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
In the present work, the image and representation of Adela, the youngest daughter of the family of the Casa de Bernarda Alba, one of the most popular works of the Spanish author Federico García Lorca (1898-1936), will be analyzed. In this work, there are different themes, but what concerns us is to show the repression, oppression and rebellion of this character in a context of customs of the 1920s in Spain. They are revealing elements in that period in which women were relegated to the background, despite the fact that a feminist movement had already begun in Spain. By studying Adela, we seek to see how a single woman confronts her family and the society that surrounds her to fight for freedom, although its end is finally linked to
... Show MoreInterested in this research shed light on the reality of foreign trade to Iraq Who suffers from a marked deterioration due to poor economic diversification of the country And increase the degree of economic exposure , Which creates a state of extreme caution towards the question of accession to the (WTO) , As controls Iraq's foreign trade commodity , a president of one oil As well as the contribution of this item , and by a large formation in GDP , And that such a large and dangerous decline in the degree of economic diversification will create negative effects On overall economic activity components&
... Show MoreThe problem of research is that there are differences between learners in processing in formation in general and there is variation at the learners level perform scrolling skill of the passes up and down by the volley ball .Therefore the researchers decided to conduct astudy through which identify the relationship between information processing and the skill of scrolling from the top and bottom by the volleyball. The researchers used the descriptive approach by themethod of interconnectivity .Asampleconsist of21 students from first staye in collage of physical education and sports science for Girls(university of Baghdad) and attest has been applied(process information and scroll up and down) on the research sample after the required
... Show MoreThe principle of rights and duties is part of the reform project of the Commander of the Faithful Ali ibn Abi Talib, to build a state of institutions whose foundations have been built on Quranic rules, a prophetic biography, and his diligence in doing so in accordance with the requirements of interests and evil, and his certainty in determining the most important and important, and research analytical study of speeches Imam Ali and his career, in this study (the principle of rights and duties) of the ruler and the parish because of their role in the reform process, which depends on the demolition and construction together, as it is the responsibility of the ruler to demolish all constructed corrupt and contrary to the principles of Islam
... Show MoreThe N-[(2,3-dioxoindolin-1-yl)-N-methylbenzamide] was prepared by the reaction of acetanilide with isatin then in presence of added paraformaldehyde, the prepared ligand was identified by microelemental analysis, FT.IR and UV-Vis spectroscopic techniques. Treatment of the prepared ligand with the following selected metal ions (CoII, NiII, CuII and ZnII) in aqueous ethanol with a 1:2 M:L ratio, yielded a series of complexes of the general formula [M(L)2Cl2]. The prepared complexes were characterized using flame atomic absorption, (C.H.N) analysis, FT.IR and UV-Vis spectroscopic methods as well as magnetic susceptibility and conductivity measurements. Chloride ion content was also evaluated by (Mohr method). From the obtained data the octahed
... Show MoreBackground: with the advent of new postmaterial in dentistry, it has become important to measure fitness of post restoration along the horizontal plane of the root space.This study aimed to measure and compare, the cement film thickness of conventional zinc phosphate cement in micrometer between the post and root dentin along horizontal plane at different post space regions (coronal, middle and apical) of four types of posts, by using stereomicroscopy. Material and methods: Thirty-two extracted human maxillary canines, mandibular canines and maxillary central incisors (n=32) were instrumented with ProTaper system files (hand use) and obturated with gutta-percha for ProTaper and AH26® root canal sealer. After 24hrs of incubation at 37ºC, p
... Show MoreA mixture model is used to model data that come from more than one component. In recent years, it became an effective tool in drawing inferences about the complex data that we might come across in real life. Moreover, it can represent a tremendous confirmatory tool in classification observations based on similarities amongst them. In this paper, several mixture regression-based methods were conducted under the assumption that the data come from a finite number of components. A comparison of these methods has been made according to their results in estimating component parameters. Also, observation membership has been inferred and assessed for these methods. The results showed that the flexible mixture model outperformed the
... Show MoreThis work presents experimental research using draped prestressed steel strands to improve the load-carrying capacity of prestressed concrete non-prismatic beams with multiple openings of various designs. The short-term deflection of non-prismatic prestressed concrete beams (NPCBs) flexural members under static loading were used to evaluate this improvement. Six simply supported (NPCBs) beams, five beams with openings, and one solid specimen used as a reference beam were all tested as part of the experiment. All of the beams were subjected to a monotonic midpoint load test. The configuration of the opening (quadrilateral or circular), as well as the depth of the chords, were the varia
Background: Myasthenia gravis is an autoimmune disease of the neuromuscular junction that results in fluctuating muscle weakness as well as significant fatigue. Disease exacerbation is a critical condition, and the predisposing factors for it need to be identified to improve preventive measures.
Objectives: Our study aims to determine the predisposing factors for myasthenia gravis exacerbations in a group of Iraqi patients.
Subjects and Methods: A total number of 30 myasthenia gravis patients were admitted to the hospital with an exacerbation of their symptoms, determined as the development of functional disability, dysphagia, or respiratory fai
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