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
In this work, an efficient energy management (EEM) approach is proposed to merge IoT technology to enhance electric smart meters by working together to satisfy the best result of the electricity customer's consumption. This proposed system is called an integrated Internet of things for electrical smart meter (2IOT-ESM) architecture. The electric smart meter (ESM) is the first and most important technique used to measure the active power, current, and energy consumption for the house’s loads. At the same time, the effectiveness of this work includes equipping ESM with an additional storage capacity that ensures that the measurements are not lost in the event of a failure or sudden outage in WiFi network. Then then these
... Show MoreIn this work a study and calculation of the normal approach between two bodies,
spherical and rough flat surface, had been conducted by the aid of image processing
technique. Four kinds of metals of different work hardening index had been used as a
surface specimens and by capturing images of resolution of 0.006565 mm/pixel a good estimate of the normal approach may be obtained the compression tests had been done in strength of material laboratory in mechanical engineering department, a Monsanto tensometer had been used to conduct the indentation tests. A light section measuring equipment microscope BK 70x50 was used to calculate the surface parameters of the texture profile like standard deviation of asperity peak heights
Soil improvement has developed as a realistic solution for enhancing soil properties so that structures can be constructed to meet project engineering requirements due to the limited availability of construction land in urban centers. The jet grouting method for soil improvement is a novel geotechnical alternative for problematic soils for which conventional foundation designs cannot provide acceptable and lasting solutions. The paper's methodology was based on constructing pile models using a low-pressure injection laboratory setup built and made locally to simulate the operation of field equipment. The setup design was based on previous research that systematically conducted unconfined compression testing (U.C.Ts.). Th
... Show MoreThe present study aims to detect CTX-M-type ESBL from Escherichia coli clinical isolates and to analyze their antibotic susceptibility patterns. One hundred of E. coli isolates were collected from different clinical samples from a tertiary hospital. ESBL positivity was determined by the disk diffusion method. PCR used for amplification of CTX-M-type ESBL produced by E. coli. Out of 100 E. coli isolates, twenty-four isolates (24%) were ESBL-producers. E. coli isolated from pus was the most frequent clinical specimen that produced ESBL (41.66%) followed by urine (34.21%), respiratory (22.23%), and blood (19.05%). After PCR amplification of these 24 isolates, 10 (41.66%) isolates were found to possess CTX-M genes. The CTX-M type ESBL
... Show MoreThis paper is an attempt to investigate the syntactic and semantic features of the English phrasal verbs. In this paper, phrasal verbs were classified into subgroups according to their syntactic and semantic characteristics. After giving a survey of literature written on the meaning and definition of phrasal verbs, two sections have been devoted to tackle the most important issues in this category of English verbs. Section one sheds light on the basic definitions of the term ‘phrasal verb’ which are, according to the researcher’s point of view, sufficient to cover the area of the study. In addition, it studies the number and the importance of phrasal verbs in English. Section two deals with the syntactic and semantic features of Engli
... Show MoreCarbon dioxide geo-sequestration (CGS) into sediments in the form of (gas) hydrates is one proposed method for reducing anthropogenic carbon dioxide emissions to the atmosphere and, thus reducing global warming and climate change. However, there is a serious lack of understanding of how such CO2 hydrate forms and exists in sediments. We thus imaged CO2 hydrate distribution in sandstone, and investigated the hydrate morphology and cluster characteristics via x-ray micro-computed tomography in 3D in-situ. A substantial amount of gas hydrate (∼17% saturation) was observed, and the stochastically distributed hydrate clusters followed power-law relations with respect to their size distributions and surface area-volume relationships. The layer-
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в статье рассматриваются проблемы преподавания русской литературы в иракской аудитории.. Использование литературы в преподавании иностранного языка, как правило, имеет две цели. Первая-чисто лингвистическая .. Вторая цель, однако, ассоциируется больше с экстралингвистикой и представляет собой ознакомление студентов с различными аспектами русской жизни, культуры,
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