Background: Ischemic VSD or ventricular septal rupture (VSR) is a rare but lethal complication of myocardial infarction (MI). Multi-system coronary disease is present in more than 50% of these patients. The event occurs 2-8 days after an infarction and often precipitates cardiogenic shock. The differential diagnosis of postinfarction cardiogenic shock should exclude free ventricular wall rupture and rupture of the papillary muscles. To avoid the high morbidity and mortality associated with the disorder, patients should undergo emergent surgery. Concomitant coronary artery bypass may be required.
Objective: This study stressed on a very serious complication of a common pathology (myocardial infarction), despite it,s lethal complication but still it is treatable and still surgery is the only salvageable option.
Patients & methods: Retrospective study of 7 consecutive cases with ischemic VSR encountered from (1st Jan. 2008-30 of September 2011). All of the cases were carefully assessed & fully investigated preoperatively (by echocardiography study, catheterization ...etc) & for all of them emergency open heart surgery was done with heart lung machine to close a post infract VSD using synthetic patch and ventriculotomy closed with reinforced Teflon felts , all of them(except the last case which died immediately post operatively) stayed for 2-3 days in the CICU under follow up .
Results: Seven patients have been operated upon, 4 males (57%) and 3 female (43%), and their ages ranged between 50-63 years (75% in the 6th decade). Three of them (43%) were diabetic only but all of them were hypertensive. All of them were haemodynamically unstable so operation carried on emergently within 12-18 days post infarction (one operation done within 27 hours of infarction) and in none of them the clinical status helped to postpone them until more than 3 weeks post infarct. Five Out of the seven patients survived the operation, one died immediately post operatively &another one died 7 days post operatively due to renal failure (due to pre operative impaired renal function). Operative & early post operative mortality is (28%).
Conclusion: We need to be more aware about this fatal complication of acute MI taking in consideration its late presentation (2-8) days.
We have to work hardly to improve early revascularization to decrease the incidence of VSR. Improvement in surgical technique using double patch and glue improve mortality & morbidity rates. More cases need to have a better understanding & management of these cases.
In this paper, the continuous classical boundary optimal control problem (CCBOCP) for triple linear partial differential equations of parabolic type (TLPDEPAR) with initial and boundary conditions (ICs & BCs) is studied. The Galerkin method (GM) is used to prove the existence and uniqueness theorem of the state vector solution (SVS) for given continuous classical boundary control vector (CCBCV). The proof of the existence theorem of a continuous classical boundary optimal control vector (CCBOCV) associated with the TLPDEPAR is proved. The derivation of the Fréchet derivative (FrD) for the cost function (CoF) is obtained. At the end, the theorem of the necessary conditions for optimality (NCsThOP) of this problem is stated and prov
... Show MoreThis paper deals with the continuous classical optimal control problem for triple partial differential equations of parabolic type with initial and boundary conditions; the Galerkin method is used to prove the existence and uniqueness theorem of the state vector solution for given continuous classical control vector. The proof of the existence theorem of a continuous classical optimal control vector associated with the triple linear partial differential equations of parabolic type is given. The derivation of the Fréchet derivative for the cost function is obtained. At the end, the theorem of the necessary conditions for optimality of this problem is stated and is proved.
Research covers the uses the method of Quality Rating Evaluation to evaluate the
quality of production through which a determination of product quality of its production in
order to determine the amount of sales hence the profits for the company. The most important
function is to satisfy consumer at reasonable prices. Methods were applied to the product
(toothpaste) in the General Company for Vegetable Oil – Almaamoon Factory .
The company's has obtained ISO-certified (ISO 9001-2008). Random samples of
final product intended for sale were collected from the store during months (February, April ,
June , October and December) for the year 2011 to determine the "quality rating " through
the applicat
Numerous integral and local electron density’s topological parameters of significant metal-metal and metal-ligand bonding interactions in a trinuclear tetrahydrido cluster [(Cp* Ir) (Cp Ru)2 (μ3-H) (μ-H)3]1 (Cp = η5 -C5Me5), (Cp* = η5 -C5Me4Et) were calculated and interpreted by using the quantum theory of atoms in molecules (QTAIM). The properties of bond critical points such as the delocalization indices δ (A, B), the electron density ρ(r), the local kinetic energy density G(r), the Laplacian of the electron density ∇2ρ(r), the local energy density
... Show MoreThis paper aims to study the quaternary classical continuous optimal control problem consisting of the quaternary nonlinear parabolic boundary value problem, the cost function, and the equality and inequality constraints on the state and the control. Under appropriate hypotheses, it is demonstrated that the quaternary classical continuous optimal control ruling by the quaternary nonlinear parabolic boundary value problem has a quaternary classical continuous optimal control vector that satisfies the equality constraint and inequality state and control constraint. Moreover, mathematical formulation of the quaternary adjoint equations related to the quaternary state equations is discovered, and then the weak form of the quaternary adjoint
... Show MoreIslamic manuscripts are considered an identity for the civilizational, cognitive and cultural development of nations and the Islamic world as a whole, and to identify this identity, the closing statement usually written at the end of the manuscript helps us with this, meaning that the closing entries serve as the identity document of the manuscript
The objective of this study was tointroduce a recursive least squares (RLS) parameter estimatorenhanced by using a neural network (NN) to facilitate the computing of a bit error rate (BER) (error reduction) during channels estimation of a multiple input-multiple output orthogonal frequency division multiplexing (MIMO-OFDM) system over a Rayleigh multipath fading channel.Recursive least square is an efficient approach to neural network training:first, the neural network estimator learns to adapt to the channel variations then it estimates the channel frequency response. Simulation results show that the proposed method has better performance compared to the conventional methods least square (LS) and the original RLS and it is more robust a
... Show MoreThe topic of the research dealt with the image of Iraq in the British press based on a sample of the newspapers (The Guardian and the Daily Telegraph), which are among the most important and largest newspapers in the United Kingdom and the world, because of its active role in guiding local and international public opinion towards important issues and events, Since these two newspapers are interested in the accuracy of sensitive political topics, the message aimed at knowing the media image that these two newspapers painted about Iraq in the period that was limited to the first quarter of 2019, and also to know the nature of the contents promoted by these newspapers about the Iraqi reality, The method of content analysis was used as an ap
... Show MoreTranslation is a dynamic and living process that cannot be considered equal to the original text and requires the appropriate structure, language, thought and culture of the target language, and the translator's intellectual, linguistic and cultural influences inadvertently penetrate into the translated text. It causes heterogeneity of the destination text with the source text.
Admiral's theory is trying to help by providing components and suggested approaches to resolve these inconsistencies. In the meantime, in addition to the mission of putting words together, the translator must sometimes sit in the position of the reader and judge and evaluate the translated text in order to understand its shortcomings and try to correct it a
... Show MoreThe scholars of Iraq in the modern and contemporary era have been interested in the definition of tremendous knowledge treasures left by the successive Iraqi civilizations on Mesopotamia and around the cities, through the census and extrapolation of manuscript heritage and even printed, they compiled indexes,evidence