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 purpose of this study was to find out the connection between the water parameters that were examined in the laboratory and the water index acquired from the examination of the satellite image of the study area. This was accomplished by analysing the Landsat-8 satellite picture results as well as the geographic information system (GIS). The primary goal of this study is to develop a model for the chemical and physical characteristics of the Al-Abbasia River in Al-Najaf Al-Ashraf Governorate. The water parameters employed in this investigation are as follows: (PH, EC, TDS, TSS, Na, Mg, K, SO4, Cl, and NO3). To collect the samples, ten sampling locations were identified, and the satellite image was obtained on the
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Las diferencias entre el pretérito perfecto simple y el imperfecto son uno de los temas más complejos de la lengua española, no sólo para el estudiante, sino para el profesor, puesto que sistematizar los casos y hacerlos fácilmente comprensibles al alumno es tarea difícil. Los profesores de lengua, cuyas investigaciones han dado lugar a una serie de teorías y de corrientes metodológicas y didácticas que permiten enfocar la enseñanza de una lengua extranjera de manera muy distinta a como se hacía tradicionalmente. Vamos a repasar muy brevemente cuáles son estas teorías.
En primer lugar es necesario señalar en qué consiste el aprendizaje de una segunda lengua:
"El aprendizaje de una segunda lengua (L2) es el
... Show MoreThe problem of rebellion is considered one of the features of rapid changes that a society undergoes in all spheres and directions of life, especially in the realm of social relations, customs, traditions, values, and principles. Rebellion may manifest itself in rebellion against oneself, against values or traditions, or against social or governmental authority. One may find that submission plays a vital role in all of these interactions. This study deals with the problem of rebellion in the works of two renowned authors: The French Gustave Flaubert and the Israeli Amos Oz, through two main characters who share similar qualities and traits. Emma Bovary and Henna Konin demonstrate this through their rebellion against themselves, their relati
... Show MoreThe research aims to show the relationship between the use of automated accounting systems technology and its impact on enhancing the efficiency and effectiveness of the internal control system in a sample of Bahraini universities in light of the rapid changes in the electronic business environment. Automated accounting and its impact on enhancing the efficiency and effectiveness of the internal control system, and it is concluded through the analytical study of the research sample that there is a percenta
... Show MoreThe mysterious letters, the philosophy of existence and the meaning of these letters in the Qur'an is one of the mysterious issues that has always occupied the minds of Interpreters. Each Interpreter has tried to provide his own interpretation and understanding of these mysterious letters. Since these letters are part of the surah of the Qur'an and at the same time, the appearance of these letters, unlike other verses, does not indicate meaning, the commentators have approached these verses with their preconceptions. In this article, an attempt has been made to investigate the role of pre-interpreters of descriptors in a descriptive and analytical method in finding the meaning of syllables. However, each of them has tried to interpret th
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The development taking place on the sports field at the general level and in the game of football at the private level, being the most popular game in the world, has reached very advanced stages. The use of modern aids and technology has contributed greatly to this development from the collective and individual aspects, as the goalkeeper is the most important position in the team, the use of devices gave objective readings about the goalkeeper’s ability in terms of skill and physical aspects, as the importance of the research lies in designing an electronic device to measure the degree of bending of the knee angle because of its great importance in developing the skill of catching and dimensions of the high ball for football goalkeepers.
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Women are considered the real power to build societies, as they are half of society, and it is their responsibility to raise generations، as human history testifies to the recording of great names with their giving and achievement in various scientific, social and humanitarian disciplines. Because of the importance of women in our lives, society must give them special care, whether at home or within the community structure to which they belong, so that they contribute to the image that brings about a transformation in the public scene, as well as providing them with support to take charge of bringing about change themselves, and this explains the interest of the press at all levels. Women's issues and topics through various journal
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The last ten years observed a shift enormous scientific in the method and way that it deals professional with the cost accounting and reflected the result those shift enormous scientific of increase the competitive environmental that accompanied the emergence of a modern manufacturing environmental on surface the long roductive life and emergence advanced information technology that give a central focus of his important on client with growing global markets growth on a large scale.
The research aim to define the concept of cost awareness, the concept and methods of strategic cost management and the role of cost awareness for managers of industrial units in strategic of cost managem
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