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
This research is carried out to investigate the behavior of self-compacting concrete (SCC) two-way slabs with central square opening under uniformly distributed loads. The experimental part of this research is based on casting and testing six SCC simply supported square slabs having the same dimentions and reinforcement. One of these slabs was cast without opening as a control slab. While, the other five slabs having opening ratios (OR) of 2.78%, 6.25%, 11.11%, 17.36% and 25.00%. From the experimental results it is found that the maximum percentage decrease in cracking and ultimate uniform loads were 31.82% and 12.17% compared to control slab for opening ratios (OR
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Sovereign wealth funds are an important tool for achieving economic stability and avoiding the local economy from external shocks, including the shocks of international oil prices. The spread of these funds is the result of large current account surpluses in many Asian and oil-exporting economies. These surpluses are due to higher commodity prices Has led to a rapid accumulation of foreign assets in central banks. Many countries with rent economies face the problem of their dependence on non-renewable natural resources, especially the oil countries, including Iraq. Oil revenues are more than 97% of oil exports, so they suffer from structural imbal
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Strategic leadership is the main source to enable organizations of excellence in light of turbulent environment, it is also the capabilities of organizational renewal organization’s ability to anticipate changes that take place or possible occurrence.
As a result of the many changes that characterize the environment where they operate researched hospitals, many of them began looking for ways to help it achieve a lot of their own competitive advantages.
The subject of organizational renewal capabilities of subjects that are not obvious interest in the Arab environment in general and Iraq in particular, and longer. The problem of the research and field presence of deficiencies in
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This paper provides an identification key to the species of Orthetrum Newman, 1833 (Odonata, Libellulidae), including six species that were collected from different localities in Iraq.
The species of O. anceps (Schneider, 1845) is registered as a new record in Iraq; the most important characters which are used in diagnostic key are included
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This study aimed at evaluating the torsional capacity of reinforced concrete (RC) beams externally wrapped with fiber reinforced polymer (FRP) materials. An analytical model was described and used as a new computational procedure based on the softened truss model (STM) to predict the torsional behavior of RC beams strengthened with FRP. The proposed analytical model was validated with the existing experimental data for rectangular sections strengthened with FRP materials and considering torque-twist relationship and crack pattern at failure. The confined concrete behavior, in the case of FRP wrapping, was considered in the constitutive laws of concrete in the model. Then, an efficient algorithm was developed in MATLAB environment t
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This paper aims to study the effect of circular Y-shaped fin arrangement to improve the low thermal response rates of a double-tube heat exchanger containing Paraffin phase change material (PCM). ANSYS software is employed to perform the computational fluid dynamic (CFD) simulations of the heat exchanger, including fluid flow, heat transfer, and the phase change process. The optimum state of the fin configuration is derived through sensitivity analysis by evaluating the geometrical parameters of the Y-shaped fin. For the same height of the fins (10 mm), the solidification time is reduced by almost 22%, and the discharging rate is enhanced by almost 26% using Y-shaped fins compared with the straight fins. The results demonstrate that the sol
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This paper aims to study the effect of circular Y-shaped fin arrangement to improve the low thermal response rates of a double-tube heat exchanger containing Paraffin phase change material (PCM). ANSYS software is employed to perform the computational fluid dynamic (CFD) simulations of the heat exchanger, including fluid flow, heat transfer, and the phase change process. The optimum state of the fin configuration is derived through sensitivity analysis by evaluating the geometrical parameters of the Y-shaped fin. For the same height of the fins (10 mm), the solidification time is reduced by almost 22%, and the discharging rate is enhanced by almost 26% using Y-shaped fins compared with the straight fins. The results demonstrate that the sol
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Background: Dorsal plication on each side of the penis at the 2 and 10-o’clock positions had been a mainstay for correction of ventral penile curvature. However, because only the 12-o’clock position proved to be a nerve-free zone, dorsal plication at the 12-o’clock position can be advocated.
Objectives: To evaluate tunica albuginea plication with and without neurovascular bundle mobilization in patients with ventral penile curvature. Type of the study: A prospective study.
Methods: A 34 patients with a mean age of (4.8 ± 0.54) years, Who still
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