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.
Simulation of the Linguistic Fuzzy Trust Model (LFTM) over oscillating Wireless Sensor Networks (WSNs) where the goodness of the servers belonging to them could change along the time is presented in this paper, and the comparison between the outcomes achieved with LFTM model over oscillating WSNs with the outcomes obtained by applying the model over static WSNs where the servers maintaining always the same goodness, in terms of the selection percentage of trustworthy servers (the accuracy of the model) and the average path length are also presented here. Also in this paper the comparison between the LFTM and the Bio-inspired Trust and Reputation Model for Wireless Sensor Network
... Show MoreBackground: There is a recognized association between prolongation of the heart rate corrected QT interval (QTc) and antipsychotic drugs. QTc prolongation may increase the risk of ventricular tachyarrhythmias, especially torsade de pointes, and therefore, sudden cardiac death.
Objective: This study assess the effect of antipsychotics and prolongation of the heart rate corrected QT interval (QTC), and QTC prolongation may increase the risk of ventricular tachyarrhythmias, especially torsade de pointes and sudden cardiac death.
Results: Abnormal QTc was defined as an interval of more than 440 ms (0.44 second) and was present in 21.7% (43 patients of 198). Benzhexol (-0.333
... Show MoreBackground: Schneiderian first rank symptoms are
considered highly valuable in the diagnosis of
schneideria.
They are more evident in the acute phase of the
disorder and fading gradually with time. Many studies
have shown that the rate of these symptoms are
variable in different countries and are colored by
cultural beliefs and values.
Objectives: To find out the rate of Schneiderian first
rank symptoms among newly diagnosed schizophrenic
patients, to assess which symptom(s) might
predominate in those patients, and to find out if there
is/are any correlation(s) between the occurrence of
these symptoms and the sex of the patients.
Methods: Out of twenty-four patients with no past
psychiatric hi
The article analyzes the neologisms that arose in the Iraqi dialect after the 2003 US-British invasion and the fall of Saddam Hussein's regime, according to the theory I advocate: "The Basic Outline of Reference," a developed theory of Arab legacy and cognitive theory, which came out in 1987 in America, so we have used the terminology of cognitive grammar. In this theory it is stated that the reference is the interaction between four components: perception, imagination, imaginative comprehension and the linguistic sign or symbolization (the neological word in this article), which are closely related, so that none of them can be lacking, because they constitute a holistic whole that belongs to a deeper level. Let us
... Show MoreIn the cuurent article, the photophysical properties of 3,6-bis(5-bromothiophen-2-yl)-2,5-bis(2-ethylhexyl)-2,5-dihydropyrrolo[3,4-c]pyrrole-1,4-dione were investigated. The visible absorption bands at 527, 558 and 362 nm in propylene carbonate and the compound was found to be fluorescent in solution and in the plastic film with emission wavelengths between 550- 750 nm. The Stokes Shift of P.C., acetonitrile, diethyl ether, Tetrahydrofuran THF, cyclohexane, dibutyl ether, and dichloromethane DCM are 734, 836, 668, 601, 601, 719, and 804 cm-1 in respectively. The Stokes Shift Δ was less in THF and cyclohexane, than the solvents, which indicates that the energy loss is less between the excitation and fluorescence states. The
... Show MoreThe researcher studied transportation problem because it's great importance in the country's economy. This paper which ware studied several ways to find a solution closely to the optimization, has applied these methods to the practical reality by taking one oil derivatives which is benzene product, where the first purpose of this study is, how we can reduce the total costs of transportation for product of petrol from warehouses in the province of Baghdad, to some stations in the Karsh district and Rusafa in the same province. Secondly, how can we address the Domandes of each station by required quantity which is depending on absorptive capacity of the warehouses (quantities supply), And through r
... Show More Background: pedicular screw fixation is rapidly becoming a widely used method of spinal instrumentation. Despite improvement in design of instruments and surgical technique and the use of intra-operative fluoroscopy, pedicle cortical perforations occur endangering nearby neurovascular or extra vertebral structures.
Objective: This is a prospective (consecutive cases study) designed for Evaluation of incidence of pedicle screw misplacement in our study sample, compare our results to what is published in literature.
Patients and Method: This study involved 25 adult patients ( 10 males and 15 females ) their age ranged between ( 18 and 70 years) who underwent spinal surgery with pedicle screw fixation for different disorders of
study aimed to investigate the effect of fish bone in the of chemistry and self-organized learning for students of the second grade‚ achievement . The study sample consisted of 84 students from the second grade students middel in the of alrasheed boysschool, of the Directorate of Educational Karkh II, in two divisions, Division of (a) an experimental group that studied the strategy fish bone, and the Division (d) a control group which studied the usual way. The results indicated the presence of significant differences in favor of the experimental group that studied using the fish bone in achievement and learning self-organized strategy students
The use of destructive weapons in wars without restrictions and controls, which eat green and dry land, pollute the environment and cause genocide, has become the problem of the times.
International conventions for the protection of the environment during armed conflicts are characterized by generality, ambiguity, and open to interpretation by the participating states in the agreement, and each state interprets these texts to serve its interests, but the Islamic Sharia stipulates the prohibition of the use of these comprehensive destructive weapons in an unambiguous manner, As stated in the Holy Quran:
... Show MoreJean-Paul Sartre and Badr Shakir al-Sayyabe are among the most prominent writers that critiqued the destructive role of capitalism and the patriarchal power system in the period of the Post-World War II crisis. Divided into three chapters, the present study examines two of the most eminent literary works in the history of the Western and Eastern societies in the fifties of the last decade: Jean Paul Sartre’s play : The Respectful Prostitute and Badr Shaker al-Sayyabe’s poem: The Blind Prostitute.
Chapter one discusses the position of the prostitute in a patriarchal societies. Chapter two linguistically analy
... Show More