSM, SEM, and BET techniques. These studies discovered the fruitful fabrication of biodegradable magnetic GA/Fe3O4 composite hydrogel possessing porous structure with large surface are

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Publication Date
Wed May 01 2019
Journal Name
Journal Of Engineering
Non-Destructive Damage Assessment of Five Layers Fiber Glass / Polyester Composite Materials Laminated Plate by Using Lamb Waves Simulation
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Composite materials are widely used in the engineered assets as aerospace structures, marine and air navigation owing to their high strength/weight ratios. Detection and identification of damage in the composite structures are considered as an important part of monitoring and repairing of structural systems during the service to avoid instantaneous failure. Effective cost and reliability are essential during the process of detecting. The Lamb wave method is an effective and sensitive technique to tiny damage and can be applied for structural health monitoring using low energy sensors; it can provide good information about the condition of the structure during its operation by analyzing the propagation of the wave in the

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Publication Date
Wed Feb 01 2023
Journal Name
Measurement: Sensors
Dynamic monitoring of saturated stiff clay soil foundation structure by falling weight deflectometer system under impact loads sensors effect
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Experiments research is done to determine how saturated stiff clayey soil responds to a single impulsive load. Models made of saturated, stiff clay were investigated. To supply the single pulse energy, various falling weights from various heights were tested using the falling weight deflectometer (FWD). Dynamic effects can range from the major failure of a sensitive sensor or system to the apparent destruction of structures. This study examines the response of saturated stiff clay soil to a single impulsive load (vertical displacement at the soil surface below and beside the bearing plates). Such reactions consist of displacements, velocities, and accelerations caused by the impact occurring at the surface depth induced by the impact loads

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Publication Date
Thu Dec 29 2016
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Survey of Some Parasitic Worms on Three Fish Species from Euphrates River at Al- Haklania District, Al-Anbar Province
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    In the present study, a total of 272 freshwater fishes belonging to three species namely: Cyprinus carpio, Barbus xanthopterus and Aspius vorax, were collected from Euphrates river at Al-Haklania distrct, Al-Anbar province  during the period from August 2008 till the end of July 2009, by using gill nets and cast nets.       Fishes were survyed for intestinal parasitic worms. The investigation revealed the infectation of these fishes with four parasitic species: the digenetic trematode  Aspidogaster limacoides from the intestine of C. carpio, B. xanthopterus and A. vorax, larval nematode Contracaecum spp. from the body cavity of C. carpio and the external surface of intestine of B

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