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 research seeks to achieve its goal of demonstrating the impact of applying banking governance variables on the financial performance of Islamic banks, and the independent research variables are represented by (X) by (the number of independent members in the board (X1), the number of directors in the board (X2), the number of committees emanating from the board ( X3), the percentage of shares owned by major shareholders in the board (X4), the number of members of the Sharia supervisory board (X5)), and the dependent variable (Y) is represented by (rate of return on assets (Y1), rate of return on equity (Y2)).
The research sample included (4) Islamic banks, namely (Iraqi Islamic Bank, National Islamic Bank, Jihan Islamic Bank,
... Show MoreThe procedures for imposing disciplinary sanction against the worker represent the steps that must be followed to verify the violation attributed to the worker in preparation for taking the decision to impose disciplinary sanction on him in terms of the procedures for carrying it out, i.e. from the moment of the disciplinary violation until the judgment thereof, as well as the rights, obligations and legal ties resulting from these procedures, These procedures are governed by multiple and dispersed rules, and they aim in their entirety to control the discipline process and determine its course by adhering to the restrictions stated in the law that regulate the process of imposing them, and perhaps one of the most important of these proce
... Show MoreWith today's rapid and full of dangers the world banking sector is one of the most vital sectors at risk, and on the supervisory bodies responsible for monitoring the work of banks to take an active role in influencing the banks and put on the right track and is compatible with internationally approved curriculum. The lie of the research problem in the weak supervisory role of the Central Bank for banks in general and private banks in particular, limited the process of performance audit carried out by the Federal Office of Financial Supervision in auditing oversight role of the Central Bank control over the banks, according to the methods of performance audit followed by the upper bodies of financial control and accounting, And it was ba
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The research aims to monitor the image of the man in the group (The Cart and the Rain) by the storyteller (Badiaa Amin); With the aim of highlighting an aspect of feminist writing, especially with regard to the relationship of women to men, and determining the form adopted by the storyteller in drawing the features of men.
The research used the descriptive-analytical method in the space of its textual formation, which aims to stand on the text and deconstruct its narrative significance. To provide a comprehensive picture of it.
Three images of the man appeared in the group's stories, represented by (the authoritarian, the negative, and the positive), and the image of the authoritarian ma
... Show MoreBanks was one of the institutions that are highly concerned with the issue of performance evaluation, in order to achieve optimal use of resources that enable them to achieve operational and strategic objectives both in light of the global competition fierce for the start of the research problem of banks to adopt in assessing the performance of the realization of just the traditional financial indicators which has become insufficient to keep pace with the constant evolution in the business environment, which requires work on the use of the necessary information needed to evaluate the performance of all the Bank's activities through
the use of the Balanced Scorecard method. The research aims to shed light on the dimensions of perf
... Show MoreThis research deals with the frameworks and mechanisms of international press coverage of the issue of foreign interference in the formation of the Iraqi government in the Saudi newspapers Asharq Al-Awsat and Kayhan Al-Arabi Iran and how this topic was addressed in the two newspapers. The frameworks for international press coverage of external interference in the formation of the Iraqi government. ”This research is one of the descriptive research that adopted the survey method، which made it possible to use the content analysis tool to analyze
the content of the two newspapers، whose numbers are (624) from the
newspapers (Al-Sharq Al-Awsat Al-Saudi Arabia and Kayhan Al-Arabi Iran) from (1/1/2018 to 31/12/2018)، and the researc
The movement and broadening of foreign and European words into Persian is a topic within historical linguistics. Such changes are semantic, phonological
Since many of these European loanwords into Persian took a remarkable space within Persian dictionaries, and became an indispensible part of the language, a study of the original languages of these loanwords may identify the enormous effect of those languages upon Persian, being a receptor language, and may refer to the liveliness.
Among the important factors which helped the movement of various loanwords into Persian are:
- Geographical: this is seen via contact between Persian people and those neighboring people, specifically those speaking Ara
The diseases presence in various species of fruits are the crucial parameter of economic composition and degradation of the cultivation industry around the world. The proposed pear fruit disease identification neural network (PFDINN) frame-work to identify three types of pear diseases was presented in this work. The major phases of the presented frame-work were as the following: (1) the infected area in the pear fruit was detected by using the algorithm of K-means clustering. (2) hybrid statistical features were computed over the segmented pear image and combined to form one descriptor. (3) Feed forward neural network (FFNN), which depends on three learning algorithms of back propagation (BP) training, namely Sca
... Show MoreBackground: Many anti-obesity medicines have been increased in recent years to solve the problem of obesity; among these medicines are Green Lean Body Capsules (GLBCs) which contain green plants and fruits extract.
Objective: This study was designed to evaluate the effects of daily oral consumption of GLBCs on level of serum lipids, renal function tests, and the histological structure of the kidney in albino rats.
Materials and Methods: Twenty adult albino male rats weighing 240-260 g were divided into 2 equal groups: control group and GLBCs-treated group. During the 4-weeks treatment, each rat in the GLBCs-treated group was orally administered with 20 mg/kg B.W. of GLBCs, while the control rats were orally
The study aims to identify the effectiveness of a structural theory-based training program in enhancing the teaching practices of Arabic language teachers teaching grade ten in South Al Batinah in Sultanate of Oman. The study used the quasi-experimental design, and the sample consisted of 40 male and female teachers. To achieve the objectives of the study, a training program, an observation form and a measurement tool of teachers’ tendencies towards a structural teaching were made. The program was implemented with an experimental group of 20 female and male teachers in the first semester of the academic year 2018/2019. The study has found that there is a statistically significant difference between the average grades before and after i
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