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
An essential tool for studying the web is its ability to show how energy moves through an ecosystem. Understanding and elucidating the relationship between species variety and their placement within the inclusive trophic dynamics is also beneficial. A food web ecological model with prey and two rival predators under fear and wind flow conditions is developed in this article. The boundedness and positivity of the system’s solution are established mathematically. The stability and existence constraints of the system’s equilibria are examined. The proposed system’s persistence limitations are established. Additionally, the bifurcation analysis of every potential equilibrium is examined using the Sotomayor theorem. To describe the
... Show MoreThe objective of the study: To diagnose the reality of the relationship between the fluctuations in world oil prices and their reflection on the trends of government spending on the various economic sectors.
The research found: that public expenditures contribute to the increase of national consumption through the purchase of consumer goods by the state for the performance of the state's duties or the payment of wages to employees in the public sector and thus have a direct impact on national consumption
The results of the standard tests showed that there is no common integration between the oil price fluctuations and the government expenditure on the security sector through the A
... Show MoreThis study was aimed to investigate the load of bacterial contaminant in fresh meat with different types of bacteria.One handered and seven samples were collected from different regions of Baghdad . These samples included 37 of fresh beef 70 of fresh sheep meat. All samples were cultured on different selective media to identitfy of contaminated bacteria .The result revealed that The percentage of bacterial isolate from raw sheep meat were, % 23.8of StreptococcusgroupD,29.4 % of Staphylococcus aureus ,14.7 % of E.coli , %4.9of Salmonella spp, ,%3.5 of pseudomonas aeruginosa, %14.7.%14.7 of Proteus spp.% 2.1 of Listeria spp while the raw beef meat content %5.55 of Staphylococcus aureus, %8.14 of streptococcus group D , %5.18 %1.85 of E.coli,
... Show MoreAbstract:
This study seeks to shed light on the important processes are linked to the impact of accounting information on the behavior of producer and user of information and are urging informational and informational use. That accounting as a system of accounting information and functions of the delivery of information to decision makers Under behavioral entrance to the formulation of accounting theory should be taken into account Othertlk accounting information in the behavior of the decision maker which requires an explanation of human behavior and predictable.
On the other hand that the accounting information that should be delivered to the decision maker will affect your beha
... Show MoreThe present study aims to test a range of hypotheses about the effectiveness of each of the theory of transactional leadership, and the theory of transformational leadership in the Egyptian environment, and to identify any of them are better able to predict the effectiveness of leadership. And after the effect will be to identify the quality of the relationship between the leader and the subordinate in leadership , and what is the role of transformational leadership dimensions influencing the effectiveness of leadership. The field study was conducted on a sample of companies' public and private sector and the government in Egypt. The results of the study resulted in experimental that transacti
... Show MoreThis research aims to study the effect of heat on the efficiency of solar cells of neutrons ranging from card to these cells in the case of dark and light before and after irradiation using the neutron source as well as electrical properties have been studied
Approaching the turning of the millennium, the American theatre witnessed an arousing
interest much shown in patients suffering of severe diseases as a subject matter to drama. In a
discussion of Margaret Edson's Wit, the light is shed on how far such patients, who were literally
involved in secular visions during their life-time, become apt to create a different one on their
death beds. The vision newly blossomed becomes much rooted in the spiritual life; it is a
redemptive vision that can amend what those patients' hearts and minds have long ignored.
Further, the human touch that has been ignored during man's healthy secular life is ultimately
needed for the time being. It helps to enhance man's vision towards the
Abstract The study aimed at reviewing translation theories proposed to address problems in translation studies. To the end, translation theories and their applications were reviewed in different studies with a focus on issues such as critical discourse analysis, cultural specific items and collocation translation.
Increased the need to promote the profession of auditing, and improving the performance of the audit process, which comes through the effective implementation of its tasks, where the auditor collects the necessary data about the nature of client activity, and any other information it deems necessary to carry out the planning and development of the strategy for how to determine the procedures for implementing the audit process and the scope and timing for evidence clues in order to form an opinion technician neutral about the fairness of the financial statements, as required by the standards of the field work of the planning and supervision of the internal control and evidence to prove, but the failure of the auditor whether in th
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Abstract
Islam has been concerned with preserving and maintaining rights, so the provisions in which it is preserved are legislated. Among that is the testimony that made it a way to prove the truth and obliges its bearer to fulfill right in order to preserve the right and establish justice and prevent injustices by defying conflict, and tyranny .
And while acknowledging that divine absolute wisdom that is the cause and origin of legal rulings is sufficient, it is obligatory to abide by its provisions and imposes obedience, surrender, contentment and work in accordance with its controls.
However, the realization of the defects behind the legislation in a comprehensive way that realizes the dev
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