Background : The hepatopulmonary syndrome (HPS) is defined as the triad of liver disease, arterial deoxygenation, and pulmonary vascular dilatation. The reported prevalence of HPS in cirrhotic patients varies between 5% -17.5%.Objective : To estimate the prevalence of hepatopulmonary syndrome among patients with chronic liver disease and portal hypertension and to study the correlation between HPS and the severity of liver disease.Patients and methods : Thirty patients were studied for the presence of HPS using transthoracic contrast echocardiography for detection of pulmonary vasodilatation. Arterial oxygen saturation (SaO2) was determined in erect and supine position using a pulse oximeter , (SaO2 ≤ 92 % in supine position and/or a decrease of ≥ 4% after change from supine to upright position) to detect hypoxia and ortheodeoxia.Result : Eleven of thirty patients (36.6%) with chronic liver disease and portal hypertension were found to have contrast echocardiographic evidence of intrapulmonary right-to-left shunting. Arterial oxygen desaturation was present in 3 patients (27.3%) of those with intra-pulmonary right-to-left shunting ,they were considered as clinically significant HPS ,the remaining 8 patients were considered as subclinical HPS. Dyspnoea was more often present in patients with clinically significant HPS (100%) compared with subclinical HPS (25%), and patients without HPS (9%). HPS correlated significantly with severity of liver disease according to the Child-Pugh score.Conclusion: hepatopulmonary syndrome is not uncommon , the prevalence of clinically significant hepatopulmonary syndrome (in this study) was 10% of patients with chronic liver disease and it correlated with disease severity according to the Child-Pugh score
The aim of this work is study the partical distribution function g(r12,r1) for Carbon ion cases (C+2,C+3,C+4) in the position space using Hartree-Fock's Wave function, and the partitioning technique for each shell which is represented by Carbon Ions [C+2 (1s22s2)], [C+3 (1s22s)] and [C+4 (1s2)]. A comparision has been made among the three Carbon ions for each shell. A computer programs (MATHCAD ver. 2001i) has been used texcute the results.
The Vulnerable Indian Roofed Turtle Pangshura tecta (Gray, 1831) (Testudines: Geoemydidae) occurs in the Sub-Himalayan lowlands of India, Nepal, Bangladesh, and Pakistan. Little is known about its natural history, no studies have been conducted revealing its natural predators. In this study, a group of Large-billed Crow Corvus macrorhynchos Wagler, 1827 (Passeriformes: Corvidae) was observed hunting and predating on an Indian Roofed Turtle carcass in the bank of river Kuakhai, Bhubaneswar, India. The first record of this predation behaviour is reported and substantiated by photographic evidence.
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Escherichia coli (E. coli) is a frequent gram-negative bacterium that causes nosocomial infections, affecting more than 100 million patients annually worldwide. Bacterial lipopolysaccharide (LPS) from E. coli binds to toll-like receptor 4 (TLR4) and its co-receptor’s cluster of differentiation protein 14 (CD14) and myeloid differentiation factor 2 (MD2), collectively known as the LPS receptor complex. LPCAT2 participates in lipid-raft assembly by phospholipid remodelling. Previous research has proven that LPCAT2 co-localises in lipid rafts with TLR4 and regulates macrophage inflammatory response. However, no published evidence exists of the influence of LPCAT2 on the gene expression of the LPS receptor complex induced by smooth or rough b
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The research amid to find out the extent of Iraqi oil companies commitment to implement internal control procedures in accordance with the updated COSO framework. As the research problem was represented in the fact that many of the internal control procedures applied in the Iraqi oil companies are incompatible with most modern international frameworks for internal control, including the integrated COSO framework, issued by the Committee of Sponsoring Organizations of the Tradeway Committee. The research followed the quantitative approach to handling and analysing data by designing a checklist to represent the research tool for collecting data. The study population was represented in the Iraqi oil companies, while the study sample
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Abstract
This Research aims for harnessing critical and innovative thinking approaches besides innovative problem solving tools in pursuing continual quality improvement initiatives for the benefit of achieving operations results effectively in water treatment plants in Baghdad Water Authority. Case study has been used in fulfilling this research in the sadr city water treatment plant, which was chosen as a study sample as it facilitates describing and analyzing its current operational situation, collecting and analyzing its own data, in order to get its own desired improvement opportunity be done. Many statistical means and visual thinking promoting methods has been used to fulfill research task.
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Abstract Lateral Epicondylitis (LE) which has been referred to as the Tennis Elbow as well is a lesion affecting common tendinous origins of wrist extensors due to chronic overuse injury that results in damaging common extensor tendons which join forearm extensor muscles to humerus. The aim of the present evidence-based clinical statement is reviewing scientific evidences for efficacy of a variety of the rehabilitation methods, chronic lateral epicondylitis management. It is focused upon treating chronic lateral epicondylitis and the latest developments in physiotherapy area for managing chronic lateral epicondylitis. Due to the fact that primary physical impairments in the LE are decreased is the strength of the grip, fundamentally due to
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