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 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
Francisco de Quevedo is a well-known man of letters in the Golden Age of Spanish literature. He is the witness who related to us, in his works, the Spanish community in that era. He showed in most of his writings the political weakness of Spain, and made prominent the remarkable literary aspect of Spain. He had a very good tlent for poetry, and a rather polite style in exploiting colloquialisms in his literary writings. He wrote about philosophy, where his most prominent work was "The cradle and the grave". The writer was also very well-known for his puns which were employed to clarify his inner thoughts regarding the Spanish situation at that time.
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... Show MoreBackground: There has always been a need for valuable measurements that can be used to measure hearing loss degree in patient who cannot responses to the subjective (behavioral) tests.
Objectives: to examine the accuracy of the click - Auditory Brain stem Response (ABR) test in estimating the hearing loss degree in comparison with the behavioral tests {Free Field (FF) or Pure Tone Audiometry (PTA )}.
Subjects and method: One hundred twenty one children, with suspected hearing loss, their age between 1-9 year, 51 females and 70 males were examined in this work.
Result: The relationship between the hearing loss thresholds using the behavioral
In this paper, we introduce and study a new concept named couniform modules, which is a dual notion of uniform modules, where an R-module M is said to be couniform if every proper submodule N of M is either zero or there exists a proper submodule N1 of N such that is small submodule of Also many relationships are given between this class of modules and other related classes of modules. Finally, we consider the hereditary property between R-module M and R-module R in case M is couniform.
One technique used to prepare nanoparticles material is Pulsed Laser Ablation in Liquid (PLAL), Silver Oxide nanoparticles (AgO) were prepared by using this technique, where silver target was submerged in ultra-pure water (UPW) at room temperature after that Nd:Yag laser which characteristics by 1064 nm wavelength, Q-switched, and 6ns pulse duration was used to irradiated silver target. This preparation method was used to study the effects of laser irradiation on Nanoparticles synthesized by used varying laser pulse energy 1000 mJ, 500 mJ, and 100 mJ, with 500 pulses each time on the particle size. Nanoparticles are characterized using XRD, SEM, AFM, and UV-Visible spectroscopy. All the structural peaks determined by the XRD
... Show MoreAge, hypertension, and diabetes can cause significant alterations in arterial structure and function, including changes in lumen diameter (LD), intimal-medial thickness (IMT), flow velocities, and arterial compliance. These are also considered risk markers of atherosclerosis and cerebrovascular disease. A difference between right and left carotid artery blood flow and IMT has been reported by some researchers, and a difference in the incidence of nonlacunar stroke has been reported between the right and left brain hemispheres. The aim of this study was to determine whether there are differences between the right and left common carotid arteries and internal carotid arteries in patient
The research aims to improve the effectiveness of internal control system according to a model COSO, by identifying the availability of system components according to the model and then improve the effectiveness of each component by focusing on areas for improvement in each component, as it was addressed to a model COSO and then Maamth with the environment, the current Iraqi by introducing some improvements on the form of some mechanisms of corporate governance of the Council of Directors, and senior management, the Audit Committee, Committee appointments, especially that supplies application available in the laws and legislation, the current Iraqi, taking into consideration to make some
... Show MoreAbstract:
There is a close relationship between rigidity and distort structure of production and productivity and inflation rates. The effects of this relationship are distorted the contribution rate of the productive sectors and the disproportionate of exchange rate in foreign trade.
raising the general level of prices is one of the way that have been used by previous governments (inflationary financing or deficit financing) in order to speed up the process of capital formation, depending on the availability of economic resources idle.
The fabricating inflation for development does not represent a true understanding of the nature of the
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