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
In this work, the occurrence conditions of both local Bifurcation and persistence were studied, Saddle-node bifurcation appears near fourth point, near the first point, the second point and the third point a transcritical bifurcation occurred but no pitchfork bifurcation happened near any of the four equilibrium points. In addition to study conditions for Hopf-bifurcation near positive stable point that is the fourth point. Besides discuss persistence occurrence as globally property of the food chain of three species include prey, first predator and top predator with impact of toxin in all species and harvesting effect on the predator’s only. Numerical results for the set of hypothe
In The Name Of God the Most Gracious, the Most Merciful [Should he not know he that created? And he is the one that understands the finest mysteries (and) is well-acquainted] surah Al-Mulk verse No. (14), this Qur’anic verse is one of the pieces of evidence that indicates the suitability of Sharia for the human life, since God Almighty created the creation and he is the best-known concerning the needs of his creation to survive and for life to continue.
One of the key ways for the continuity of human life is Sharia's possession of the feature of suitability for every time and place, and for the whole world, and it is comprehensive to all the details of life and its integrated systems, a systems that comp
... Show MoreThe research consists of five chapters and aims to explore the administrative skills of leaders in physical education colleges and their relationship with administrative reform. The study sample included (deans, vice deans, and heads of departments) from physical education colleges for the academic year 2012-2013, with a total of 61 individuals. They were selected using the purposive sampling method, and the researcher distributed questionnaires to them, collecting 60 valid responses and excluding one due to its invalidity. After defining the concepts of administrative skills and administrative reform and redownloading relevant literature and previous studies, as well as consulting with a group of experts in management and psychology, the r
... Show MoreThe rapid changes in the field of transferring and exchanging information via cloud platforms have revolutionized the field of modern visual media, as cloud computing technology has greatly influenced the media institutions, providing effort, money and high-quality materials. The research included five chapters, the first came under the methodological framework for the research and the second Theoretical framework, the first two included the concept of cloud computing and the second platforms for cloud computing in the visual media and the third chapter Research procedures and the fourth chapter The sample analysis and the fifth chapter The research results were the most prominent
1. The cloud service made the benefit beyond the typic
In data transmission a change in single bit in the received data may lead to miss understanding or a disaster. Each bit in the sent information has high priority especially with information such as the address of the receiver. The importance of error detection with each single change is a key issue in data transmission field.
The ordinary single parity detection method can detect odd number of errors efficiently, but fails with even number of errors. Other detection methods such as two-dimensional and checksum showed better results and failed to cope with the increasing number of errors.
Two novel methods were suggested to detect the binary bit change errors when transmitting data in a noisy media.Those methods were: 2D-Checksum me
In this research we study a variance component model, Which is the one of the most important models widely used in the analysis of the data, this model is one type of a multilevel models, and it is considered as linear models , there are three types of linear variance component models ,Fixed effect of linear variance component model, Random effect of linear variance component model and Mixed effect of linear variance component model . In this paper we will examine the model of mixed effect of linear variance component model with one –way random effect ,and the mixed model is a mixture of fixed effect and random effect in the same model, where it contains the parameter (μ) and treatment effect (τi ) which has
... Show MoreThe behavior of thinking is consider one of the modern concepts that appear in the last 20 years, this concept has attracted the attention of psychologists and researchers for thinking has a great role in many fields like teaching ,educational,economical,cultural and social fields.
One of thinking manner is imaginal thinking that has a great role in human civilization. imaginal thinking lead to innovation ,poems, inventions and arts. imaginal thinkingled to highscores in talented schools by escalating their thinking range and solving problems that consider one of organized and free assumption thinking.
The development of problems thinking strategies reflect the development of organized brain process ability.
That studies assumes
The interplay of predation, competition between species and harvesting is one of the most critical aspects of the environment. This paper involves exploring the dynamics of four species' interactions. The system includes two competitive prey and two predators; the first prey is preyed on by the first predator, with the former representing an additional food source for the latter. While the second prey is not exposed to predation but rather is exposed to the harvest. The existence of possible equilibria is found. Conditions of local and global stability for the equilibria are derived. To corroborate our findings, we constructed time series to illustrate the existence and the stability of equilibria numerically by varying the different values
... Show MoreI noticed a researcher while working in the kindergarten that there is a group of
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