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.
أن السياسة النقدية في العراق لم تشهد تحسناً كبيراً في دورها المطلوب
منها، وهذا يعود الى جملة من التغيرات على أدائها ودورها في التأثير على المتغيرات الأقتصادية المهمة، اذ حصلت ظروف صعبة على المستوى السياسي والأقتصادي اسهمت في أضعاف دورها في العراق. فالحروب العسكرية الثلاثة في وقت قياسي دمرت البنى التحتية للأقتصاد العراقي، وأخرت عملية التنمية الأقتصادية والبشرية لعدة عقود بسبب الأستنزاف الكبير للمو
This study was carried out to evaluate the antioxidant activity of Iraqi sumac seeds (Rhus coriaria. L) (Anacardiaceae). Total phenolic compounds and flavoniods were determined in three different sumac seed extracts (SSE) (aqueous,ethanolic and methanolic extract). For extraction Antioxidant activity of SSE were evaluated by various antioxidant assays, including total antioxidant capacity, reducing power,by using 1,1-diphenyl-2-picryl hydrazyl (DPPH) radical scavenging, nitric oxide scavenging, Hydroxyl radical scavenging, and metal ion chelating activities. These various antioxidant activities were compared with ascorbic acid as a standard antioxidant.The results showed that the three(SSE), contained large amounts of phenolic and flavonio
... Show MoreThis study aims to identify the level of application of blue ocean leadership activities in public organizations and to build a conceptual and cognitive framework around this concept. The study adopted a descriptive-analytical approach, and the research sample consisted of (95) individuals from the senior management working at the center of the Iraqi Ministry of Communications (director general, department manager, section head). The data analysis technique used is structural equation modeling (SEM) and the Statistical Package for the Social Sciences (SPSS). The results indicate that the senior management in the Ministry of Communications is working to adopt the blue ocean leadership style through its activities, but not to the leve
... Show Moretock markets changed up and down during time. Some companies’ affect others due to dependency on each other . In this work, the network model of the stock market is discribed as a complete weighted graph. This paper aims to investigate the Iraqi stock markets using graph theory tools. The vertices of this graph correspond to the Iraqi markets companies, and the weights of the edges are set ulrametric distance of minimum spanning tree.
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