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 legal protection of the human genome is an ethical issue related to the future of human existence. After the disclosure of the human genetic map, scientific practices and research related to the human genome increased, especially the negative applications of genetic engineering that violates basic human rights, especially the right to human dignity, and pose real challenges to the existence and diversity of Present and future generations. Therefore, the existence of legal rules at the national and international levels is an absolute necessity to prohibit these threats and to arrange civil and criminal liability for those who violate them.
It is very known how great is the role of the Jewish writers in the system of the Zionist movement. The movement relied on writers and writers to carry out their programs, especially those pertaining to the creation of a "national homeland" for Jews. Most Jewish writers sang of Palestine even though they were not born there.
On such a basis, we have followed closely the writings of writers, critics and others by the end of the nineteenth century and the beginning of the twentieth century. We found that these writings are based on one common question: What is the fate of the Jewish people?
Most of these writings were accompanied by Theodor Herzl's proj
... Show MoreOur research comes to shed light on Iraqi literature as literature that arose in special circumstances alongside foreign literature. Using comparative research methods, we chose to highlight two distinguished writers, who have their mark in the world of literature. The first is the Iraqi writer Maysaloun Hadi, who is considered an icon of Iraqi feminist literature, and the second is the French writer Le Clézieu, who won the Nobel in 2008. We will see through the research how the two authors expressed their views of modernity and urbanism. And how each of them separately portrayed the psychological and moral projections that formed the essence of man today.
Résumé
Notre recherche abord un des points inc
... Show MoreResearches in the field of evaluation of industrial products emotionally are internationally new and non-existing in the Arabic speaking countries, which is considered the crux of the problem in the current research, in addition to the need of the designers and design students to know how to measure the emotional responses for the industrial product in order to get benefit from them in their designs. The research objective is to get a tool that uses emojis in measuring the emotional responses for the products. The researcher designed an emotional verbal wheel and emojis wheel. The sample of the research consisted of (7) chairs different in design and use, and the respondents were (89) students. The most important results are:
1- Desi
Background: Urological anomalies are frequently associated with anorectal malformations which are a common source of significant morbidity.
Objective: Is to evaluate the incidence and nature of the urological anomalies with patients of anorectal malformations (ARM).
Patients & methods: The data from 95 patients with ARM were studied from January 2009 to January 2012 in this cross-sectional study. All patients underwent sonography of urinary tract. Voiding cystourethrogram (VCUG) was done in patient with abnormal sonography & to all male patients with ARM who underwent colostomy. Other imaging studies were done in selected cases.
Results
... Show MoreThis study aimed at identifying the trend to applying the Joint Audit as an approach to improve the financial reports quality with all their characteristics (Relevance, Reliability, Comparability, Consistency), as well as enclose the difficulties that faced the auditors in the Gaza Strip in implementing the Joint Audit. In order to achieve the study aims, a measure was used to identify the trend to apply the Joint Audit and it was distributed to the study sample which is consisting of (119) individuals and retrieved thereof (99) valid for analysis, approximately (83.2%), (69) of them are Auditors, (30) financial managers and accountants. The researcher used the analytical descriptive method, and after analyzing the results, the s
... Show MoreThe study aimed at interpreting the role of architectural design quality in in build competitiveness model in accordance with the proposal included the idea of architectural design quality for its removal; interesting design factors of the environment, good design of the spaces, and design aesthetic explanatory variable. The competitiveness dimensions; the level of innovation, stimulate research, and the quality of the company's products, and activating the role of human resources, entrepreneurship, profitability, market share and competitiveness, variable responsive. The study of construction companies in the Ministry of Housing and Construction has taken the Iraqi society for the study. The sample consisted of (48) manage
... Show MoreThe article describes the basic principles of modeling a dictionary article in the “Dictionary of the Language of Russian Folklore Lexicon epics” (M. A. Bobunova, A. T. Khrolenko). Among such principles are the principle of linguocentrism (representation of universal cognitions in strict observance of the traditions of lexicographic science), the principle of anthropocentrism (language learning as a means of human consciousness / subconsciousness), the principle of expansionism (attracting material from various knowledge bases), the principle of explanatory ("explanatory moment"), and fractal principle (synergistic potential of the presented material: nonlinearity and self-similarity; hierarchical organizati
... Show MoreThere is a mutual relationship between the form of a text and its meaning so as separating these two or devaluating the role of one of them leads to the absence of the value therein. Thus, a translation is important as to how it relates the details of a text. That is, the text has special features which go beyond form, and these set out its distinctiveness. Here, we tackle Saleh al-Jafari's Arabic translation of "Rubbayat al-Khayyam" of Naysapour descriptively and analytically by depending on extracts from the original text. This translation is evaluated on the basis of Spanish critic Maria Carmen Valero Garces. Herein, we discuss the effectiveness of this theory in the criticism of literary texts. It has been concluded that al-Jaf
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