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.
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
استخلص عامل التلزن من E. faecalis EM1 بعد تكسير الخلايا بعدة طرق واختيار الطريقة التي تعطي اعلى قيمة تلزن والترسيب بالكحول الاثيلي , واجري فحص التلزن وقياسه للمستخلص مع انواع من البكتريا السالبة لملون غرام تضمنت Escherichia coli و Klebsiella pneumoniae و Serratia
Evaluation is one of the most important elements of teaching process. The recent trends in evaluation and educational reform movements have called for using alternative evaluation, which focuses on performance evaluation. Authentic assessment is usually described as formative, in which students participate in their acquisition, in addition to the fact that students are productive and active, which is reflected in the students' achievement and skill level. The study aims to reveal the degree of knowledge and use of alternative assessment tools by primary school teachers in Gaza -Palestine. To meet the objective of the study, the researchers used the descriptive-analytical method and the questioner as a study tool. The study sample c
... Show MoreMaxim Gorky’s Mother is one of the most important literary genre in social realism, in which he depicts female characters with revolutionary fervor and enthusiasm, projecting his social ideologies and dreams. Though the novel unique importance lies in the fact that it has been thoroughly analyzed by many writers, historians and sociologists, there are almost no studies devoted to the role of women out of a Marxist and feminist point of view. The present paper sheds light on the Russian woman‘s important role in overcoming all adversity and gain her position on Social Realism.
Одно из центральных мест сре
... Show MoreThis study was undertaken to introduce a fast, accurate, selective, simple and environment-friendly colorimetric method to determine iron (II) concentration in different lipstick brands imported or manufactured locally in Baghdad, Iraq. The samples were collected from 500-Iraqi dinars stores to establish routine tests using the spectrophotometric method and compared with a new microfluidic paper-based analytical device (µPAD) platform as an alternative to cost-effective conventional instrumentation such as Atomic Absorption Spectroscopy (AAS). This method depends on the reaction between iron (II) with iron(II) selective chelator 1, 10-phenanthroline(phen) in the presence of reducing agent hydroxylamine (HOA) and sodium acetate (NaOAc) b
... 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 study aims to provide a Suggested model for the application of Virtual Private Network is a tool that used to protect the transmitted data through the Web-based information system, and the research included using case study methodology in order to collect the data about the research area ( Al-Rasheed Bank) by using Visio to design and draw the diagrams of the suggested models and adopting the data that have been collected by the interviews with the bank's employees, and the research used the modulation of data in order to find solutions for the research's problem.
The importance of the study Lies in dealing with one of the vital topics at the moment, namely, how to make the information transmitted via
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