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
The study aimed to reveal the impact of employing the strategy of the talk-ative groups on the achievement and academic tendencies of chemistry forstudents of the fifth grade of applied science for the academic year (2018 -2019), and to achieve this goal the researcher used the experimental methodon the sample of the study consisting of (50) students, prepared achievementtest falls Under (60) paragraphs, and the scale of tendencies for chemistryfalls under (30) paragraphs, and after the researcher completed the researchexperiment according to what was planned:The superiority of the experimental group studied according to the strate-gy of the talkative groups was found in the post-application of the test ofachievement and attitudes of chemis
... Show MoreGaining the relationship between the central government and local governments is great importance especially after the expanded functions of the central government and became unable to carry out their works without all that delegate or transfer parts of its powers to lower levels.
The aims of the research is to determine the relationship of the central government with the local government in accordance with the principle of administrative decentralization with the presentation of the competent authorities, the control of local governments, according to the Provincial Council Act No. 21 of 2008 amended.
The research has a problem that has been the relationship of the central
... Show MoreThe Noble Qur’an is the book of God, the Blessed and Exalted, in which is the teachings of God Almighty’s religion, which is Islam, in order for people to unite it and establish servitude to it. The individual and the society alike saw it appropriate to make my opinion alerting the seriousness of this matter, so the research was entitled (The Impact of Sins and Disobedience on the Individual and Society in the Holy Qur’an - Objective Study), knowing that we touched upon some of the effects, which we found it appropriate to mention in this research in the service of the good. Its details came in the Holy Qur’an without referring to others, noting their arrangement in the Holy Qur’an..
Education in it s different levels becomes development in any country. There fore, nations pay great attention to educational systems, because they perceive that preparing human resources is essential to the development of these nations.
The present study deals with the a academic frames which formulate education in each educational system such as educational philosophy , educational aims , educational strategies by which the academic frames are carried out, which is limited to curriculum, teacher preparations, school activities, in addition to guidance and counseling.
This study reaches some conclusion which are derived from the description of the academic and practical frames some suggestion are made for the mechanism which facil
Luqman's story stated that human instinct, if I was brought up properly, reaches wisdom and inflicts the right to everything. It is to go to worship God and adhere to the satisfaction of morals and high morals that are ordered to meet among human beings in this life, because this worship educates in the soul the most beautiful morals needed by human beings of honesty, honesty and modesty, and the work of good and virtues, and distancing the soul from evil and vices.
The research aims to test the effect of the behavioral factors (intangible) represented by an explanatory variable represented by organizational silence and a responsive variable of quality of Function life. The problem was the negative effects of the organizational silence on the morale of the employees and consequently their performance and the quality of function life. To collect the data and information needed to measure the two variables of research conducted in the health center / Sulaikh by taking a sample of (40) employees to test the hypotheses of research through the survey of their views, using statistical tools non parametric using the program. The most important recommendations were the establishment of training workshops fo
... Show MoreA study of the singlet and triplet states of two electron systems in the first excited state was performed using a simple quantum mechanical model, which assigns the 1s,and 2s orbital with two different variational parameters. Our results agree with a high level calculation used by Snow and Bills.
The research aims to apply the activities of the green value chain as one of the modern administrative techniques that economic units resort to develop solutions to the pollution problems that occur due to the activity of economic units and their products that may cause damage to the environment as well as the waste of natural resources and to identify the production of environmentally friendly products and reduce the costs of environmental failure of both types Internal and external that may be borne by economic units such as taxes, fines and compensation due to non- observance of environmental requirements and the preservation of human health and protection of the environment.To achieve the goal of the research, the researchers re
... Show MoreRecent studies agree that the democratic system in a country can only be established in an atmosphere of political and religious freedom. However, the term democracy and the term freedom have become controversial because their concepts remain multiple and different. Karl Popper is one of the most prominent philosophers in modern Western political thought, and one of the defenders of democracy as opposite to dictatorship. It has defined its function by its ability to restrain the ruling elite and to enforce it to prevent their tendency to tyranny. This can be achieved only in the context of the close relationship between democracy and freedom, so, if there is democracy in the absence of absolute freedom, democracy is a gateway to expandin
... Show MoreThe current research discusses “The impact of the critical factors for the transfer of knowledge on opportunities and strategic success ", the attention have been increased on knowledge transfer and strategic success subjects because on being one of the important and contemporary issues, which have a significant impact on the existence of organizations and its future. The research aims to identify the critical factors for knowledge transfer in private high education environment which enables (the college community surveyed) to achieve strategic success, also the research sought to answer questions related to research problem by testing a number of major and minor hypothes in impact, in order to test the hypotheses I used a fiel
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