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
There is no access to basic sanitation for half the world's population, leading to Socioeconomic issues, such as scarcity of drinking water and the spread of diseases. In this way, it is of vital importance to develop water management technologies relevant to the target population. In addition, in the separation form of water treatment, the compound often used as a coagulant in water treatment is aluminum sulfate, which provides good results for raw water turbidity and color removal. Studies show, however, that its deposition in the human body, even Alzheimer's disease, can cause serious harm to health and disease development. The study aims to improve the coagulation/flocculation stage related to the amount of flakes, i
... Show MoreThe problem of Bi-level programming is to reduce or maximize the function of the target by having another target function within the constraints. This problem has received a great deal of attention in the programming community due to the proliferation of applications and the use of evolutionary algorithms in addressing this kind of problem. Two non-linear bi-level programming methods are used in this paper. The goal is to achieve the optimal solution through the simulation method using the Monte Carlo method using different small and large sample sizes. The research reached the Branch Bound algorithm was preferred in solving the problem of non-linear two-level programming this is because the results were better.
Multiple sclerosis (MS) is a chronic, inflammatory demyelinating disease of central nervous system with complex etiopathogenesis that impacts young adults (Lee et al., 2015), and MS impacts younger and middle aged character and leads to a range of disabilities that can alter their daily routines (Yara et al, 2010). Although, the exact cause of MS is still undetermined, the disease is mediated by adaptive immunity through the infiltration of T cells into the central nervous system (Bjelobaba et al, 2017). MS causes the Focal neurological symptomsand biochemical changes in the molecular level and the variation of neural cells such as loss or alteration of sensation, motor function, visible signs such as blurred vision or transient blindness,
... Show MoreThis research study Blur groups (Fuzzy Sets) which is the perception of the most modern in the application in various practical and theoretical areas and in various fields of life, was addressed to the fuzzy random variable whose value is not real, but the numbers Millbh because it expresses the mysterious phenomena or uncertain with measurements are not assertive. Fuzzy data were presented for binocular test and analysis of variance method of random Fuzzy variables , where this method depends on a number of assumptions, which is a problem that prevents the use of this method in the case of non-realized.
Insurance companies seeking to develop programs to promote and market their services and to increase its customer through the use of modern technical marketing and reduce its dependence on agents and take advantage of work of the banks by alliances with them and including reinforcing get the parties to competitive advantages in the financial market , the insurance services intangible service stops marketed over the insurance awareness and requires exceptional promotional efforts. &nbs
... Show Moreيكشف هذا المقال عن مشكلة الصفات ذات المكون الكمي والتي تعتبر واحدة من اقوى الموارد المكونة للكلمات التعبيرية والتقويمية و يتم تحليل التركيبات الدلالية ذات الاوجه المتعددة التي تنشا من عملية توظيف الصفات المشتقة بمساعدة اللواحق والتي تدل على الاتجاه العام للغات السلافية وذلك لتطوير الدلالات العاطفية والتقييمية في الكلمات ذات معنى الميزة او الخاصية يتم تقديم تعريف انماط تكوين المعاني الضمنية في دلالات
... Show MoreThe increase in the Iraqi population put pressure on urban cities as there were no new cities built since the 1980s due to the wars and the economic blockade imposed in 1991 and the deteriorating security situation after 2003, where the population in 2018 reached about forty million people. Iraq also suffered during the past decades from problems and challenges in many respects that affected the local environment, and the constructed buildings had a role in increasing these impacts, so the Ministry of Housing worked to issue the Iraqi Green Architecture Code in 2019 to reduce damage to the environment and use resources more efficiently. And because the constructed buildings were not constructed according to green standards, including Bas
... Show MoreAbstract: Iatrogenic furcal root perforations are serious complications during dental treatment. This study was aimed to compare the sealing ability of new bioceramic root repair material TotalFill® with the other perforation repair materials (GIC, MTA and Biodentine) using a dye- extraction method.Materials and Methods: Forty extracted, human mandibular molars with non-fused well developed root were collected. Artificial perforations were made from the external surface of the teeth. Then the teeth were randomly divided into 4 experimental groups (n= 10) according to the type of repair material used in this study; Medifil glass ionomercement, TotalFill® bioceramic root repair material, BiodentineTM and MTA Plus. The specimens were then im
... Show MoreThe disposal of textile effluents to the surface water bodies represents the critical issue especially these effluents can have negative impacts on such bodies due to the presence of dyes in their composition. Biological remediation methods like constructed wetlands are more cost-effective and environmental friendly technique in comparison with traditional methods. The ability of vertical subsurface flow constructed wetlands units for treating of simulated wastewater polluted with Congo red dye has been studied in this work. The units were packed with waterworks sludge bed that either be unplanted or planted with Phragmites australis and Typha domingensis. The efficacy of present units was evaluated by monitoring of DO, Temperature, COD
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