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
This study expands the state of the art in studies that assess torsional retrofit of reinforced concrete (RC) multi-cell box girders with carbon fiber reinforced polymer (CFRP) strips. The torsional behavior of non-damaged and pre-damaged RC multi-cell box girder specimens externally retrofitted by CFRP strips was investigated through a series of laboratory experiments. It was found that retrofitting the pre-damaged specimens with CFRP strips increased the ultimate torsional capacity by more than 50% as compared to the un-damaged specimens subjected to equivalent retrofitting. This indicated that the retrofit has been less effective for the girder specimen that did not develop distortion beforehand as a result of pre-loading. From
... Show MoreTo evaluate the cost-effectiveness of emicizumab compared to recombinant activated factor VII (rFVIIa) in Iraqi patients with hemophilia A and inhibitors.
A retrospective cost-effectiveness analysis was conducted on 46 male patients with hemophilia A and inhibitors treated at a public children’s hospital in Baghdad. Data collection was conducted between November 2024 and March 2025. Clinical and economic data were retrospectively collected for a 12-m
The present paper applies Fanon Psychological reading of the problem of the Black introduced in his book Black Skin White Mask to Crooks, The black Character in John Steinbeck’s Of Mice and Men. The analysis of this character infers three essential points regarding the artistic achievement of the author. First, he uses a fictional character that offers a psychological interpretation of the black problem of alienation and loneliness in a way that does not disgrace the black. Second, he applies Fanon’s way of showing the various attitudes that the black adopts in contact with the white society. Third, he affirms that the black inferiority complex comes as a result of double proc
... Show MoreThe optical transmission and UV-VIS absorption spectra have been recorded in the wavelength range (200-1100m) for different composition of polyaniline and polyvinyl Alcohol(PVA ) blends thin films. Polyaniline was prepared in acidic medium to enhancement the solubility and processibility, The optical energy gap (Eopt) refractive index and optical dielectric constant real and imaginary part have been evaluated. The effects of doping percentage of prepared polyaniline on these parameters was discussed and the non –linear behavior for all these parameters was investigated.
Recent developments in two main phases of cumulus cloud studies are discussed; first the relations between the clouds and their energy sources in the subcloud layer and second, the interaction between the clouds and their environment in the cloud layer. Under the first heading, the various originating impulses for cumulus formation are mentionitd. and how the character of this impulse affects the spacing, scale and temperature structure of the clouds. The possible origins of trade cumuli are considered.
Abstract
It considers training programs is an important process contributing to provide employees with the skills required to do their jobs efficiently and effectively, so it should be concerned with and the focus of all government our organizations, and perhaps the most important reasons that I was invited to select the subject (evaluation of training programs directed toward the diagnosis of the phenomenon of financial and administrative corruption) It is the importance of those programs working in the regulatory institutions General and the Office of Inspector General of Finance and the Ministry particularly for employees because of their role in the development of their skills and their experience and their beha
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The purpose of this research is to develop a proposed framework for achieving the Integration of the Target Cost and Resource Consumption Accounting Techniques and to show the role they play in reducing products costs and supporting the competitive advantage to cope with contemporary changes. To achieve this goal, the researchers followed the analytical method using the statistical questionnaire as a means of collecting data from the research sample include accounting, administrative, technical, engineering staffs and others. The research sample consists of (56) individuals and for the purpose of conducting statistical analysis of the data and testing hypotheses, the statistical program (SPSS) wa
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The purpose of the present paper is to light on the relationship between jobs design, analysis and its reflections on reinforcing workers' vocational adjustment. The present paper aims to accomplish cognitive and applied goals, top of which, test of functional analysis ability to have effect upon workers' vocational adjustment via job design directly and indirectly owning to the virtual factor practiced by these practices on the sought organization. The problem of the present paper comes with many, the most important is the of how to bolster and back up worker's technical adjustment through good and accurate design for the job.
Based on this problem and goals as to expla
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