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
Despite the multiplicity of institutions contributing to the decision-making process in the United States of America, they interact to crystallize positions regarding international and strategic situations. The formulation of the national security policy depends on a number of institutions that complement each other in order to achieve an advanced security situation. Thus, the decision reflects the process of interaction of the existing regulatory institutions. This is because the essence of the national security and achieving its requirements also stems from the existence of a coherent system of shared beliefs and principles in the American society. Besides, these elements are the bases for achieving
... Show MoreThe message of our Prophet Muhammad (peace and blessings of Allaah be upon him) was the most complete of the messages, and the conclusion of the messages and completed by the mercy of this nation. Al-Khalal al-Baghdadi al-Hanbali (may Allaah have mercy on him) was a scholar who updated his writings. And The Nha Brhnha and became an independent and arranged doctrine Such a world of Galilee Hambali must show his character and his knowledge and its impact on the Islamic arena.
Abstract
The research discusses the biography of Imam Al-Qanuji, his syllabus in his book “ Raudha Al- Nadia , and Public, particular, edition definition. Then it mentions the types of matters and the Imam Al-Qanuji’s opinion in it, and it mentions the early and contemporary scholars’ opinions and simplifies their logical and unwritten proofs. It also discusses and librates the place of dispute, then it swages reliable based on the power of the proof and interest without any contravention which the orthodox law orders. Furthermore, the research discusses matters like, whether there is any particular formula for public, or whether the public considers the Quraan as i
... Show MoreThis research aims to examine the role of global green finance as a critical driver of both economic and environmental sustainability within small and medium-sized agricultural enterprises (SMEs) in Iraq. Utilizing a convergent mixed-methods framework, the study integrates qualitative interviews with key stakeholders and a quantitative survey of 300 agricultural SMEs to assess the barriers, enablers, and institutional conditions influencing the adoption of green finance. The findings indicate that, despite growing awareness and substantial latent demand for sustainability-linked investments, adoption is significantly constrained by institutional fragmentation, regulatory ambiguity, and resource limitations at the firm level. Grounded in Ins
... Show MoreIn the present study, five derivatives have been designed to be synthesized as possible mutual prodrugs for 5-Fluorouracil (5-FU) and non steroidal anti-inflammatory drugs (NSAIDs) to selectively deliver the drugs into the cancer cells. The synthesis of the target compounds were accomplished following multistep reaction procedures, the chemical reaction followed up and the purity of the products were checked by TLC. The structure of the final compounds and their intermediates were confirmed by their melting points, infrared spectroscopy and elemental microanalysis, the hydrolysis of compound III was studied using HPLC technique. According to the results mentioned above, compounds (I−V) can be good candidates as possible mutual prod
... Show MorePraise be to God, prayer and peace be upon the Messenger of Allah and after:
The science of interpretation is related to the book of God Almighty; it is considered one of the most honorable sciences. It started with a long time ago. In the early days of Islam, the area of the Islamic state expanded. The people entered the religion of Allah in groups. In the language, and people do not know more than the meanings of the Koran was the need to write in this scie234nce is strong, and perhaps the first of the thousand in the (meanings of the Koran) Abu Ubaida in his book (metaphor of the Koran), Abu Ubaida was affected by his specialization in Arabic science, Prominent on his book.
The second section wa
... Show MoreThe study of these selected traces shows that what Imam Mardini did on Imam al-Zayla'i and enabled him to graduate the hadiths of the book (guidance and conclusions) as well as in choosing the novel closest to Murad the work and not as described by al-Zayla'i .... never deserves descriptions.