Background: Transradial compared to classic transfemoral coronary intervention has been shown to have similar efficacy rates, while being more cost-effective and most importantly safer due to fewer access site complications. Furthermore, patient comfort is increased and outpatient treatment may be feasible..Objectives: To start trans-radial intervention program and the initial learning curve for fellows and the catheterization –laboratory nursing staff. To test how could it be applicable and comfortable for our patientsMethods: This prospective study was performed in Ibn-Albitar hospital for cardiac surgery over a period of 6 months from the 1st of August 2012 till the 1st of February 2013. Every patient referred for percutenuos coronary intervention whether on scheduled or on an emergency basis was considered initially for trans-radial approach for intervention unless they are excluded. Allen test was required ensuring adequate ullnar collateral supply. Sledinger technique was used for radial artery puncture and a special radial sheath was introduced. Intervention was performed through the same catheter and equipments that are used for femoral approach.. medication given according to center protocol, the relevant data collected and patients immediately ambulated unless they receive sedation.Results: A total of 126 patients were referred for intervention during the study period, 20 cases were excluded for various reasons , 6caese were crossed over to femoral approach and the other 100 cases the procedure completed transradially. The mean age of the patients was 57 ± 8 years. Of these 72% were males ,with different risk factors . Most cases presented with chronic stable angiana (87%). Access site was right radial artery in 87% of patients while left radial approach used in 13% of patients. In 72% of cases single guiding catheter was used, in 21% of cases 2 guiding catheter were used and more than 2 types of guiding catheter were used in 7% of cases. In most session of intervention single artery was treated (78%) , 2 vessel intervention in 21%, 3 vessel in one case..Lesions treated were different types 26%,36%,38% A,B and C respectively. The success in obtaining radial access was 97.7% ,while angiographic procedural success rate was 96%. Mean total procedure time was ( 43+/-23min ), mean fluoroscopy time (13+/-8 min )and the average amount of contrast used was (178+/-80ml). with no major complication apart from 3% small heamatom and 6% radial loss. Around 80% of patients preferred TRI approach.Conclusion: Radial artery approach for percutenuos coronary interventions has high procedural success rate and associated with low risk of access site complications and no significant increase of procedural and fluoroscopy time. It is comfortable approach for most patients especially female and obese. Early ambulation with no risk of bleeding and reduction of the duration of hospital stay are in favor of TRI approach.
The objective of the present investigation was to enhance the solubility of practically insoluble mirtazapine by preparing nanosuspension, prepared by using solvent anti solvent technology. Mirtazapine is practically insoluble in water which act as antidepressant .It was prepared as nano particles in order to improve its solubility and dissolution rate. Twenty formulas were prepared and different stabilizing agents were used with different concentrations such as poly vinyl pyrrolidone (PVPK-90), poly vinyl alcohol (PVA), poloxamer 188 and poloxamer 407. The ratios of drug to stabilizers used to prepare the nanoparticles were 1: 1 and 1:2. The prepared nanoparticles were evaluated for
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In most recent studies, long-term retention after orthodontic treatment has been hypothesized that may be necessary to maintain the stability of the dentition and avoid post-treatment changes. The bonded fixed retainer is characterized by its clinical effectiveness, patient acceptance, and lack of patient complaints as compared with a removable retainer. An electronic database (such as PubMed, PubMed Central, Web of Science, Science Direct, Cochrane Library, Scopus, and ResearchGate) has been collected using specific keywords. Of the 152 articles, only randomized clinical trials that investigated different types of fixed retainers or compared fixed with removable retainers were illustrated in tables and included in this review. The
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The organizational culture is considered as an important topic. In this research, this topic was studied in modern paints Industries Company to assess its role in job performance and to show if there is this relationship between them or no. it is, also, attempted to measure this strength of this relationship if any. The 40 cases research sample was chosen. This sample included the chief executive, his assistants, key managers, and their assistants. The questioner consists of two sets of questions : the first set ( concerning the organizational culture) covers six variables (Physical structures , Symbols
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research aim :
- The research aimed to investigate the effect of two treatment
methods in the gaining of fourth grade students in geography
object.
- Research hypothesis
there are no statistically significant differences at the level of ( 0.05 )
in the average level of achievement in geography between the first
experimental group ( strengthening lessons ) and the second group
( re- teaching )
no individual differences statically significant at the level of ( 0.05 )
in the average level achievement in geography object of the second
experimental group ( re- teaching ) and the first experimental group
( strengthening lesson )
the research sample : the researcher selected randomly Baghdad
The current research aims to determine the role of strategic leadership in achieving organizational excellence. In this context the sample of the research consist of 123 managers .The research problem can be summarized as {what is the role of strategic leadership in achieving organizational excellence}which resulted in a number of sub-questions and its goal was to explain the theoretical philosophy and intellectual expositions of this variables because of they are vital variables imposed by the current situation. To achieve research objectives we had use the questionnaire as a tool to collect data and information after verifying the validity and dependency of the measures. A number of statistical techniques and tools had been use
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In light of this, attention should be paid to tax reform as part of a comprehensive economic reform program. Therefore, the research started from the problem of the weak efficiency of the tax reform process in the General Authority for Taxation, as well as the need to know the addition of new taxes or increase taxes.The research aims study the relative importance of each disabled person, whether organizational, human, financial, legislative or technical. The research led to a number of conclusions, the most important of which were that the financial obstacles occupy the highest importance of the other obstacles and for the success of the tax reform, the material resources must be provided in order to provide the n
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Abstract
The research aims to shed light on strategic cohesion and its dimensions represented by (strategic logic, organizational excitement, organizational founding, organizational synergy) and measure its impact on achieving organizational prosperity and its dimensions represented by (intellectual capital, innovation, infrastructure, organizational agility, sustainable competitive advantage). The research problem emerged by raising the main question, which is: Does the management of the researched company realize the importance of practicing strategic cohesion and its role in achieving organizational pros
... Show MoreThis research aims at to identify the extent to which creative thinking skills Impact the change &development of Administrative Leadership styles In Administrative Leadership of the Medical City Department. Identify the nature of the relationship between them, determine the prevailing leadership style, &measure the level of creative thinking skills they have. In order to achieve the objectives of the research, the descriptive analytical method was adopted.
The research tool consisted of a questionnaire consisting of (61) paragraphs, in addition to the interview & observation. The research sample consisted of (170) administrative leaders in the upper &middle organizational levels. The
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The main objective of the central bank is to achieve price stability and target in fractionates. Therefore, the bank sought to use modern tools and policies in order to reduce the negative effects of the accumulation of foreign reserves represented by monetary sterilization, similar to developed and developing countries alike, but with different available tools that are possible and imposed by the local financial and monetary environments, such as the window for buying and selling foreign currency, open market operations and deposit facilities. And lending existing. Because any in crease in the monetary base resulting from the accumulation of foreign reserves will affect price stability directly due to the consumer nature of the
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