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.
This research includes the use of an artificial intelligence algorithm, which is one of the algorithms of biological systems which is the algorithm of genetic regulatory networks (GRNs), which is a dynamic system for a group of variables representing space within time. To construct this biological system, we use (ODEs) and to analyze the stationarity of the model we use Euler's method. And through the factors that affect the process of gene expression in terms of inhibition and activation of the transcription process on DNA, we will use TF transcription factors. The current research aims to use the latest methods of the artificial intelligence algorithm. To apply Gene Regulation Networks (GRNs), we used a progr
... Show MoreAtorvastatin calcium (ATR) is an antihyperlipidemic agent used for lowering blood cholesterol levels. However, it is very slightly soluble in water with poor oral bioavailability, which interferes with its therapeutic action. It is classified as a class II drug according to Biopharmaceutical Classification System (low solubility and high permeability).
This research studies the effect of adding micro, nano and hybrid by ratio (1:1) of (Al2O3,TiO2) to epoxy resin on thermal conductivity before and after immersion in HCl acid for (14 day) with normality (0.3 N) at weight fraction (0.02, 0.04, 0.06, 0.08) and thickness (6mm). The results of thermal conductivity reveled that epoxy reinforced by (Al2O3) and mixture (TiO2+Al2O3) increases with increasing the weight fraction, but the thermal conductivity (k) a values for micro and Nano (TiO2) decrease with increasing the weight fraction of reinforced, while the immersion in acidic solution (HCl) that the (k) values after immersion more than the value in before immersion.
The study aimed to highlight the reality of the functional pressures with its dimensions (role ambiguity, role conflict, role burden, glass ceiling, and discrimination in composition). The researchers also relied on the questionnaire as a essential tool for data collection. The field study was conducted at the University of Mohammed Khiedr - Biskra -, the study was conducted on the basis of the total survey, which included all the workers of the 6 faculties of Biskra University (523 female employees).
After the analyzing of the data using the version 21 of the statistical program Spss, The study reached a number of results, the most of them is the low level of the functiona
... Show MoreThis research studied the relationship of patterns of investigator personality with the big five dimensions (Extraversion, stability, interoperability, openness, and personal benevolent), in facing the job stress with its resources(characteristics of the role, quality of work, organizational structure, work environment, organizational policies, social relations, and organizational processes) which the investigators exposed to it at the General Inspectors Offices.
The researcher derived the idea of research from the importance of the work of these offices in a confrontation of various cases of financial and administrative corruption in Iraq at the present time, since itis one of the most important in
... Show Morewith intellectual and philosophical in modern administrative thought. The focus of the target on the identification of the strategic concept of human resource management practices in business organizations. It studied the scientific concept, in terms of how it has been the shift from personnel management, and to human resources management, and then to HR management strategy. The research has included extensive serious discussions about the nature of the changes, and how to determine the nature and content of the strategic perspective of human resources management in the changing and volatile world of business. It was also the explanation and clarification theoretical philosophies that came in various previous studies, and i
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Concentrated research topic in addressing variable vital to the work of offices of inspectors general, construction and scale effectiveness and efficiency is the organizational structure, which are important as is obvious to any researcher in the management and organization and this variable would affect the exercise task supervision and inspection of financial and administrative corruption and combat efficiently, Thus this effect will be placed in the fold ability to achieve goals. That the creation of the organizational structure and requirements to achieve harmony between its properties is creating step towards success. This research aims to analyze the characteristics and style o
A theoretical model is developed to determine time evolution of temperature at the surface of an opaque target placed in air for cases characterized by the formation of laser supported absorption waves (LSAW) plasmas. The model takes into account the power temporal variation throughout an incident laser pulse, (i.e. pulse shape, or simply: pulse profile).
Three proposed profiles are employed and results are compared with the square pulse approximation of a constant power.
In this work lactone (1) was prepared from the reaction of p-nitro phenyl hydrazine with ethylacetoacetate, which upon treatment with benzoyl chloride afforded the lactame (2). The reaction of (2) with 2-amino phenol produced a new Schiff base (L) in good yield. Complexes of V(IV), Zr(IV), Rh(III), Pd(II), Cd(II) and Hg(II) with the new Schiff base (L) have been prepared. The compounds (1, 2) were characterized by FT-IR and UV spectroscopy, as well as characterizing ligand (L) by the same techniques with elemental analysis (C.H.N) and (1H-NMR). The prepared complexes were identified and their structural geometries were suggested by using elemental analysis (C.H.N), flame atomic absorption technique, FT-IR and UV-Vis spectroscopy, in additio
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