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
Personality regard as one of the human soul pillars that has been built throughout the life of people, starting from the fertilizing process to different stages of people ages. Over time, numerous scientific studies have shown that fetus has the ability to hear and feel and he is being stereotyped since the first stages of formation. Accordingly, the process of forming human personality set up since that date. Besides, the socialization means that take different resources to enhance human personality such as holy Quran, school, social media, and social environment. The emergence of social media made the world as a small village which gives the chance for all people, over the world, to obtain the knowledge easily and limitless. Thus, the
... Show MoreThe article considers metaphors as one of the fundamental means used by L. Ulitskaya when writing the family chronicle "Medea and her Children" (1996), for the formation of images of heroines - representatives of the pronounced feminine principle in the work. Here I describe the results of the next stage of research related to the work of Lyudmila Evgenievna Ulitskaya as a representative of modern Russian prose.
This study aims at identifying the reality of alternative assessment for teachers of the first cycle of the basic education in the Sultanate of Oman with respect to the degree of teachers' use of alternative assessment strategies, level of self-efficacy for alternative assessment strategies, and attitude towards alternative assessment, and their relationship with other variables. To achieve the aims of the study, a descriptive research approach was utilized. A 5-point self-rated questionnaire was developed. It consists of three sections: Actual use of alternative assessment strategies (21 items), self-efficacy for alternative assessment strategies (21 items), and attitude towards alternative assessment (27 items). The psychometric proper
... Show MoreAbstract:
This research emerged due to the needs of Iraqi social sector for diagnosing the problems ,finding the appropriate solutions,and exploiting the social opportunities to solve these problems .The research problem focused on raising the following question: "Were Iraqi Managers in the Ministry of Labor and Social Affairs able to use their qualifications as social entrepreneurs in the ministry to improve the quality of life of the disadvantaged groups?", In light of that, the importance and objectives of the study were determined, and this research derives its importance from trying to address social problems by measuring the degree of meeting the subjective and objective needs of the custo
This research aims to underscore the significance of women's emotional intelligence in enhancing the effectiveness of the Board of Directors, a crucial component of internal governance, particularly during crises. Despite strides made in recent decades in appointing women to senior roles in government, business, and education, challenges persist in improving women's leadership opportunities, especially in developing countries. The study utilizes statistical methods, including Pearson's correlation, to analyze the relationships between variables within a sample of banks listed on the Iraqi securities market, comparing periods before and during the COVID-19 pandemic (2019 and 2020). The goal is to measure the impact of female emotiona
... Show MoreThe study aims to follow modern methods in teaching rhythmic gymnastics skills by directing learners to develop their perceptions and absorb what the world deals with today and develop intelligence among learners, the researchers searched for the strengths of the learner by providing them with an opportunity to form their kinetic formation, hence the problem came by introducing a method of self-intelligence and social to guide the learner in the search for ways and solutions to overcome boredom and economy Time and effort in the educational process in learning and give them the freedom to express their ideas And their skills and here came the role of social and self-intelligence to teach the individual and collective kinetic formati
... Show MoreThe emergence of mixed matrix membranes (MMMs) or nanocomposite membranes embedded with inorganic nanoparticles (NPs) has opened up a possibility for developing different polymeric membranes with improved physicochemical properties, mechanical properties and performance for resolving environmental and energy-effective water purification. This paper presents an overview of the effects of different hydrophilic nanomaterials, including mineral nanomaterials (e.g., silicon dioxide (SiO2) and zeolite), metals oxide (e.g., copper oxide (CuO), zirconium dioxide (ZrO2), zinc oxide (ZnO), antimony tin oxide (ATO), iron (III) oxide (Fe2O3) and tungsten oxide (WOX)), two-dimensional transition (e.g., MXene), metal–organic framework (MOFs), c
... Show MoreThe concept of TQM is based on one of the concepts that combine administrative and innovative methods. The aim of the research is to demonstrate the dimensions of TQM in enhancing the satisfaction of the taxpayers through a survey of a sample of officials in the General Authority for Taxation and 50 officials. In the collection of data and information, and the results were analyzed using the SPSS program to find the most important compounds and factors in he method of analysis.
The research problem was represented by the non-application of the General Authority for Taxation to the entrances and modern practices in the administrative work. The results of some of the complications that accompany the tax accounting process, which af
... Show MorePraise be to God, Lord of the Worlds, and prayers and peace be upon the Master of Messengers and his family and companions.
The study of the jurisprudential opinions of scholars, their choices, or their weightings, sheds light on the approach they followed in their choices, and reveals the originality of the scholar or his influence on those who preceded him from among the scholars.
And the commentators of the noble hadith of the Prophet have their important contributions in this aspect, as they undertake the task of explaining the noble hadith, the second source of legislation
Contemporary commentators have their share in the service of the honorable hadith, and the statement of their choices and preferences, and am
... Show MoreMS Elias, RGM AL-helfy, Plant Archives, 2019