Background: The normal decline in systolic blood pressure during recovery phase of treadmill exercise dose not occur in most patients with coronary artery disease, in others recovery values systolic blood pressure may even exceed the peak exercise value. Objectives: Treadmill exercise test parameters indicating the presence and extent of coronary artery disease have traditionally included such as exercise duration, blood pressure and ST-segment response to exercise. The three –minute systolic blood pressure ratio is another important indicator of presence and significance of coronary artery disease is useful and obtainable measure that can be applied in all patients who are undergoing stress testing for evaluation of suspected ischemic heart disease and this increase the sensitivity of exercise test . Type of the study: A prospective study. Methods: Between April 2011 and April 2012 ,all patients underwent treadmill exercise test , echocardiography coronary angiography in Ibn Ab-bitar Hospital Cardiac Surgery. Clinical and procedural data for patients undergoing treadmill and coronary angiography were prospectively collected and entered into database specially designed for the present study.To calculate mean systolic blood pressure ratio for each , Measurement of blood pressure in the 3rd minute of recovery time and divided by peak systolic blood pressure during exercise test ,after excluding patients . Coronary angiography was done for all patients who under went treadmill exercise test and multiple views were taken accordingly to clarify the lesion and critical lesion defined as >50% stenosis in LMS and >70% stenosis in LAD,LCX and RCA. Results: We studied 100 patients In the period from April 2011 to April 2012, 78(78%) male and 22 (22%) a female with a mean age 55.49±7.60 who undergone treadmill exercise testing and coronary angiography to assess the chest pain, 32 patient had normal blood pressure 68 had hypertension and 24 patients had normal coronary angiography and 76 patients had abnormal coronary angiography. SBP/3 minute recovery blood pressure ratio was significantly higher in patient with coronary artery disease than patient without coronary artery disease (mean ±SD O.92±0.09 VS 0.81 SBP/3 minute recovery blood pressure ratio was significantly related with the severity of coronary artery disease its higher in three vessels than one vessel disease 0.95±0.10 vs0. 91 ±0.01 p-value 0.0001. Conclusions: post exercise blood pressure response in patients with coronary artery diseaseis higher than patients with normal coronary artery .post exercise blood pressure is related to the severity of coronary artery disease
The article aims to study the liquidity that is required to be provided optimally and the profitability that is required to be achieved by the bank, and the impact of both of them on the value of the bank, and their effect of both liquidity and profitability on the value of the bank. Hence, the research problem emerged, which indicates the extent of the effect of liquidity and profitability on the value of the bank. The importance of the research stems from the main role that commercial banks play in the economy of a country. This requires the need to identify liquidity in a broad way and its most important components, and how to
... Show MoreThis paper presents an in-depth stylistic analysis of the linguistic artistry andliterary techniques employed by Paulo Coelho in his novel By the River Piedra ISat Down and Wept. A close reading approach guided by stylistics and linguisticsframeworks reveals Coelho's extensive incorporation of imaginative metaphors,vivid imagery, poetic diction, and resonant symbols across the narrative. Analysisspecifically elucidates how Coelho adeptly manipulates various stylistic features toconvey thematic content, shape characterization, and produce aesthetic impacts.Findings provide critical insights into Coelho’s linguistic mastery and contribute toresearch in stylistics and literary linguistics through rigorous examination of anentire contemporary
... Show MoreConcrete structures are exposed to aggressive environmental conditions that lead to corrosion of the embedded reinforcement and pre-stressing steel. Consequently, the safety of concrete structures may be compromised, and this requires a significant budgets to repair and maintain critical infrastructure. Prediction of structural safety can lead to significant reductions in maintenance costs by maximizing the impact of investments. The aim of this paper is to establish a framework to assess the reliability of existing post-tensioned concrete bridges. A time-dependent reliability analysis of an existing post-tensioned involving the assessment of Ynys-y-Gwas bridge has been presented in this study. The main cause of failure of this bridge was c
... Show MoreA harvested prey-predator model with infectious disease in preyis investigated. It is assumed that the predator feeds on the infected prey only according to Holling type-II functional response. The existence, uniqueness and boundedness of the solution of the model are investigated. The local stability analysis of the harvested prey-predator model is carried out. The necessary and sufficient conditions for the persistence of the model are also obtained. Finally, the global dynamics of this model is investigated analytically as well as numerically. It is observed that, the model have different types of dynamical behaviors including chaos.
Multiplesclerosis(MS)isachronic,inflammatory,immune-mediateddiseaseof the central nervous system (CNS). More than 2 million people worldwidehave MS. The goal of the present study was to compare Iraqi patients' treat-ment satisfaction with three different disease-modifying therapies (DMTs),administeredorally,subcutaneously,andbyslowinfusion;namely,fin-golimod, interferon beta-1b (IFNβ-1b), and natalizumab, respectively. Aswell as to assess the individual differences among these therapies about theireffectiveness, convenience and global satisfaction also to assess the role ofcertain predictors on treatment satisfaction. Patient satisfaction with medi-cation assessed by the Treatment Satisfaction Questi
... Show MoreMany of researchers have written about social responsibility and business strategy and competitive advantage, and they have given particular attention to the relationship between economic and social responsibility , but what is missing in this aspect is how the economic units that use their core competencies to advance social responsibility initiatives so that they can achieve a significant competitive advantage and create value for it ?
The current research aims to verify the view that "the economic and social objectives in the long term is not contradictory in nature but complementary objectives essential", as well as make sure that the s
... Show MoreThis study was conducted in 2018, at Technical College of Applied Sciences, Sulaimani Polytechnic University, and Kurdistan Region-Iraq. The aim of the study was to determinate nutritional compositions and some elemental contents in marketable white button mushroom (Agaricus bisporus) that is collected in local markets of Kurdistan Region-Iraq. Five different samples (A: Penjwen product fresh, B: Sulaimani product fresh, C: American caned, D: Valencia Netherlandcaned and E: Erbil product fresh) were collected to be observed. The elements were analyzed by Atomic Absorption Spectrometry methods, and their chemical compassions were determined, too. The collected data were analyzed by One Way ANOVA. The highest fat, protein, fiber and dry matte
... Show MoreThe aim of this book is to present a method for solving high order ordinary differential equations with two point boundary condition of the different kind, we propose semi-analytic technique using two-point osculatory interpolation to construct polynomial solution. The original problem is concerned using two-points osculatory interpolation with the fit equal numbers of derivatives at the end points of an interval [0 , 1] . Also, we discussion the existence and uniqueness of solutions and many examples are presented to demonstrate the applicability, accuracy and efficiency of the methods by compared with conventional method .i.e. VIDM , Septic B-Spline , , NIM , HPM, Haar wavelets on one hand and to confirm the order convergence on the other
... Show MoreIn this paper, we have been used the Hermite interpolation method to solve second order regular boundary value problems for singular ordinary differential equations. The suggest method applied after divided the domain into many subdomains then used Hermite interpolation on each subdomain, the solution of the equation is equal to summation of the solution in each subdomain. Finally, we gave many examples to illustrate the suggested method and its efficiency.
Abstract
Value Added Tax (VAT) is one of the most important types of indirect taxes because of its advantages in achieving financial, economic and financial objectives. The introduction of VAT is part of the reform of the structure of the Lebanese public tax system aimed at reducing the fiscal deficit and resulting inflation, which still lacks a general consumption tax. There is also an urgent need to increase treasury revenues , Because of its broad tax base, as it imposes on the consumption of locally produced and imported goods, in addition to the role played by this tax in support of the local product &nbs
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