Back ground: Chronic total occlusion (CTO) of coronary arteries remains one of the most challenging lesion subsets in interventional cardiology even with the development of medical devices and operator expertise. Successful revascularization results in improved in angina status ,increased exercise capacity and reduces the need for lat CABG surgery .
Objectives: This study sought to determine the overall procedural success rate of percutaneous coronary intervention (PCI) for CTOs and to examine the relation between variables such as; patients’ characteristics, risk factors, lesion characteristics and procedural success rate.
Methods: In this study ,clinical and coronary angiography data of (80) patients with CTO who underwent PCI between May 2009 and May 2010 in Ibn Al-Baitar Hospital for cardiac surgery and Al-Nassryia cardiac center were prospectively analyzed . The clinical data were collected using the patients files and angiographic data by review of their films.
Results: There were (80) Patients with CTO ,They included 62 men (77.5%) and 18 women (22.5%) ,Age range 36-76 year with mean age 55±8.75 and male to female ratio was 3:1 .The procedural success rate of PCI was 66 patients (82.5%). All 23patients(100%) with lesionlength less than 15 mm had successful PCI compared to 43 out of 57 patients in whom the lesion was more than 15mm (75.4%) p value < 0.01. The procedure was successful in 54 patients out of 60 with tapered stump(90%) compared to 12 out of 20 patients with abrupt stump(60%) p value <0.005.In CTO lesion with angulations less than 45 degree ,the procedure was successful in 27 patients out of 28 (96.4%)compared to 39 out of 52 patients in whom the angulations was more than 45 degree 52(75%) p value<0.01. The most common cause of procedural un success was inability of guide wire crossing through the totally occluded segments which represented 11(78.5%), Inability to cross the lesion with a balloon in 2 patients(14.2%) and inability to dilate balloon in one patient (7.1%) P<0.001.
Conclusion: Percutaneous coronary intervention of chronic total occlusion is an effective therapeutic procedure with high success rate 82.5%. The length of chronic total occlusion ,degree of angulations and stump morphology are strong predictors of success procedure.
The problem motivation of this work deals with how to control the network overhead and reduce the network latency that may cause many unwanted loops resulting from using standard routing. This work proposes three different wireless routing protocols which they are originally using some advantages for famous wireless ad-hoc routing protocols such as dynamic source routing (DSR), optimized link state routing (OLSR), destination sequenced distance vector (DSDV) and zone routing protocol (ZRP). The first proposed routing protocol is presented an enhanced destination sequenced distance vector (E-DSDV) routing protocol, while the second proposed routing protocol is designed based on using the advantages of DSDV and ZRP and we named it as
... Show MoreIn light of accelerating environmental degradation, the transition to a green economy is an imperative for achieving sustainable development. This study provides a critical analysis of the international legal and institutional framework governing this transition, revealing a significant gap between normative developments and the institutional framework on one hand, and their practical implementation on the other. The transition faces legal obstacles, including reliance on non-binding voluntary commitments and conflicts between environmental obligations and global trade and investment rules. It also reveals a significant financing gap, as financial flows to developing countries continue to lag behind commitments, in add
... Show MoreBroyden update is one of the one-rank updates which solves the unconstrained optimization problem but this update does not guarantee the positive definite and the symmetric property of Hessian matrix.
In this paper the guarantee of positive definite and symmetric property for the Hessian matrix will be established by updating the vector which represents the difference between the next gradient and the current gradient of the objective function assumed to be twice continuous and differentiable .Numerical results are reported to compare the proposed method with the Broyden method under standard problems.
Capillary pressure is a significant parameter in characterizing and modeling petroleum reservoirs. However, costly laboratory measurements may not be sufficiently available in some cases. The problem amplifies for carbonate reservoirs because relatively enormous capillary pressure curves are required for reservoir study due to heterogeneity. In this work, the laboratory measurements of capillary pressure and formation resistivity index were correlated as both parameters are functions of saturation. Forty-one core samples from an Iraqi carbonate reservoir were used to develop the correlation according to the hydraulic flow units concept. Flow zone indicator (FZI) and Pore Geometry and Structure (PGS) approaches were used to identify
... Show MoreThe development of Japanese society passed through long historical stages and as a result of the bitter experience of Japan in the Second World War and its exhaustion, it was able to build a modern modern state after 1945. Japan is a country of culture, civilization, science and technology, a country that appreciates the value of solidarity work. And the role of active civil society. This is what makes us in Iraq stand and draw their experience in the advancement and development, especially that they also passed bitter political stages, Iraq today passes through the most historical periods of forestry through its historical heritage in terms of the existence of complex social problems, the US occupation of Iraq in 2003 highlighte
... Show MoreThis paper presents two main parts: The first part involves manufacturing the specimens form composite material for mechanical testing (tensile, flexural and fatigue tests), then design a custom foot orthesis (CFO) and manufacturing from composite lamination (3nylglass 2carbon fiber 3nylglass) for patient suffer from flexible flat foot since birth and over-pronation. The second part of this research involves a design a model of custom foot orthesis in (solid work 2018) and then analysis of custom foot orthosis in engineering analysis program (ANSYS V.18.2).The applied pressure in boundary condition adopted from Force Sensor Resistance (FSR 402 ) in various regions in foot after wearing composite CFO. Used a composite materials in engineerin
... Show MoreIraq faces significant economic challenges, owing in part to its reliance on oil revenue and the country's overburdened public sector. The supremacy of State-Owned Enterprises (SOEs), obstructive rules, a lack of access to finance, a shortage of skilled labor, and inadequate infrastructure all impede private sector growth. This research relied mainly on information from global development organizations, most markedly the World Bank, as well as policy documents, and it discovered a scarcity of pertinent educational writings. The following are the key findings of this research: Recent economic growth has not resulted in poverty reduction; the stretched history of war and insecurity in Iraq has hampered progress and development; the private se
... Show MoreA particulate composite material was prepared by adding the Titanium dioxide (TiO2) with a particle size of (75-150) µm to Epoxy resin at weight percentage of (10%,20%,30%,40%,50%).The following some mechanical properties were studied,fracture toughness, hardness.casting preparation methods were used in this study includes preparing plate of matrix and composites. specimens were prepared according to ASTM for the Mechanical properties tests. After that Another samples were heat treated for three and six hour at 65C?. Fracture toughness (Kic) represent for stress intensity factor results were showed that the curve of three hours aging increases in fracture toughness (Kic) for composites but for six hours aging increases fracture tough
... Show MoreThe group for the multiplication of closets is the set G|N of all closets of N in G, if G is a group and N is a normal subgroup of G. The term “G by N factor group” describes this set. In the quotient group G|N, N is the identity element. In this paper, we procure K(SL(2,125)) and K(SL(2,3125)) from the character table of rational representations for each group.