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
In The Name of Allah Most Gracious Most Merciful
In this research, I will deal with the significance of the imperative and the disagreement of the fundamentalists in the general requirement by dividing it into an introduction and two sections. , and the appropriate indication.
الخلاصة لقد شكل المحافظون الجدد وهم بالأساس نخبة من المثقفين ومن السياسيين الأمريكيين كتلة ضغط كبيرة التأثير على الإدارة في عهد الجمهوريين. حمل هؤلاء المحافظون مشروعاً إيديولوجياً البسوه لسلطة الجمهوريين وهو يهدف إلى جعل أمريكا سيدة العالم من دون منازع خاصة بعد انهيار الاتحاد السوفييتي ونهاية الحرب الباردة. واكب هذا الحدث التاريخي الكثير من الأفكار ومنها (نهاية التاريخ)، وصراع الحضارات، وكذ
... Show MoreThis study is an attempt to investigate the conceptual metaphor of UP and DOWN commonly used in Iraqi community. Some of the metaphorical expressions in Iraqi colloquial Arabicarewidely used by Iraqi speakers in everyday language. Ithas been analyzed by following the cognitive theory of metaphor (Lakoff& Johnson,1980).The study indicates that the Iraqi speakerexperiences more of the metaphorical expressions of UP and DOWN to referto many of the abstract concepts that shape his/her impression of everyday life situations.
Competitive advantage is a substantial strategic objective for organizations. It requires high levels in the quality of products and services provided to customers, continuous improvement of costing , care for creativity and innovative employees, and speed unique to the marketing and financial engineering, and business re-engineering processes. The situation in this area, requires actors to attract and develop human resources, including help in proper implementation of the strategic tasks that targeted by those institutions. According to the opinions and viewpoints of management scholars, the competitive advantage resource is the most important issue for organizations in the third millennium, which can be a
... Show MoreAfter more than ten years of successful march of the European single currency and EU countries faced a crisis in one of its debt, which recently joined the monetary union is not Greece . Perhaps mpre than th effects of this crisis, the fact that its consequences were not confined to Greece alone , but expand it to include all EU countries in general and the countries of the European Monetary Union in particular.
Sine the debt crisis that emerged Greek and talk a lot a bout their effects on the global economy and the potential harm done th the situation of the global economy recovers from the global financial crisis (mortgage crisis), or delayed and also the fears of other crises to other member states suf
... Show MoreThe present study was conducted on the Iraqi Pin-tailed Sandgrouse (Pterocles alchata) to study the lung's morphological description and histological structure. This study was used 5 samples of adult male sandgrouse bird. The birds were dissected. The lungs were removed from the coelomic cavity, cleaned to remove impurities, and photographed to describe their morphological features. The samples were fixed using formalin (10%) solution for 36-48 hours and then preserved in alcohol (70%) to prepare the microscopic slides. The results showed that the lung of the Iraqi sandgrouse bird is red in color, has a trapezoidal shape and has three surfaces (costal, visceral, and vertebral). The costal surface shows ribs impressions that extend f
... Show MoreDrilling deviated wells is a frequently used approach in the oil and gas industry to increase the productivity of wells in reservoirs with a small thickness. Drilling these wells has been a challenge due to the low rate of penetration (ROP) and severe wellbore instability issues. The objective of this research is to reach a better drilling performance by reducing drilling time and increasing wellbore stability.
In this work, the first step was to develop a model that predicts the ROP for deviated wells by applying Artificial Neural Networks (ANNs). In the modeling, azimuth (AZI) and inclination (INC) of the wellbore trajectory, controllable drilling parameters, unconfined compressive strength (UCS), formation
... Show MoreFunctionally graded materials (FGMs), with ceramic –ceramic constituents are fabricated using powder technology techniques. In this work three different sets of FGMs samples were designed in to 3 layers, 5 layers and 7 layers. The ceramic constituents were represented by hard ferrite (Barium ferrite) and soft ferrite (lithium ferrite). All samples sintered at constant temperature at 1100oC for 2 hrs. and characterized by FESEM. Some physical properties were measured for fabricated FGMs include apparent density, bulk density, porosity, shrinkage and hardness. The results indicated that the density increase with the increase the number of layer. Lateral shrinkage is one of the important parameter f
... Show MoreIn light of the enquiry raised by the Economist Mary Finn in 1995 concluding that high utilization in absorptive capacity of the economy is of inflationary tendency for industrial countries due to the equality between high rates of utilization of absorptive capacity and resource – shortage conditions leading to price inflation, the same idea was used to prove that budget utilization of operational costs and elevating absorptive capacity at the expense of investment budget leads to inflationary tendency that becomes a burden on financing the step- in policy of the Central bank to control prices through its foreign currency reserves at a time when the economy turned into an importer of non- tradable goods and being subject
... Show MoreA study of characteristics of the lubricant oils and the physical properties is essential to know the quality of lubricant oils. The parameters that lead to classify oils have been studied in this research. Three types of multi-grades lubricant oils were applied under changing temperatures from 25 oC to 78oC to estimate the physical properties and mixture compositions. Kinematic viscosity, viscosity gravity constant and paraffin (P), naphthenes (N) and aromatics (A) (PNA) analysis are used to predict the composition of lubricants oil. Kinematic viscosity gives good behaviors and the oxidation stability for each lubricant oils. PNA analysis predicted fractions of paraffin (XP), naphthenes (XN),
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