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.
Since 1990 internal combustion engines and variable systems has been considered as emission. Noise can be defined as undesirable sound, and in high levels it can be considered ahealth hazard. Large internal combustion engines produce high levels of noise. In many countries there are laws restricting the noise levels in large engine rooms and fixed applications. Locomotives engines have the minimum emission influence because of noise control techniques capability.
In this paper study on a single cylinder internal combustion engine was conducted. The engine works by adding ethanol to gasoline, at variable speeds, without adding ethanol, and with adding 10 and 20% ethanol in volumetric ratio. Using one sound insulator or two or with
... Show MoreThe term ischemic heart disease (IHD) defines a disease spectrum of diverse etiology, with the common factor being on imbalance between myocardial oxygen supply and demand . Fifty patients (30 male and 20 female) attending Ibn- Al- betar cardic center, the mean age of male was 65 years and 58 years for female were included in the present study , Thirty healthy subjects ( 15 male and 15 female ) of matched age were used as control groups. Some biochemical parameters including lipid and lipoprotein, total cholesterol (TC) , triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL), in addition to lactic acid and lactate dehydrogenase (LDH) activities , were evaluated in the sera of IHD patient groups
... Show MoreIncremental forming is a flexible sheet metal forming process which is performed by utilizing simple tools to locally deform a sheet of metal along a predefined tool path without using of dies. This work presents the single point incremental forming process for producing pyramid geometry and studies the effect of tool geometry, tool diameter, and spindle speed on the residual stresses. The residual stresses were measured by ORIONRKS 6000 test measuring instrument. This instrument was used with four angles of (0º,15º,30º, and 45º) and the average value of residual stresses was determined, the value of the residual stress in the original blanks was (10.626 MPa). The X-ray diffraction technology was used to measure the residual stresses
... Show MoreClopidogrel is a prodrug that must be transformed into an active metabolite by hepatic cytochrome P450 (CYP) isoenzymes to prevent platelet clotting. Polymorphisms of the CYP2C19 gene can cause a reduction or complete loss of CYP2C19 enzyme activity resulting in inhibiting clopidogrel metabolism, effectiveness and increase stroke recurrence risk in ischemic stroke patients. This study aims to investigate the correlation between genetic polymorphisms in CYP2C19*2 and*3 and recurrent risk in patients with ischemic stroke taking clopidogrel 75mg in Kurdistan region –Iraq. This retrospective case-control study was carried out at Kurdistan, Erbil, Medicina medical center, and Rizgary general hospital from January 2021 to
... Show MoreBackground: Circulatory diseases are one of the leading causes of death in the world which continue to rise despite preventive measures.
Objective: To determine gender, age and cause specific trends of mortality due to circulatory diseases between 2007 and 2011 in Erbil city.
Methods: A review of registered death records from disease of circulatory system was performed at the statistical unit in Directorate of Health in Erbil city. No special codes for the cause of death were available on death certificate. Statistical analysis was done using SPSS version 19
Results: Diseases of circulatory system was responsible for 25.5% of total deaths during the study period. Highest rates were recorded at 2011 with 74 deaths per100000 popul
Background: Study the correlation between the left ventricular end diastolic volume (LVEDV), ejection fraction (EF) and the development of arrhythmia.
Patients and methods: Two hundreds patients with documented acute coronary syndrome and myocardial infection with dysrhythmia documented by ECG and holter monitoring assessed at the cardiac department at Baghdad teaching hospital over the period Jan-Dec 2007. These dysrhythmias were corelated with left ventricular end diastolic volume and ejection fraction.
Results: The patients were divided into 4 groups according to LVEDD and EF. The 1st group, 40 patients (20%) found to have non sustained ventricular tachycardia was associated with higher LVEDD (62-72
Liquefied petroleum gas (LPG), Natural gas (NG) and hydrogen were all used to operate spark ignition internal combustion engine Ricardo E6. A comparison of CO emissions emitted from each case, with emissions emitted from engine fueled with gasoline as a fuel is conducted.
The study was accomplished when engine operated at HUCR for gasoline n(8:1), was compared with its operation at HUCR for each fuel. Compression ratio, equivalence ratio and spark timing were studied at constant speed 1500 rpm.
CO concentrations were little at lean ratios; it appeared to be effected a little with equivalence ratio in this side, at rich side its values became higher, and it appeared to be effected by equivalence ratio highly, the results s
... Show MoreBackground: Ischemic heart disease is a major cause of the diastolic heart failure. Risk of heart failures was increased with microvascular coronary disease, which is characterized by left ventricular stiffness with impaired relaxation and reduced compliance. Aim of this study is to estimate the effect of the severity of myocardium ischemia on the left ventricle ejection fraction and left ventricular volume using SPECT with 99mTc MIBI and to compare the results with the echocardiography. The study included 117 subjects with ischemic heart disease were examined using SPECT and echocardiography techniques. The following
... Show MoreMental disorders (MDs) are a common problem in Primary Health Care Centers (PHCCs). Many people with serious MDs are challenged by symptoms and disabilities that result from the disease and by stereotypes and prejudice due to misconceptions about mental illness. This study aims at evaluating the knowledge, and attitude toward mental health concepts and services and causes of the reluctance to seek those services among people attending PHCCs. A descriptive cross-sectional study was conducted. The random sampling technique was used to include (10) of Directorates of Health (DoHs) coverage north, middle, and south of Iraq. The study was executed in (50) selected PHCs, (5) PHCCs in each DoH involved randomly selected (30) people attending th
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The research draws its importance from identifying the methods of profit management in misleading the financial statements, which in turn is reflected in the decisions of the authorities that relied on these reports, and then the models that help in detecting those methods used by the auditors. Risks. The index (margin of excess cash) was used to detect profit management practices on a group of banks listed in the Iraqi market for securities and the number of (23) banks, including (12) commercial bank and (11) Islamic bank and the results were compared to commercial banks with Islamic banks.((The research started from the hypothesis that the use of the (excess cash margin) model in the banking sector reveals the management
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