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.
Considering the magnitude of its economic, social and political impact, unemployment represents a crucial challenge confronting the majority of the countries of the world. The problem of the study was the high rates of unemployment in Sudan and the inability of economic growth rates to keep pace with the steady increases in unemployment rates during the study period. This study aimed to identify the economic and social variables influencing unemployment rate in Sudan, in addition to measuring the impact of these variables over the period (1981-2015). Data were collected from databases of the World Bank and Atlas of the World's data .The study hypothesized the presence of statistically significant and direct relationship between u
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ملخص البحث:
ان الله تعالى هو الذي خلق جميع المخلوقات ، والذي بيده الموت والحياة وان كل هذه المخلوقات تحتاج الى اوامر ، وهذه الاوامر الالهية وجهها الله لعبادة بوساطة انبياءه ( عليهم السلام) فكانوا هم اول المستسلمين والمنقادين لأوامره ، فجاءت الآيات الكريمة مخاطبة للأنبياء واقوامهم بشكل عام ولنبينا محمد (r) بشكل خاص.
اما عن المضمون البحثي فقد جاءت مادته مقسمة الى ثل
... Show MoreThe current research aims to measure Generalized Anxiety Disorder among students of the University of Sulaymaniyah / College of Basic Education, and to identify the significance of differences between sex, scientific specialization and age, and for that reason, the research sample of (102) male and female students was chosen in a random manner, and the researcher used the diagnostic criteria for the generalized anxiety disorder contained He mentioned it in the Statistical and Diagnostic Manual of Psychiatry, and the paragraphs of the scale were formulated according to those standards after they verify the conditions of honesty and consistency, and the use of appropriate statistical means. The results of the research indicated that genera
... Show MoreAttacking a transferred data over a network is frequently happened millions time a day. To address this problem, a secure scheme is proposed which is securing a transferred data over a network. The proposed scheme uses two techniques to guarantee a secure transferring for a message. The message is encrypted as a first step, and then it is hided in a video cover. The proposed encrypting technique is RC4 stream cipher algorithm in order to increase the message's confidentiality, as well as improving the least significant bit embedding algorithm (LSB) by adding an additional layer of security. The improvement of the LSB method comes by replacing the adopted sequential selection by a random selection manner of the frames and the pixels wit
... Show MoreIn this work, two cone-inverted cylindrical and cross-hybrid dielectric resonator antennas are stacked and excited by the coaxial probe method with an operating standard resonant frequency of 5.438 GHz. A drawback of these standard Dielectric Resonator Antennas (DRAs) is their narrow bandwidth. For good antenna performance, a stacked DR geometry and a thick dielectric substrate having a low dielectric constant are desired since this provides large bandwidth, better radiation power, reduces conductor loss and nonappearance of surface waves. Many approaches, such as changing the shape of the dielectric resonator, have been used to enhance bandwidth. Using DRA, having the lowest dielectric constant, increases the bandwidth and the electroma
... Show MoreA theoretical study to design a conformal microstrip antennas was introduced in this work. Conformal microstrip antennas define antennas which can be conformed to a certain shape or to any curved surface. It is used in high-speed trains, aircraft, defense and navigation systems, landing gear and various communications systems, as well as in body wearable. Conformal antennas have some advantages such as a wider-angle coverage compared to flat antennas and low radar cross-sectional (RCS) and they are suitable for using in Radome. The main disadvantage of these antennas is the narrow bandwidth. The FDTD method is extremely useful in simulating complicated structures because it allows for direct integration of Maxwell's equations depending o
... Show MoreLow cost Co-Precipitation method was used for Preparation of novel nickel oxide (NiO) nano particle thin films with Simple, with two different PH values 6, 12 and its effect on structural and optical properties as an active optical filter. Experimental results of structural properties X-ray diffraction (XRD) showed that both Nickel oxide nanoparticles with (PH=6 and 12) have polycrystalline structure smaller average particle size about 8.5 nm for PH=6 in comparison with PH=12. Morphological studies using Scanning electron microscopy (SEM) and atomic force microscope (AFM) show uniform nano rod distribution for PH=6 with smaller average diameter, average roughness as compared with NiO with
... Show MoreBackground: Alcohol remains the single most significant cause of liver disease throughout the Western world, responsible for between 40 and 80% of cases of cirrhosis in different countries. Many of the factors underlying the development of alcoholic liver injury remain unknown, and significant questions remain about the value of even very basic therapeutic strategies.
Patients and Methods: In a cross sectional study, 113 alcoholic patients with evidence of liver disease in the absence of other significant etiology attending the Gastoenterorology and Hepatology Teaching Hospital between December 2001 and December 2003 were studied for the hematological and biochemical spectrum of alcoholic liver disease in
The charge density distributions (CDD) and the elastic electron scattering form
factors F(q) of the ground state for some odd mass nuclei in the 2s 1d shell, such
as K Mg Al Si 19 25 27 29 , , , and P 31
have been calculated based on the use of
occupation numbers of the states and the single particle wave functions of the
harmonic oscillator potential with size parameters chosen to reproduce the observed
root mean square charge radii for all considered nuclei. It is found that introducing
additional parameters, namely; 1 , and , 2 which reflect the difference of the
occupation numbers of the states from the prediction of the simple shell model leads
to very good agreement between the calculated an