Background: Coronary artery disease remains the main cause of death despite several preventive programs. Epicardial adipose tissue is a visceral fat depot of the heart located along the large coronary arteries and on the surface of ventricles and apex. Intima media thickness is commonly recognized as the initial stage in the development of atherosclerosis. The development of ultrasound machines, advances in echocardiographic devices and high resolution transducers facilitate comprehensive analysis of epicardial fat thickness (EFT) and carotid –intima media thickness (C-IMT).
Aim: To investigate the relationship of echocardiographic epicardial fat thickness (EFT) and carotid –intima media thickness (C-IMT) with the severity of coronary artery disease.
Methods: A cross sectional multicenter diagnostic accuracy study carried out at Ibn Al-Nafis Cardiovascular Hospital, Ibn Al- Bitar Cardiology Center and Ghazi Al-Hariri Hospital –Iraqi Center for Cardiology during the period between October 2016 and May 2017 assessing. History regarding demographic data and risk factors was taken. Two dimensional transthoracic echocardiographic measurements were done. EFT was measured from parasternal long axis view perpendicular to the right ventricular free wall. C-IMT was measured according to that recommended by the American society of echocardiography (ASE).
Results: The current study demonstrated that the EFT has a direct and significant correlation with the number of involved vessels (P value ˂ 0.001, r= 0.770). The validity of EFT to discriminate between multiple vessels disease and no vessel involvement is excellent (AUC= 0.984, cut point > 8mm, sensitivity=92.9%, specificity= 93.3%). There is inverse and significant correlation between ejection fraction (EF) and three vessels disease (P value ˂ 0.001, r= -0.507). Also there is a direct and significant correlation between C-IMT and severity of CAD. ROC analysis for validity of C-IMT to discriminate between multiple vessels disease and no vessel involvement is excellent (AUC= 0.961, cut point > 1.04mm, sensitivity=92.9%. specificity=86.7%). C-IMT is fair to discriminate between single vessel disease and no vessel involvement (AUC=0.738, cut point ˃ 0.84mm, sensitivity 100%), so if correlated with age, C-IMT above 0.84 can be used as a cut off point for the prediction of CAD. Finally, EFT and C-IMT are more likely to reflect severity of CAD than their ratio.
Conclusions: C-IMT and EFT are simple and reproducible parameters that can be used as a screening tool for the presence and severity of CAD especially before symptoms appearance in high risk patients
Several adipokines are produced and secreted from adipose tissue, such as retinol binding protein-4, which triggers metabolic syndromes and insulin resistance. Retinol binding protein-4 transfers vitamin A or retinol in the blood. Higher levels of retinol binding protein-4 are interrelated with progress of metabolic disease, comprising obesity, metabolic syndrome, and type 2 diabetes mellitus. The present study investigates the role of retinol-binding protein-4 levels in type 2 diabetic Iraqi patients with metabolic syndrome. Sixty type 2 diabetic patients aged 40–53 years were examined. Of these 30 patients has metabolic syndrome and 30 without metabolic syndrome. The patients sampled were from the National Diabetes Center/ Mustansiriyah
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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
... Show MoreStrategic 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
... Show MoreThe research addresses a fundamental Islamic jurisprudential Purposeful issue, which is (Sharia), and to indicate the impact of this on Islamic jurisprudence, deriving rulings and extracting purposes, and to repel the illusion that this issue is only doctrinal, and clarifying the aspects of similarities and links between them by explaining the origin of deriving the purposes of Islamic Law (Sharia) through the meanings and wisdom learned from the texts and the explanation of the rulings. The rulings of Islamic Law (Sharia) have urged bringing benefits and repelling harms, and that the path to do so is reason and its production. I began the research by defining the purposes of Islamic Law (Sharia), then defining the rule of rational right
... Show MoreAltruism is one of good qualities of human being expressing his highness and triumph. Self control has A signifies in a lot of psychological, educational, Social, ethical and healing fields Where the higher self control relates with high degrees of carefulness accuracy, problem solving, choice. judgment and decision making. the present study aimos at measuring altruism among university students , self control among them , recognizing the statistically differences significance on self control among university students according to gender variable and recognizing the correlation between attruism and self control among university students . the sample consists of the basic application one (200) students (100) males and (100) males that had
... Show MoreThe study aims to identify the Traumatic Symptoms (physiological, emotional, and cognitive) of earthquakes among the targeted sample; it also aims to identify the significant differences between psychological, emotional, and cognitive traumatic symptoms of earthquakes according to the gender and age of participants. The study additionally seeks to identify thepsychological positive-negative reactions associated with earthquakes according to gender and age of the participants. To measure the traumatic symptoms of earthquakes, a 4-point Likert scale questionnaire with (20) items (questions) accompanied with a 4-point Likert scale questionnaire with (18) items (questions) were used to measure the Psychological positive-n
... Show MoreAbstract-Industrial and urban development has resulted in the spread of plastic waste and the increase in the emissions of carbon dioxide resulting from the cement manufacturing process. The current research aims to produce green (environmentally friendly) concrete by using plastic waste as coarse aggregates in different proportions (10% and 20%) and nano silica sand powder as an alternative to cement in different proportions (5% and 10% by weight). The results showed that compressive strength decreased by 12.10% and 19.23% for 10% and 20% plastic waste replacement and increased by 12.89% and 20.39% for 5% and 10% silica sand replacement respectively at 28 days. Flexural strength decreased by 12.95% and 19.64% for 10% and 20% plastic waste
... Show MoreThe dependable and efficient identification of Qin seal script characters is pivotal in the discovery, preservation, and inheritance of the distinctive cultural values embodied by these artifacts. This paper uses image histograms of oriented gradients (HOG) features and an SVM model to discuss a character recognition model for identifying partial and blurred Qin seal script characters. The model achieves accurate recognition on a small, imbalanced dataset. Firstly, a dataset of Qin seal script image samples is established, and Gaussian filtering is employed to remove image noise. Subsequently, the gamma transformation algorithm adjusts the image brightness and enhances the contrast between font structures and image backgrounds. After a s
... Show MoreThis study aims at finding out the sentimental smartness of the kindergarten children
and its relationship with some variables.
1- The level of the sentimental smartness of the kindergarten children.
2- Investigating the Zero hypothesis in that there are no significant statistical differences in
the sentimental smartness between the kindergarten children according to the sex variables
(males and females).
Some statistical tools have been used in order to arrive at the results that verify the
hypotheses of this study. The researcher uses (1) the distinctive power between two
distinctive groups; (2) the relationship between the item and the total degree (Pearson
correlation factor); and (3) Elfakronbach formula t