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
Diyala River is one of the important rivers that provide water for the Governorate of Diyala. In this research, the morphology and sediment transport of this river were studied using HEC-Ras software. The selected length of the river in the present study is 193 km and extended from Diyala Weir to the confluence of Tigris River and Diyala River. The fieldwork period extended from June 2020 till August 2020, where suspended-load and bed-load samples were collected and surveyed some cross-sections. The one-dimensional sediment transport model has been calibrated for five years, from 2014 to 2019. The results were compared with the measured cross-sections in 2019, and the suitable value of (maximum depth
... Show Morewords of God the Quranic text , is genera words have many faces and connotations a ccording to references, cutures and Ages.That the Quranic text is fixed , But the connotations are moveable the scientists agreed about the miracle of the Qurantic text , But they differd of the Position of miracLe including the muatazala and Al- Ashaira who have adopted the idea of sytem and miracle of linguistic . Most of them were lingustics, grammerians and writers as: AL- Jahith, AL- Faraa Abivbeida , Ibn kutaba , AL -Rumani , AL -katabi , AL- Bakilaai , AL- Gargani and Others.
They also differed in what the words of Allaah mean . Is the Quranic text creature or updated ,it is the issue that exhausted the effort.of muslim scientists though its imbo
Idioms are a very important part of the English language: you are told that if you want to go far (succeed) you should pull your socks up (make a serious effort to improve your behaviour, the quality of your work, etc.) and use your grey matter (brain).1 Learning and translating idioms have always been very difficult for foreign language learners. The present paper explores some of the reasons why English idiomatic expressions are difficult to learn and translate. It is not the aim of this paper to attempt a comprehensive survey of the vast amount of material that has appeared on idioms in Adams and Kuder (1984), Alexander (1984), Dixon (1983), Kirkpatrick (2001), Langlotz (2006), McCarthy and O'Dell (2002), and Wray (2002), among others
... Show MoreFlorida is one of the most important American states. It was discovered by the Spanish explorer (De León), and subsequently, French and English colonies were established. By June 25, 1868, Florida had become one of the American states. Its economic importance became prominent after the increase in commercial activities, and its economy grew significantly in the first quarter of the twentieth century. In addition, its important geographical location enabled it to play a significant role in global politics.
The study of the concept of the location of control and the level of ambition of important topics and represent a large area in the educational and psychological sciences, which gives importance to this study at the present time, is the complex and difficult conditions experienced by the Kurdish man, all age groups or social segments, and because of the changes It increases the rate of stress and hardship, which in turn raises the rate of psychological and physical disorder to prevent a healthy individual's compatibility, which has a fundamental impact on their personality, leading to a defect in some important organs of the personality.
The research aimed to identify the location of control among students of the Uni
Al-Manas and Al-Muhais are two words in a close sense of the strange words of the Holy Quran. The word Al-Manas was mentioned once in the Holy Qur'an in Surat (PBUH). ) / 36 .. What we will see in the folds of the search, God willing.
Each Arab Islamic city is distinguished by its distinctive characteristics dictated by the nature of its location and its characteristics, as we see it mountainous in the mountains, deserts in the deserts, and coastal in the coasts, and this is reflected in the models of its buildings and designs and even in its structure. However, this uniqueness did not stand in the way of the emergence of characteristics and common characteristics of these cities over time, the factors derived from the core of the life of the community habits and traditions and beliefs and living requirements and environmental conditions that all piled in the process of building and construction of the Arab Islamic city to draw The features and lines of life of the co
... Show MoreRotating blades are the important parts in gas turbines. Hence, an accurate mathematical estimation (F.E.M) of the stresses and deformations characteristics was required in the design applications to avoid failure. In recent year’s there are researchers interest in the effect of temperature on solid bodies has greatly increased, The main of this study investigated the thermal and rotational effects. So, the thermal stresses due to high pressure and temperature are studies, also determine the steady state stresses and deformations of rotating blades due to mechanical effect. Many parameters such as thickness and centre of rotating are investigated in this paper. The
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