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.
Abstract: A novel design of Mach Zehnder Interferometer (MZI) in terms of using special type of optical fiber that has double clad with graded distribution of the refractive index that can be easily implemented practically was suggested and simulated in this work. The suggested design is compact, rapid, and is simple to be modified and tested. The simulated design contains a MZI of 1546.74 nm of central wavelength that is constructed using special type of double clad optical fiber that has two different numerical apertures. The first aperture will supply single mode propagation via its core, while the second numerical aperture supports a zigzag wave propagation (multimode) in the first clad region. The interferometer’s
... Show MoreIn this research the specifications of Iraqi drinking bottled water brands are investigated throughout the comparison between local brands, Saudi Arabia and the World Health Organization (WHO) for bottled water standard specifications. These specifications were also compared to that of Iraqi Tap Water standards. To reveal variations in the specifications for Iraqi bottled water, and above mentioned standards some quality control tools are conducted for more than 33% of different bottled water brands (of different origins such as spring, purified,..etc) in Iraq by investigating the selected quality parameters registered on their marketing labels. Results employing Minitab software (ver. 16) to generate X bar,
... Show MoreThis study applies a discourse analysis framework to explore the portrayal of women in Maysloon Hadi’s novel (The Black Eyes) (2011), using Critical Discourse Analysis (CDA) and Norman Fairclough’s tri-dimensional model (1989) as the analytical foundation. It investigates the roles and challenges women face in the novel. While there is growing interest in the portrayal of women in literature, Iraqi literature—especially from the perspective of Iraqi women writers remains underexplored. Hadi’s *The Black Eyes* provides a unique case to examine this intersection. Despite the novel’s rich narrative, which offers insight into Iraqi women’s lives, there is a lack of comprehensive CDA to understand how its language constructs
... Show MoreBackground: Breast cancer is the commonest type of malignancy among women worldwide and in Iraq. Tru-cut needle biopsy technique provides adequate tissue for histopathological diagnosis of suspected breast lumps and assessment of hormonal receptors (estrogen, progesterone and HER2neu) prior to surgical operation.
Objectives: To assess estrogen, progesterone andHER2neu expression using breast cancer tissue specimens obtained by tru-cut biopsy, to correlate the findings with clinicopathological parameters of known prognostic significance in breast cancer patients.
Patients and Methods: This prospective study was held within the Main Referral Center for Early Detection of Breast Tumors/Medical City Teachi
The research aimed to statement, which impact that the development of Iraqi auditing standards in the fight against corruption and to fulfill the reform requirements by conducting a comparative study analysis with a framework proposal to amend the Iraqi Audit directory number statement (6) issued by the Accounting and Auditing Standards Board of the Republic of Iraq dated 08/24/2002 on audit planning and supervision on the basis of the latest versions of international auditing standards in this regard.
The researchers concluded that there is a need to update the standards (evidence) audit accredited in the Republic of Iraq in accordance with international auditing standards to meet the requirements of the report of the external a
... Show MoreReceipt date: 8/8/2020 acceptance date: 9/11/2020 Publication date: 31/12/2021
This work is licensed under a Creative Commons Attribution 4.0 International License.
The American-Iranian relations have been characterized by tensions since the arrival of the guardian jurist regime in Iran to leadership in 1979, as it was considered a turning point not only in the cont
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Witness the current business environment changes rapidly reflected on the performance of the facility wishing to stay , which is no longer style reaction enough to handle installations with their environment , and quickly began to lose its luster with the emergence of a message and the vision of contemporary business environment from a set of parts interacting with each other and the concept of behavioral includes all dimensions of performance, it is imperative to adopt a system installations influence variables and positive interaction through the development of strategic plans and the use of implementation and follow-up strategies to ensure the effectiveness of the method for meas
... Show MoreThe research involved a rapid, automated and highly accurate developed CFIA/MZ technique for estimation of phenylephrine hydrochloride (PHE) in pure, dosage forms and biological sample. This method is based on oxidative coupling reaction of 2,4-dinitrophenylhydrazine (DNPH) with PHE in existence of sodium periodate as oxidizing agent in alkaline medium to form a red colored product at ʎmax )520 nm (. A flow rate of 4.3 mL.min-1 using distilled water as a carrier, the method of FIA proved to be as a sensitive and economic analytical tool for estimation of PHE.
Within the concentration range of 5-300 μg.mL-1, a calibration curve was rectilinear, where the detection limit was 3.252 μg.mL
Certainly there is a negative impact on development due to corruption in its corruption forms It is administrative and financial as well as direct impact on all sectors Including the health sector, which has seen in Iraq a marked setback in performance and services , The research aims at the possibility of demonstrating the negative effects of financial and administrative corruption on health institutions and Inability to meet health needs The extent to which Regulatory institutions and institutions manage to reduce financial and administrative corruption and ways of dealing with it The phenomenon of financial and administrative corruption is the most serious phenomenon because of its impact on economic growth, which in turn impedes the
... Show MoreSemi-empirical methods were applied for calculating the vibration frequencies and IR absorption intensities for normal coordinates of the {mono (C56H28), di (C84H28), tri (C112H28) and tetra (C140H28)} -rings layer for (7,7) armchair single wall carbon nanotube at their equilibrium geometries which were all found to have D7d symmetry point group.
Assignment of the modes of vibration (3N-6) was done depending on the pictures of their modes by applying (Gaussian 03) program. Comparison of the vibration frequencies of (mono, di, tri and tetra) rings layer which are active in IR, and inactive in Ramman spectra. For C-H stretching vibrat
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