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
Abstract:
Under the state scenario, fiscal policy will not be able to use the oil surpluses optimally and economically and society, as long as these surpluses are not directed by public expenditure towards new productive investments and by following the path of fiscal policy after one year 2003 and until 2013 we note that it is based on the method of spending (excessive) consumption, and did not take any action towards the budget deficit planned at the beginning of the fiscal year, and the actual surplus at the end of the fiscal year, which represents the highest expenditure in the budget, Salaries and wages of workers in various government agencies with the expansion of spending on the security side.&n
... Show MoreThe present study aims to evaluate the effects of methotrexate (MTX) with and without vitamin A (Vit. A) on some biochemical parameters and histological structure in male rabbits liver. Twenty male rabbits weighing 1250-1480 gm were divided into four equal number groups. The first group was given 2 ml distilled water as control group. The second group was given MTX (20 mg/kg), the third group was given Vit. A (5000 IU), while the fourth group was given MTX (20 mg/kg) +Vit. A (5000 IU) in alternative days. Following four weeks of treatment, lipid profile total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), [low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL)]; in addition to thyroid hormones tr
... Show MoreAbstract
The current research aims to identify the level of partnership between school and community agencies to improve secondary school outcomes for students with intellectual disabilities and develop strategies that help enhance community partnerships between schools and agencies. The researcher used the qualitative research approach; he utilized the interviews as a tool for data collection. The sample of research included (12) participants: three female school leaders, three male-school leaders, three female-school supervisors, and three male-school supervisors in schools that have programs for students with intellectual disabilities in Riyadh. The results of the study showed that the level of partnership bet
... Show MoreIn this paper, some relations between the flows and the Enveloping Semi-group were studied. It allows to associate some properties on the topological compactification to any pointed flows. These relations enable us to study a number of the properties of the principles of flows corresponding with using algebric properties. Also in this paper proofs to some theorems of these relations are given.
The researcher aims to detect the emotive equanimity in kindergartens teachers,also to uncover the anxiousness in children of kindergartens,then to detect the relationship between them,then to choose the simple random way which is about(180) teachers and children,when the twore searchers made two tools to measure the emotive equanimity and the anxiety for both teachers and children,statistical methods had been used include:(pearsons correlation coefficient,t-test for one sample,t-test for two independent samples are individuals).the researcher led to multiple results:
1-the teacher has an emotive equanimity.
2-children has no anxiousness.
Urinary tract infections (UTIs) mean microbial pathogens in the urethra or bladder (lower urinary tract). Important risk factors for recurrent UTI include obstruction of the urinary tract, use of a bladder catheter or a suppressed immune system. This study aims to isolate and identify bacteria from patients with TCC-bladder cancer or patients with a negative cystoscope and estimate antibiotic susceptibility patterns and evaluate some of the virulence factors. From a total of 62 patients with TCC-BC or negative cystoscope, only 35 favorable bacterial growths were obtained, including Escherichia coli (UPEC), a significant bacterial isolate, and Stenotrophomonas maltophilia. The percentage of multi drug-resistance bacteria
... Show MoreThe financial statements must accurately, clearly and fairly present the financial situation and financial statements should be reliable as well. Pursuant to Board Decision No. (74) 2020, CBI obliges banks, according to the Banking Law No. (94) for the year 2004, Article (33) paragraph 2 concerning real estate owned from previous years and expropriated as a result debt settlement , to apply a real estate liquidation provision at a rate of 20% for each property expropriated and at a rate of 100% for each year of delay up to (5) years .also from the significance of the issue of real estates that become a property of banks as a result of debt settlement and the pr
... Show More