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.
Abstract
The present research paper provides an analysis of Thomas Dekker’s
exaltation of the figure of the Babylonian woman as a tragic heroine in his dramatic
art. The paper falls into two sections. The first section outlines the deliberate
mispresentation of the figure of the Babylonian woman in the Bible and the
misreading of that figure. The second section reveals Dekker’s rectification of the
distorted image of the Babylonian woman, whom he defends and glorifies as a
heroine and a victim of misinterpretation and conspiracy.
The study aimed to assess the level of ANG‑2 in MM patients at diagnosis and in remission state and elaborate on its correlation with interleukin‑6 (IL‑6) and beta‑2 microglobulin (B2M) levels. Sixty MM patients; 20 newly diagnosed (ND), and 40 patients in remission were included. Twenty healthy individuals were included as a control group. Plasma levels of ANG‑2, B2M, and IL‑6 were tested by enzyme‑lin ked immunosorbent assay. There are significant statistical differences between ND patients and those in remission in hemoglobin, neutrophil count, blood urea, serum creatinine, glomerular filtration rate, B2M, IL6, and ANG‑2 (P = 0.001, 0.033, 0.005, 0.001, 0.001, 0.001, 0.004, and 0.001, respectively). ANG‑2 showed signifi
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الغرض من البحث دراسة تأثير ادارة المعرفة (استراتيجية الشخصنة والترميز) في تحقيق التفوق الاستراتيجي في بيئة المصارف الاهلية العراقية ، وتم اعتماد منهج البحث الوصفي والتحليلي ، لذا اعتمد الباحث الفلسفة الوضعية وفق المنهج الاستنباطي لغرض اشتقاق فرضية البحث الاولى من الجانب النظري وتوصل البحث الى مجموعة من النتائج اهمها ان استراتيجية الشخصنة حققت تقدماً كبيراً في قدرتها على التأثير في التفوق الاستراتيجي بوصف
... Show MoreOur research sheds light on one of the most important aspects of David Grossman's play, "Ricky's Garden, גן ריקי " which is characterized by its realistic portrayal of characters. Grossman gradually moves towards the inner awareness of his characters, expressing their emotions and thoughts through conversations and emotional conflicts, referring to their past and rooted background. Grossman transformed the main subject of his play (psychological depth) into a presentation and arrangement of all the elements of the play in a way that expresses emotional nature more powerfully by each child in the garden. This is reflected in their actions and words, making Grossman's works suitable for study and always of interest to specialized resear
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أن كرة السلة بما تتضمنه من مهارات حركية متنوعة تتطلب من ممارسيها امتلاك عدد من القدرات الحركية الخاصة وبشكل خاص التوافق العضلي العصبي والرشاقة والقوة المميزة بالسرعة، فضلاعن قدرات الإدراك الحس- حركي (إدراك المكان وقوة دفع الكرة سواء بالطبطبة العالية أو الواطئة .... الخ ) لذا تكمن أهمية البحث في إيجاد الطرق والوسائل التي تطور قدرة الطالبة على إدراك قوة دفع الكرة والإحساس بها أثناء تعلم وتدريب الطبطبة بأنواعها ب
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Abstract: The article aimed to formulate an MLX binary ethosome hydrogel for topical delivery to escalate MLX solubility, facilitate dermal permeation, avoid systemic adverse events, and compare the permeation flux and efficacy with the classical type. MLX ethosomes were prepared using the hot method according to the Box–Behnken experimental design. The formulation was implemented according to 16 design formulas with four center points. Independent variables were (soya lecithin, ethanol, and propylene glycol concentrations) and dependent variables (vesicle size, dispersity index, encapsulation efficiency, and zeta potential). The design suggested the optimized formula (MLX−Ethos−OF) with the highest desirability to perform the
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Abstract
We Can Summarize This Research According To the Following Points
A- result
1- We conclude a new method to teach the recitation we call it (listening
method) which consist of four steps (introduction , listening ,continuity,
evaluation )
2- This research get many listening skills that educated need it when
listen to (holy quran) beside to many propositions that help to develop
it.
3- This research briefs some principles that help the teacher when use
listening method.
B- conclusion
1- The best way to teach and learn the recitation of holy quran is by
using listening skill because the prophet (pease be upon him )learn
the holy quran by it from jebrel (pease be upon him ) and then
teach