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
Modern French novel has gained a distinctive status in the history of French literature during the first half of the twentieth century. This is due to many factors including the new literary descriptive objective style adopted by novelists like Alain Robbe – Grillet that has long been regarded as the outstanding writer of the nouveau roman, as well as its major spokesman, a representative writer and a leading theoretician of the new novel that has broken the classical rules of the one hero and evolved, through questioning the relationship of man and the world and reevaluating the limits of contemporary fiction , into creating a new form of narrative.
Résumé:
En vue de résu
... Show MoreThe study aims to provide a Suggested model for the application of Virtual Private Network is a tool that used to protect the transmitted data through the Web-based information system, and the research included using case study methodology in order to collect the data about the research area ( Al-Rasheed Bank) by using Visio to design and draw the diagrams of the suggested models and adopting the data that have been collected by the interviews with the bank's employees, and the research used the modulation of data in order to find solutions for the research's problem.
The importance of the study Lies in dealing with one of the vital topics at the moment, namely, how to make the information transmitted via
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Methods: A pre-experimental design is carried in army aviation bases in Iraq, for the period of April 1st 2019 to October 25th 2019. Non-probability "purposive" sample of (30) flight medics are selected from army aviation bases. The questionnaire consisted of two main parts: the demographic characteristics of air paramedics, and the second part included five axes, which are (50) paragraphs related to the knowledge of air paramedics towards emergency injuries. The researcher used the statistical program version 20 to analyze the data, and the stability of the questionnaire was measured through the pre and post
In drilling processes, the rheological properties pointed to the nature of the run-off and the composition of the drilling mud. Drilling mud performance can be assessed for solving the problems of the hole cleaning, fluid management, and hydraulics controls. The rheology factors are typically termed through the following parameters: Yield Point (Yp) and Plastic Viscosity (μp). The relation of (YP/ μp) is used for measuring of levelling for flow. High YP/ μp percentages are responsible for well cuttings transportation through laminar flow. The adequate values of (YP/ μp) are between 0 to 1 for the rheological models which used in drilling. This is what appeared in most of the models that were used in this study. The pressure loss
... Show MoreThe study aimed to detect the VrPIP2;7 gene using PCR approach, as well as to know the effect of the treatment with four increased melatonin concentrations of 50, 100, 150 and 200 ppm in addition to control treatment were 0 ppm on the gene expression of plasma membrane intrinsic proteins (PIP) genes in Vigna radiata L. plant exhibition for five periods of drought which is irrigation every 24 hours, 48 hours, 5 days, 10 days and every 15 days. The electrophoresis of agarose gel at a concentration of 2% showed one band when detecting the VrPIP2;7 gene with a sizeable 732 bp and using the 100 bp volume index. This gene was selected for sequencing study based on its importance as well as on the results of its gene expression. The sequencing of
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