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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 2014
Journal Name
Baghdad Science Journal
Copolymerazaion of N-vinyl-2-pyrrolidon with Acrylic Acid and Methylmethacrylate
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Low conversion copolymerization of N-vinyl-2-pyrrolidon M.W = (111.14) VP (monomer-1) has been conducted with acrylic acid AA and methymethacrylate MMA in ethanol at 70ºC , using Benzoyl peroxide BPO as initiator . The copolymer composition has been determined by elemental analysis. The monomer reactivity ratios have been calculated by the Kelen-Tudos and Finman-Ross graphical procedures . The derived reactivity ratios (r1 , r2 ) are : (0.51 , 4.85) for (VP / AA ) systems and (0.34 , 7.58) for (VP , MMA) systems , and found the reactivity ratios of the monomer AA , MMA is mor than the monomer VP in the copolymerization of (VP / AA) and (VP /MMA) systems respectly . The reactivity ratios values were used for microstructures calculation.

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Publication Date
Sun Jun 02 2019
Journal Name
Baghdad Science Journal
Studying Reactivity Relationships of Copolymers N-naphthylacrylamide with (Acrylicacid and Methylacrylate)
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            The organation ⁄monomer N-naphthylacrylamide (NAA) was prepared; subsequently the synthesized monomer was successfully copolymerized with acrylicacid (AA) and methylacrylate (MA) by free radical technique using dry benzene as solvent and benzoyl peroxide (BPO) as initiator. The overall conversion was kept low (≤ 10% wt/wt) for all studies copolymers samples. The synthesized monomer and copolymers were characterized using Fourier transform infrared spectroscopy (FT-IR), and their thermal properties were studied by DSC and TGA. The copolymers compositions were determined by elemental analysis. Kelen-Tudes and Finmman-Ross graphical procedures were employed to determine

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Uropathogenic Infection Associated with Prostate Hypertrophy and Transurethral Resection of Prostate
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Benign prostatic hyperplasia (BPH) is a prevalent condition among elderly and middle-aged men characterized by symptoms such as dysuria, urinary incontinence, and frequent micturition. The gold standard procedure for relieving BPH symptoms is transurethral resection of the prostate (TURP). However, some patients undergoing TURP are at risk of developing urinary tract infections (UTIs) due to uropathogenic bacteria. This prospective study aimed to investigate post TURP bacteruria alongside with multifactoria risk factors that implicated postoperatively compared to preoperative and intraoperative periods. Ninety patients undergoing TURP and 30 control subjects were included in the study. Urine specimen for urine analysis from pateints

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Publication Date
Fri May 01 2015
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2015 Ieee Congress On Evolutionary Computation (cec)
Differential evolution with adaptive repository of strategies and parameter control schemes
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A new Differential Evolution (ARDE) algorithm is introduced that automatically adapt a repository of DE strategies and parameters adaptation schemes of the mutation factor and the crossover rate to avoid the problems of stagnation and make DE responds to a wide range of function characteristics at different stages of the evolution. ARDE algorithm makes use of JADE strategy and the MDE_pBX parameters adaptive schemes as frameworks. Then a new adaptive procedure called adaptive repository (AR) has been developed to select the appropriate combinations of the JADE strategies and the parameter control schemes of the MDE_pBX to generate the next population based on their fitness values. Experimental results have been presented to confirm the reli

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Fri Dec 29 2017
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Syntesis and Characterization of Complexes Anthranilic Acid With Some Metal Ions
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The  research includes attempts to prepare anthranil ic acid (C7H7N02) complexes  with some metals: [Pd (II), Fe(ll), and  Fe (Ill))  which have been characterized by using:

Thermal stability (melti ng point, d composition poit), molar conductivity, IR,   UV-visible   spectra,   elemental   analysis   (C-H-N)   and   magnetic properties.  The   general  formula   has   been  given for  the   prepared complexes:-

- M(C2H6N02)2 Where M= [Pd(ll), Fe(TI), Hg(ll)]

 

:.. M(C1H6N02)l Where  M= [Fe(llf)]

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Publication Date
Thu Sep 01 2022
Journal Name
Iraqi Journal Of Physics
Structural and Morphological Characterization of MEH-PPV Nanocomposite Doped with FeCl3
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Poly [2-methoxy-5-(2-ethylhexyloxy)-1, 4-phenylenevinyl] (MEH-PPV) thin films were created in this study using both spin coating and drop casting processes. MEH-PPV thin films generated by Ferric Chloride (FeCl3) doping (0.03, 0.06, 0.09, and 0.12 wt%) were studied for some physical features using Fourier-Transform Infrared Spectroscopy (FTIR), Field Emission Scanning Electron Microscopy (FE-SEM), and Energy Dispersive X-ray Spectroscopy (EDX). An FTIR test showed that there was no chemical reaction that occurred between Ferric Chloride (FeCl3) and MEH-PPV, but rather a physical one, that is, an organic material composite occurred. As for FE-SEM, the pure sample MEH-PPV formed uniformly, but when FeCl3 was added by weight, we have differ

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Hematological and histopathological changes of rat’s hearts experimentally infected with protoscoleces
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Tue Oct 01 2019
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Generation and Experimental Stress Analysis of Elliptical Gears with Combined Teeth
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In this study, generation of elliptical gears with different teeth profiles of crowned involute, double circular arc (DCA), and combined (crowned involute with DCA) has been developed. The resulting mathematical equations have been computerized and feed to CNC end mill machine to manufacture elliptical gear models with different profiles. These models are investigated in plane polariscope to show the resulting stresses under certain load. Comparison of photo-elastic stress results shows that combined elliptical gears with DCA side as a loaded side have a minimum resulting contact stress with a reduction percentage of 40% compare with contact stresses in counterpart elliptical gear of involute profile (which is commonly u

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Publication Date
Fri Oct 20 2023
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New Metronidazole Derivative and Some of its Complexes with Antibiofilm Study
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Synthesis of a new ligand, namely [bis(2-(2-methyl-5-nitro-1H-imidazol-1-yl)ethyl) hydrogen borate] (BIB), utilizing the reaction of metronidazole with boric acid in a (2:1) mole ratio The metal complexes were synthesized utilizing the reaction of (NiCl2.6H2O and CuCl2 .2H2O) with (BIB) ligand in a 2:1 (L:M) mole ratio. All synthesized compounds were characterized utilizing spectroscopic techniques such as infrared (FTIR), nuclear magnetic resonance of protons(1H NMR), ultra violet and visible radiation (UV-Vis), thermal analysis (TG), atomic absorption (A.A.S.), micro elemental analysis (C.H.N.S.), melting point (m.p.), magnetic susceptibility, molar conductivity, and chlor

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Publication Date
Fri Jan 01 2016
Journal Name
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Theoretical and Experimental Stress Analysis of Cam With Simple Harmonic Motion
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Cams are considered as one of the most important mechanical components that depends the contact action to do its job and suffer a lot of with drawbacks to be predicted and overcame in the design process. this work aims to investigate the induced cam contact and the maximum shear stress energy or (von misses) stresses during the course of action analytically using Hertz contact stress equation and the principal stress formulations to find the maximum stress value and its position beneath the contacting surfaces. The experimental investigation adopted two dimensions photoelastic technique to analyze cam stresses under a plane polarized light. The problem has been numerically simulated using Ansys software version 15 as FE

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