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
Die Zusammenfassung :
In der Forschung „ Die Wirkungen der Nachkriegliteratur „ findet man einen Überblick über die Wirkungen der Literatur im Allgemeinen und besonders über die Wirkungen der Nachkriegliteratur in Deutschland. Das Kurzgeschichte „ das Brot“ von Wolfgang Borchert „ wird in dieser Forschung als Beispiel analysiuert, weil sie die Nachteile des Kriegs und ihre Wirkungen auf die Familienbeziehungen behandelt. Die Hauptfiguren der Kurzgeschichte sind ein alter Mann und seine Frau. Der Schriftsteller bestimmt die Rolle der Frauen in Deutschland. Die Frau in dieser Geschichte ist stärker als ihren Mann , denn er war lügner und schwach.
Post-war Literature has an e
... Show MoreThe groundwater represents the main source of water in the study area due to lack of surface water. The Dammam unconfined aquifer represents the main aquifer in the study area and Southern desert because of the regional extent, the quantity and quality of water. Many groundwater wells have been drilled in the study area to coverage the huge demand of water for agricultural purposes. The Geographic Information System (GIS) was used to estimate the volume of water which calculated (25.6964 × 109 m3) within the study area , automate calculation of the area of Al Salman basin using digital elevation models, derive the thickness maps of Al
Dammam unconfined aquifer from Key holes (KH) and Bore holes (
Inform the people of the Enlightenment including what was said in detail
In photography
For Mohammed Hashim bin Ahmed footy famous Balva Hashim (Tel: 1349 e)
Translation is a dynamic and living process that cannot be considered equal to the original text and requires the appropriate structure, language, thought and culture of the target language, and the translator's intellectual, linguistic and cultural influences inadvertently penetrate into the translated text. It causes heterogeneity of the destination text with the source text.
Admiral's theory is trying to help by providing components and suggested approaches to resolve these inconsistencies. In the meantime, in addition to the mission of putting words together, the translator must sometimes sit in the position of the reader and judge and evaluate the translated text in order to understand its shortcomings and try to correct it a
... Show MoreA new speed and sensitive batch and merging zones-flow injection analysis spectrophotometric ways for estimation of captopril in a fine material and in pharmaceutical formulations were suggested. The procedure was depended on the decline of Fe(III) as FeCl3 to Fe(II) by captopril in acetic acid as medium, the produced Fe(II) interplays with 1,10-phenanthroline to compose a soluble orange-red colored product that is determined at maximum wave length of 511nm. The manifold FIA system was able to determine of CPL. with a throughput 51 sample/h. Calibration curves of absorbance against concentration sign of that Beer, s law is submitted to within the concentration scale o
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The aim of this research is to concentrate on the of knowledge management activities, initial activities: (Acquisition, Selection, Generation, Assimilation, Emission) knowledge, and support activities: (Measurement, Control, Coordination, Leadership) that is manipulate and controlling in achieving knowledge management cases in organization, that’s is leads to knowledge chain model, then determining the level of membership for these activities to knowledge chain model in a sample of Iraqi organization pushed by knowledge (Universities). The research depends on check list for gaining the data required, theses check list designed by apparently in diagnosing research dimensions and measurem
... Show MoreIn light of the developments and intense competition that the world has witnessed, the need to search for a sustainable and continuous competitive advantage for economic units has emerged, as the economic units must not lose sight of their interest in the activities they perform to achieve that advantage, and it can be said that the goal of the research is to identify the theoretical dimensions of the green value chain represented by: (Green research and development, green design, green manufacturing, green marketing, green services) and the dimensions of the sustainable competitive advantage represented by (quality, creativity, innovation, cost, response to the customer), as well as identifyi
... Show MoreThe importance of this research comes from the possibility of achieving positive interaction between accounting and tax through the interest in setting accounting standards and adapting them to local tax legislation, as the adoption of the application of the international standard (IAS 12) for income taxes helps to measure and determine the base for income tax and may lead to an increase in the tax outcome. Through the reliance of enterprises on many accounting bases, and that the tax administration in Iraq depends on the element of personal judgment in determining the tax base, which leads to lack of objectivity in determining the tax outcome, as the impact of the accounting standard (IAS 12) on the tax base and tax outcome is one of th
... Show MoreThis research paper tries to show the significance of the narrative structure in the television advertisement and its connotations. The researchers chose the annual advertisement of Zain Mobile Telecommunication Company for the year 2020, which shed light on the global Corona pandemic crisis. The idea of the advertisement won wide approval as it focused on the suffering that everyone is witnessing like medical and security personnel in particular, and family relationships consequences.
In addition to the positive global interaction with the message presented by the Company in these exceptional circumstances. The advertisement, which lasted for 2.35 minutes, exceeded 13 million views in a short period of time. This prompted us to choos
Abstract
The research aims to identify tax exemptions, their objectives and types, as well as to shed light on the concept of sustainable development, its objectives, dimensions and indicators (economic, social and environmental), as well as to analyze the relationship between tax exemptions and economic development, in addition to measuring and analyzing the impact of tax exemptions on economic development in Iraq for the period ( 2015 - 2021) using the NARDL model. The research problem centers on the fact that failure to employ financial policy tools correctly led to a weakness in achieving economic justice, which leads to a failure to improve social welfar
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