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
A pure posteriorly posterior communicating artery (PCoA) aneurysm represents a surgical challenge. This is mainly when there is a need for good exposure of the aneurysmal neck, sac, PCoA, and anterior choroidal arteries. Ruptured pure posteriorly directed PCoA aneurysm imposes significantly extra challenge as the surgeon undergoes dissection through a tight brain. Even with measures commonly used to attain brain relaxation like the lumbar drain and cisternal fenestration. Here, we describe a technique for posterior temporal pole mobilization (TPM) as an integrated part of microsurgical clipping of ruptured pure posteriorly directed PCoA aneurysms. This technique is implicated in twenty-three successive cases of ruptured PCoA aneurys
... Show MoreThere is a great risk of cardiovascular disease (CVD) and vascular thrombosis in patients with End-Stage Renal Disease (ESRD). These patients exhibit numerous abnormalities in coagulation, fibrinolytic, inhibitory protein abnormalities in multiple levels. The study aimed to assess hypercoagulable changes by measuring the levels of antithrombin, plasma fibrinogen and FXII activity in patients with ESRD, and to find their correlation with Hemoglobin (Hb) level, WBC count, reticulocyte percentage and platelet count. This study was conducted at Al-Hayat center, Al Karama Teaching Hospital on 50 ESRD patients aged < 60 years of both genders. In addition, 20 apparently healthy individuals were included as a control group. The mean Hb level, total
... Show MoreHuman resistin is an adipokine, with a possible link to coronary heart disease.A few studies were done about resistin in acute phase of ST-segment elevation myocardial infarction (STEMI) especially in Iraqi patients. Accordingly we design a study to investigate the association between resistin concentration and acute phase of STEMI in Iraqi patients.
The present study was carried out at Al-Yarmouk Teaching Hospital from December 2011 until June 2012. Serum resistin levels were measured in 50 patients with acute STEMI (mean age: 58.16 ± 11.73 years) at the first 12 hours of admission and 34 normal controls (mean age: 53.98 ± 15.46 years) matched for age, sex and other risk factors.
Resistin level in patients wi
... Show MoreBackground: One of the drawbacks of vital teeth bleaching is color stability. The aim of the present study was to evaluate the effects of tea and tomato sauce on the color stability of bleached enamel in association with the application of MI Paste Plus (CPP-ACPF). Materials and Methods: Sixty enamel samples were bleached with 10% carbamide peroxide for two weeks then divided into three groups (A, B and C) of 20 samples each. After bleaching, the samples of each group were subdivided into two subgroups (n=10). While subgroups A1, B1 and C1 were kept in distilled water, A2, B2, and C2 were treated with MI Paste Plus. Then, the samples were immersed in different solutions as follow: A1 and A2 in distilled water (control); B1 and B2 in black
... Show MoreAdherence to cardiac medications makes a significant contribution to avoidance of morbidity and premature mortality in patients with cardiovascular disease. This quantitative study used cross‐sectional survey design to evaluate medication adherence and contributing factors among patients with cardiovascular disease, comparing patients who were admitted to a cardiac ward (
A numerical investigation of mixed convection in a horizontal annulus filled with auniform fluid-saturated porous medium in the presence of internal heat generation is carried out.The inner cylinder is heated while the outer cylinder is cooled. The forced flow is induced by thecold outer cylinder rotating at a constant angular velocity. The flow field is modeled using ageneralized form of the momentum equation that accounts for the presence of porous mediumviscous, Darcian and inertial effects. Discretization of the governing equations is achieved usinga finite difference method. Comparisons with previous works are performed and the results showgood agreement. The effects of pertinent parameters such as the Richardson number and internalRay
... Show MoreBackground: Insufficient sleep due to excessive media use is linked to decrease physical activity, poor nutrition, obesity, and decreased overall health-related quality of life.
Objectives: To assess the effect of using the internet and social media on the sleep of 4th-stage secondary school students.
Subjects and Methods: Cross-sectional study with the analytic element; for 500 secondary school students, obtained by choosing two schools randomly from each of the six educational directorates, by using a structured questionnaire.
Result: Secondary scho
... Show MoreThis study seeks to answer urgent questions about the role of new media that have emerged recently, such as the Internet and social networking sites and information services through mobile and others to increase awareness among young people, especially university students. during a field study that took place on a sample of students in the Department of Media at the University of Petra Kingdom of Jordan during the second semester in 2013 in the study the researcher finds increased attention and follow-up by young people for many of the world events and regional and local communities through exposure to a number of new media; in the forefront of the Internet and increase the level of awareness and interests young people do many of the eve
... Show Morechronic obstructive pulmonary disease (COPD) is a common respiratory disease with episodes of exacerbation. Variable factors including infectious pathogen can predispose for this exacerbation. The aim of this study is to evaluate the role of intestinal protozoa in COPD exacerbation. A total of 56 patients with COPD were included in this study. Patients were categorized into two groups based on the frequency of exacerbation during the last 6 months: those with ≤1 exacerbation (32 patients) and those with ≥2 exacerbations (24 patients). Stool specimens from each patient were collected two times (one week interval) examined for intestinal parasite. In univariate analysis, rural residence and parasitic infection were more common among patie
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