Background: Coronary artery disease remains the main cause of death despite several preventive programs. Epicardial adipose tissue is a visceral fat depot of the heart located along the large coronary arteries and on the surface of ventricles and apex. Intima media thickness is commonly recognized as the initial stage in the development of atherosclerosis. The development of ultrasound machines, advances in echocardiographic devices and high resolution transducers facilitate comprehensive analysis of epicardial fat thickness (EFT) and carotid –intima media thickness (C-IMT).
Aim: To investigate the relationship of echocardiographic epicardial fat thickness (EFT) and carotid –intima media thickness (C-IMT) with the severity of coronary artery disease.
Methods: A cross sectional multicenter diagnostic accuracy study carried out at Ibn Al-Nafis Cardiovascular Hospital, Ibn Al- Bitar Cardiology Center and Ghazi Al-Hariri Hospital –Iraqi Center for Cardiology during the period between October 2016 and May 2017 assessing. History regarding demographic data and risk factors was taken. Two dimensional transthoracic echocardiographic measurements were done. EFT was measured from parasternal long axis view perpendicular to the right ventricular free wall. C-IMT was measured according to that recommended by the American society of echocardiography (ASE).
Results: The current study demonstrated that the EFT has a direct and significant correlation with the number of involved vessels (P value ˂ 0.001, r= 0.770). The validity of EFT to discriminate between multiple vessels disease and no vessel involvement is excellent (AUC= 0.984, cut point > 8mm, sensitivity=92.9%, specificity= 93.3%). There is inverse and significant correlation between ejection fraction (EF) and three vessels disease (P value ˂ 0.001, r= -0.507). Also there is a direct and significant correlation between C-IMT and severity of CAD. ROC analysis for validity of C-IMT to discriminate between multiple vessels disease and no vessel involvement is excellent (AUC= 0.961, cut point > 1.04mm, sensitivity=92.9%. specificity=86.7%). C-IMT is fair to discriminate between single vessel disease and no vessel involvement (AUC=0.738, cut point ˃ 0.84mm, sensitivity 100%), so if correlated with age, C-IMT above 0.84 can be used as a cut off point for the prediction of CAD. Finally, EFT and C-IMT are more likely to reflect severity of CAD than their ratio.
Conclusions: C-IMT and EFT are simple and reproducible parameters that can be used as a screening tool for the presence and severity of CAD especially before symptoms appearance in high risk patients
Thyroid hemiagenesis (THA) is a rare congenital anomaly in which one lobe of thyroid gland fails to develop during embryological stage. Agenesis may be unilateral, total or isthmic. Left thyroid lobe is more commonly involved than right lobe in hemiagenesis. Agenesis of the isthmus was seen in 50% of cases. Left sided hemiagenesis is more common than right sided hemiagenesis with a Left to right ratio of 4:1. Clinically patients can be euthyroid, hypothyroid or hyperthyroid. Often it is diagnosed as an incidental finding during ultrasonography (USG) study of neck, which can easily diagnose this condition.
Actual incidence of THA is unknown; most cases are diagnosed in patients admitted for thyroid scan or thyroid surgery because
... Show MoreThe study aimed to prepare a set of qualifying exercises to improve the muscular strength of the muscles surrounding the ankle joint by applying different resistances according to the nature of the movement of this joint, which is one of the second moving joints (flexion, extension and rotation of the right and left) in order to increase the efficiency of all muscles working on this joint according to those movements and identification On the impact of these exercises and assume that there will be statistical differences between the two tests of the research sample. The researcher used the semi-articulated experimental method with a pre- and post-test for one group. The injury was evaluated on the women's national team players durin
... Show MoreBackground: Significant numbers of patients with spinal tuberculosis (TB), especially in developing countries, still present late after disease onset with severe neurological deficits.
Objective:This study was conducted to assess the outcome of surgery in patients with tuberculosis of the spine with motor deficits.
Type of the study: Retrospective study.
Methods: We retrospectively analyzed data obtained in all the patients with severe motor deficits due to spinal TB admitted to and surgically treated in four hospitals in Baghdad/Iraq during the period from January 2012 to January 2014. History, examination, imaging, histological, postoperative, a
... Show MoreThe research problem has crystallized and in light of these capabilities, the level of performance depends on the application of modern training methods based on actual experimentation, and those methods aim to develop the components of achievement in this competition, including the quantities of exerting the distinctive strength with speed for the arms and feet, which reflects on good skillful performance because the skill of shooting by jumping forward and high forms A major role in achieving goals during the competition that qualifies the team to win, and through the follow-up of the researcher in the field and academic field, I noticed that there is a weakness in some physical abilities, which affects performance and skill level
... Show MoreThe study involved preparing a new compound by combining Schiff bases generated from compounds for antipyrine, including lanthanide ions (lanthanum, neodymium, erbium, gadolinium, and dysprosium). The preparation of the ligand from condensation reactions (4-antipyrinecarboxaldehyde with ethylene di-amine) at room temperature, and was characterization using spectroscopic and analytical studies ( FT-IR, UV-visible spectra, 1H-NMR, mass spectrometry, (C.H.N.O), thermogravimetric analysis (TGA), in addition to the magnetic susceptibility and conductivity measurement of the synthesis complexes, among the results we obtained from the tests, we showed that the ligand behaves with the (triple Valence) lanthanide ions, the multidentate
... Show MoreThis research is an attempt to develop exercise with weights to strengthen some of the striking muscles in the shoulder and arm and to develop the accuracy of the smash and rectum skills. The importance of this paper lies in the study of moments of force to achieve the ability to control muscular work and to explore the impact of physical and skill exercises with weights to develop moments of force for some muscles. The experimental method on a sample of players, selected according to the intentional method, including ( 9) advanced players representing Air Force Club participating in the Premier League for season 2011-2012. It is concluded that the exercises proposed have their effective impact on developing the variables of moments force f
... Show MoreAfter the success of the reforms Keynesian save the capitalist system from collapse and to apply the concepts of state intervention in economic activity in order to revive aggregate demand to achieve the purposes of macro-economic policies which draw their scope of economic (John Keynes) theory of effective demand, which created the new role of the state away from the classical concepts. Valley transmission role of the State of (State Guardian) to the process of state overlapping that increased and social functions have become responsible for raising the standard of living of classes with limited incomes, in particular, and the rest of the classes in general, through the expansion of the delivery of public servic
... Show MoreThe study objectives were to 1) explore the real-world experience of hospital pharmacists with the differences in effectiveness safety, and interchangeability between biosimilar medicines and their reference biological counterparts, 2) reveal pharmacist recommendations to enhance the safety of biopharmaceutical medicines in public hospitals.
The study has a mixed-method design where the core component was qualitative (interviews) and the supplemental component was quantitative (adverse drug reaction, ADR, reports). This qualitative component included semi-structured (mostly face-to-face) interviews involving hospital pharmacists from different hospitals with experience with biological or biosimilar medicines. The interviews were c
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