Background: Background : Patients with non-rheumatic atrial fibrillation have high risk of thromboembolism especially ischemic stroke usually arising from left atrial appendage .Transoesophageal echocardiography provides useful information for risk stratification in these patients as it detects thrombus in the left atrial or left atrial appendage. Objective : This study was conducted at Al-Kadhimiya Teaching Hospital to assess the prevalence of left atrial chamber thrombi in patients with chronic non-rheumatic atrial fibrillation using transoesophageal echocardiography and its clinical significance as well as to verify the superiority of transoesophageal over transthoracic echocardiography in the detection of these abnormalities. Type of the study: Cross sectional study.Patients and Methods : Forty (40) consecutive patients (11 female and 29 male), at a mean age of 46 ± 9 years (range 28–60) with chronic non-rheumatic Atrial fibrillation were enrolled to this prospective study between March 2006 and December 2006. Tansthoracic and transesophageal two dimensional , M- mode , Doppler, and color- flow echocardiography were obtained with a kretz diagnostic ultrasound system. Results : The prevalence of Left atrium thrombus was 12.5%, 5 patients from the total number which was 40 patients. All of them seen bytransoesophagealechocardiography and non are detected byTansthoracic echocardiography . All the left atrial thrombi were confined to the left atrial appendage (100%). Left atrial spontaneous echo contrast was detected in 10 patients 25% by transoesophageal echocardiography, but was not observed in patient bytransthoracic echocardiography. All the 5 thrombi were found in left atria were significantly associated with spontaneous echo contrast 100% (P-value <0.001), reduced left ventricle ejection fraction (p-value <0.05) , large left atrium diameter ( p-value <0.05) and low LAAV <20 cm/s (p-value <0.001) compared to those without thrombus . Conclusions : The study showed that the prevalence of left atrial thrombus and appendage is not uncommon in patients with non-rheumatic atrial fibrillation and is exclusively seen in patients with left atrial SEC. Low Left ventricle ejection fraction , large Left atrium diameter , and low Left atrial appendages velocity are significantly associated with subsequent thrombus formation , and is more sensitive in the detection of these abnormalities compared with transthoracic echocardiography
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The education sector suffers from many problems, including the scarcity of schools that can absorb the increasing number of students in light of the increasing population growth rate, as some regions suffer from a lack of opening of new schools or the expansion of existing schools to increase their capacity so that attention is required. The research sought to identify the level of maturity of project management at the research site (Building Department in Al-Karkh I/ Ministry of Education) Being responsible for educational projects and their implementation and to know that, the ten areas of the knowledge guide to project management PMBOK have been adopted according to the PM3 model (one of the models of maturity
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... Show MorePurpose: This research seeks to provide a point of view based on the creation of sustainable value to the customer of the banks in the context of total quality management and relationship marketing. It aims to develop a model to measure the value of sustainable customer peduncular under total quality management PAL (administrative leadership, involvement of employees, continuous improvement, process improvement, staff training), through the mediation of relationship marketing and objective dimensions (administrative leadership, involvement of employees, continuous improvement, improving processes , staff training), and to explore any of the variables and dimensions more influential in the creation of sustainable value to the cust
... Show Moreالوصف Mixed ligand complexes of Cu (II), Co (II) and Zn (II) with 2-((4-(1-(4-chlorophenylimino) ethyl) phenylimino) methyl) phenol (L) and histidine (His) have been prepared and diagnosed by ¹H and13 C NMR, FT-IR and electronic spectral data, thermal gravimetric, molar conductance and metal analysis measurements. The ligand (L) shows a bidentate nature and the coordination occurs through N and O atoms of imine group and phenol group respectively whereas (His) behave as tridentate ligand, coordinating through the-NH2 group and carboxylate oxygen group and N atoms of imidazole ring. The analytical studies for three complexes have shown octahedral structure. The anticancer activity was screened against human cancer cell such Follicular
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... Show MoreKarst aquifers in semi-arid regions are vital yet exceptionally vulnerable lifelines. This study investigates how tectonic, geomorphological, and climatic factors control the dynamics of karst springs in the El Menzel Causse (Middle Atlas, Morocco). Using an integrated approach that combines field investigations, remote sensing, and quantitative hydro-climatic analysis, we identify the mechanisms driving the system’s severe decline. Results indicated that the structural architecture of the major fault systems in the North Middle Atlas Fault (NMAF) and the Median Middle Atlas Fault (MMAF), governs the spatial distribution of more than 50 springs, which occur preferentially within highly permeable fault damage zones. However, the aquifer is
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