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
Many economists believe that the development and promotion of small and medium-sized enterprises is one of the most important sources of economic and social development in countries in general and in developing countries in particular. This is considered to be an essential starting point for increasing production capacity and contributing to tackling poverty and unemployment. In view of the importance of these projects, most developing countries have concentrated their efforts on them. They have encouraged the establishment of small and medium industries, especially after they have proved their ability and efficiency in dealing with the major problems facing different economies.
The banking system plays an important role by finan
... Show MoreThe need for Dewatering is very important in construction workshops field and sometimes it needs to pay more attention as a result of its impacts on causing additional settlement of nearby pile foundations. Dewatering construction may become a costly topic if ignored during project planning and designing .In this paper a simplified procedure maybe adopted to calculate the foundation settlement induced by using dewatering system which is required to lower the water table level to reach a dry condition during construction. Synthesized case study adopted at a specified location in Baghdad city and analysis are computed for two types of piles both of them are submerged with water. Results shows the effect of dewatering on pile foundatio
... Show MoreA simple straightforward mathematical method has been developed to cluster grid nodes on a boundary segment of an arbitrary geometry that can be fitted by a relevant polynomial. The method of solution is accomplished in two steps. At the first step, the length of the boundary segment is evaluated by using the mean value theorem, then grids are clustered as desired, using relevant linear clustering functions. At the second step, as the coordinates cell nodes have been computed and the incremental distance between each two nodes has been evaluated, the original coordinate of each node is then computed utilizing the same fitted polynomial with the mean value theorem but reversibly.
The method is utilized to predict
... Show MoreThe research presented to the concept of social isolation through the manifestations of that concept and its works within the theatrical presentation space, and the diversity of directing experiences that the theatrical field benefited from, as contemporary data that contributed to the production of theatrical speech engaging with various levels of different form and content, and this was revealed through the chapters of the research that included The first chapter (the systematic framework), the second chapter (theoretical framework), which included the first topic (formations of social isolation), the second topic (social isolation in the world stage), and resulted in indicators including:
1- Postmodernism produced intellectual appr
Objective(s): The aim of this study is to determine the effectiveness of education program on Health Care Workers’ practices toward Primary Health Care Centers waste management and to identify the relationship between these practices and the demographic characteristics of the health workers. Methodology: A quasi- experimental design (pre-post tests) has been used in the present study for the period of November 16th 2014 to June 22nd 2015 .The allocated sample in the present study is consisted of (60) health care worker. The sample was randomly divided into two groups of (30) health care workers each. The stu
Numerical study has been conducted to investigate the thermal performance enhancement of flat plate solar water collector by integrating the solar collector with metal foam blocks.The flow is assumed to be steady, incompressible and two dimensional in an inclined channel. The channel is provided with eight foam blocks manufactured form copper. The Brinkman-Forchheimer extended Darcy model is utilized to simulate the flow in the porous medium and the Navier-Stokes equation in the fluid region. The energy equation is used with local thermal equilibrium (LTE) assumption to simulate the thermofield inside the porous medium. The current investigation covers a range of solar radiation intensity at 09:00 AM, 12:00 PM, and 04:00
... Show MoreDuring the period 1970-2006 the Marshes-land region was exposed to several change into many sides of vanishing steeling and growth as follow :
1- Drying this region after 1991,and re-flooded again during 2003. Many other large Marsh-land, like al-Hawaisa was dried by cutting off inlet-water fed from Iran sources .As asqunance there are transferred to different kinds of swamps ,followed by major change in the structure of the region as the rural settlement concerned. Rural settlement in this area starts new push of migration. The research did not take that in consideration in this thesis because some others took it in details in some thesis and researches. The situation of Marsh-land is getting anew face after those major changes which
The expansion of building blocks at the expense of agricultural land is one of the main problems causing climate change within the urban area of a city. The research came to determine these indicators, as a study was conducted on the expansion of the building blocks in three municipalities in the city of Baghdad for a period of four decades extended in the form of time cycles for the period (1981-2021) and using ArcMap GIS 10.7 technology. Then, the impact of this expansion on temperature rates was evaluated, as they are the most important climatic elements due to their significant effect on the rest of the elements. The results showed a clear, direct relationship between the increase in urban expansion rates and the corresponding r
... Show MoreThis prospective study investigates the prevalence of methicillin-resistant S.aureus (MRSA)
in burn unit of Al-Kindy Iraqi hospital, their susceptibility to antibiotics and bactericidal effect of near
infrared light from high powered 1064nm Nd: YAG laser and green light 532nm from SHG Nd: YAG laser
using various energy densities on these bacteria. Twenty four clinical isolates of S.aureus out of sixty
four examined patients with sever burn ulcers.MRSA was associated with 50% of S.aureus infections
.Results of antimicrobial susceptibility revealed that MRSA were multidrug resistant. After laser treatment
of non MRSA with Nd:YAG with wavelength of 1.064nm, 4mm beam diameter, energy density of
0.636 kh/cm2 and 180sec ex
Multipoint forming process is an engineering concept which means that the working surface of the punch and die is produced as hemispherical ends of individual active elements (called pins), where each pin can be independently, vertically displaced using a geometrically reconfigurable die. Several different products can be made without changing tools saved precious production time. Also, the manufacturing of very expensive rigid dies is reduced, and a lot of expenses are saved. But the most important aspects of using such types of equipment are the flexibility of the tooling. This paper presents an experimental investigation of the effect of three main parameters which are blank holder, rubber thickness and forming speed th
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