Transient drop in the heart beat or transient heart block (AVB) may be consider the main cause of syncope or presyncope inpatients with bifascicular block and syncope According to the Guidelines for cardiac pacing pacemaker consider part of treatment. Aims of our study were to evaluate whether there is role for EPS in patients BFB and to evaluate the symptoms after pacing. 42 patients were enrolled in this study, with mean age value (63.4± 12.2years), suffer from interventricular conductive defect and syncope; patients underwent EPS on admission time, and pacemaker implantation accordingly and programmed follow up for the device in the last four years. Our patients were 25 (59.5%) male and 17 (40.5%)female, all of them with syncope or presncope and good left ventricular systolic function and the left ventricular ejection fraction (LVEF ≥55%). Left bundle branch block was found in 28 (66.71%) patients, while right bundle branch block were found in,14 (33.3) of them, the result of the EPS was find the cut of HV interval for pacing which represent that that the threshold at level of 75 have a sensitivity of 91% and specificity of 80%. The greater HV intervals gave more successful results for pacing. Pacemaker was implanted in 27 (64.3%) of the patients, with significant relation between pacing and syncope disappeared after pacemaker implantation (p value 000) and in 15 (35.7%) no pacemaker was implanted with persistent symptoms. Pacing were more between patients with coronary artery disease and LBBB with abnormal EPS finding. Permanent pacemaker implantation can implant directly in those old patients with syncope and bifascicular block that associated with LBBB and coronaries artery diseases without or before EP study
This research began by explaining its variables and dimensions especially the digital gap, which the authors explained it elaborately beginning with the concept, the reasons blind its emergence of its measurement, and how to treat it. The authors supposed the potentiality of relying on enforcing knowledge in general and the groups suffer from this gap in particular, especially the targeted knowledge to treat its subject.
As enforcing knowledge usually depends on some strategies or choices of organizational orientation among them is learning and training from one side, and communication, as an indicating factor for organizational effectiveness as the authors refer from the other side.
The implicit is the narrative technique used to give indirect hidden messages. To read between the lines means to understand the implicit meaning that is not directly indicated. This technique is expressed in two forms: the hypothesis and the implications of linguistic and non-linguistic rules. Nathalie Sarraute’s "Pour un oui ou pour un non" states this narrative method through her character’s verbal and non-verbal dialogue. The present paper discusses the implicit method and shows the reason behind which the author uses it in her play "Pour un oui ou pour un non".
Résumé
... Show MoreThe research aims to show the dimensions of organizational trust represented by (administrative policies opportunities for innovation and self innovation and self- realization,availability of information,prevailing organizational values) and its reiationship to achieving the strategic position of banks represented by formation of expectations,buiiding networks,learning operations As the research was applied in each of the banks (middle east)Iraqi investment,Al-Ahly Iraqi, Business Bay, Al- Mansour investment bank),the qusestionnaire was adopted as a tool to collect data and information from the sample number (138)who are in the site (department director, division ,M.division director ,division officer, unit officer)the statistica
... Show MoreNaturally available products have been used widely for centuries in handling human disease. The present study aimed to determine the effect of aluminum potassium sulfate addition into the soft liner on tensile strength and peel bond strength. The effect of aluminum potassium sulfate evaluated by two methods, first one include incorporation of KAL (SO4)2 into soft liner monomer in concentration (2%,3% by wt.) while the second method include immersion of soft liner specimens in solution of KAL(SO4)2 in concentration(5%,10% percent) during time periods (0,10 minutes). In conclusions, the results of current study encourage use KAL (SO4)2 within soft liner material
Background: The PMMA polymer denture base materials are low in thermal and strength properties. The aim of the study was to investigate the change in glass transition temperature, E-Moudulus and coefficient of thermal expansion of acrylic denture base material by addition of Al2O3, TiO2 and SiO2nano-fillers in 5% by weight. Materials and methods: The type of polymerization is free radical bulk polymerization. one hundred twenty (120) specimens were prepared , the specimens were divided into four groups according to the material had been added (one control and three for Al2O3, TiO2 and SiO2nanocomposite) each group was subdivided in to three groups according to the test had been done on it, the degree of transition (Tg) was measured by The d
... Show MoreCompound 4-(((6-amino-7H-[1,2,4]triazolo[3,4-b][1,3,4]thiadiazin-3-yl)methoxy)methyl)- 2,6-dimethoxyphenol (6) was synthesized by multi steps. The corresponding acetonitrile thioalkyl (7) was cyclized by refluxing with acetic acid to afford 4-(((6-amino-7H-[1,2,4]triazolo[3,4- b][1,3,4]thiadiazin-3-yl)methoxy)methyl)-2,6-dimethoxyphenol (8). Two new series of 4-(((6-(3- (4-aryl)thioureido)-7H-[1,2,4]triazolo[3,4-b][1,3,4] thiadiazin-3-yl)methoxy)methyl)-2,6- dimethoxyphenol (9a-c) and of 4-(((6-(substitutedbenzamido)7H-[1,2,4]triazolo[3,4- b][1,3,4]thiadiazin-3-yl)methoxy)methyl)-2,6-dimethoxyphenol (10a-c) were synthesized as new derivatives for fused 1,2,4-trizaole-thiadiazine(8). The antioxidants of newly compounds were evaluated by DPPH
... Show MoreIn this study new derivatives of O-[2-{''2-Substituted Aryl (''1,''3,''4 thiadiazolyl) ['3,'4-b]-'1,'2,'4- Triazolyl]-Ethyl]-p- chlorobenzald oxime (6-11)have been synthesized from the starting material p-chloro – E- benzaldoxime 1.Compound 2 was synthesized by the reaction of p-chloro – E- benzaldoxime with ethyl acrylate in basic medium. Refluxing compound 2 with hydrazine hydrate in ethanol absolute afforded 3. Derivative 4 was prepared by the reaction of 3 with carbon disulphide, treated of compound 4 with hydrazine hydrate gave 5. The derivatives (6-11) were prepared by the reaction of 5 with different substitutesof aromatic acids. The structures of these compounds were characterized from their melting points, infrared spectroscopy
... Show MoreThe aim of this study is to provide an overview of various models to study drug diffusion for a sustained period into and within the human body. Emphasized the mathematical compartment models using fractional derivative (Caputo model) approach to investigate the change in sustained drug concentration in different compartments of the human body system through the oral route or the intravenous route. Law of mass action, first-order kinetics, and Fick's perfusion principle were used to develop mathematical compartment models representing sustained drug diffusion throughout the human body. To adequately predict the sustained drug diffusion into various compartments of the human body, consider fractional derivative (Caputo model) to investiga
... Show MoreIn the hybrid coolingsolar systems , a solar collectoris used to convertsolar energy intoheat sourcein order to super heat therefrigerant leave thecompressor,andthisprocess helpsin the transformation ofrefrigerant state from gaseous statetothe liquid statein upper two-thirdsof thecondenserinstead of the lower two-thirdssuchas in thetraditional air-conditioning systems and this willreduce theenergyneeded torun the process ofcooling.In this research two hybrid air-conditioning system with an evacuated tube solar collector were used, therefrigerant was R22 and the capacity was 2 tons each.The tilt angle of the evacuated tube solar collector was changed and the solar collector fluid was replaced into oil instead of water.A comparison wasi
... Show More