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 research stems from the problem that focuses on a number of questions. They are as follows: What is the extent of interest in the topic of efficiency by the banks and their role in raising the efficiency of the banking business and its development? Is the banking efficiency used in Iraqi banks clear and specific for the Iraqi banking sector? How the banking sector efficiency is measured and what are the approaches adopted in determining the banking inputs and outputs? What is the level of efficiency in the research sample of the banks and what are the causes of its decline or rise in private banks individually and in the Iraqi banking sector in general?
The re
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The current research dealt with the issue of organizational skillfulness as an entry point to reach strategic agility. The study has been tested in Iraq's mobile operators - Asia Cell, Zain Iraq and Cork Telecom. The study was applied to a sample of (93) managers distributed at various levels of management (board members, general managers, commissioners, department managers, people managers, unit managers, office managers). The survey used the questionnaire as a key tool for collecting data and information as well as personal interviews. It has sought to test a number of hypotheses related to correlation and influence relationships between the variables of the study, in order to answer the questions related to the problem of stud
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(3)
This study was carried out in epidemically field with common reed (Phragmites communis Trin.) plants in the Nassiriah cityThiQur governorate ,during 2009/2010 to investigate the influence of plant growth regulator gibberellin (GA3)and cytokinin (CK) in increasing the efficacy of glyphosate and Fluazifop-butyl in common reed control . Factorial experiment in RCBD was used with three replications in tow Factors . Glyphosate 3500mg .l־¹ gave the higher mean of injury score of common reed and lower mean of common reed shoots , shoots dry weight and rhizome dry weight(3.59,22.01 shoot /0.5m² ,0.57Kg / 0.5m² and 250.50gm /0,5m² ),respectively. All plant growth regulators gaves the higher means of common reed shoots and rhizome dry weight com
... Show MoreMany economic entities working in multiple industrial fields suffer fromlow techniques in using modern administrative means in their works. The mostused tool in measuring required procedures is to adopt and use quality costs. inspite of complications and bronchial of operations in construction projects, Theresearcher was able to find a structure to quality costs according to traditionclassification (prevention, Appraisal, failure) which enables the calculation ofthese costs and then analyze results and setting standards which can beimplemented in evaluating strategic performance for targeted project. and theforge research in theoretical fly to quality and costs concerning it inconstruction section , as well as strategically performance a
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(3)
The tax exemption, whether wholly or partially, and for an unlimited duration of the investment or for a limited period of few years, is one of the encouraging things to the flow of foreign capital. And if necessary, impose tax on the profits of the invested capital, the promotion requires that not be discriminatory taxes or payments in the amount of money with the need to avoid double taxation. The tax exemption is granted by the government and the feature according to the law of a natural person or legal entity seeking from the government purports to achieve a set of political goals, economic and social development. The reduction of taxes or grants partial exemption is one of the factors that encourage attract of direct foreign i
... Show MoreBackground: Controversy exists concerning the presence and amount of the Bennett mandibular immediate side shift among patients and whether it is necessary to accommodate for it in adjustable articulators. The aim of this study was to register and calculate the amount of any immediate side shift (ISS) present in patients requiring full mouth rehabilitation. Materials and methods: 3- dimensional condylar movements of 50 Iraqi TMD-free patients were recorded using a stereographic fully adjustable articulator system during protrusion, left and right eccentric mandibular movements. Protrusive angles of each patient were verified to figure out the suitable fossa analog for each case. The thickness of each right and left premade fossa analog sele
... Show Moreبسبب محدودية الموارد الطبيعية، فأن سكان الخليج ومنذ القدم وجهوا جلّ نشاطاتهم توجهاً بحرياً: صيد الاسماك وصناعة اللؤلؤ العنصر الرئيس في حجم التشغيل، وتكوين الفائض الاقتصادي في المنطقة آنذاك.
لقد تزايدت أهمية هذا النشاط بخاصة بعد النصف الثاني من القرن التاسع عشر، لرواج تجارة اللؤلؤ عالمياً، وأنفتاح الخليج على الدول الاوروبية التي شهدت نهضة صناعية متسارعة، وحيث وصلت الخليج العديد من بضائع
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Establishing sustainable cities and residential neighborhoods requires the development of new planning strategies, as adopting sustainable planning strategies when planning urban land uses for residential neighborhoods is necessary due to the large number of urban land use problems that have emerged during urbanization. The most prominent modern concept concerned with the land was the concept of sustainability, as sustainable planning aspires to link knowledge with sustainability through measures to achieve it. Therefore, sustainable planning works to apply the principles of sustainability in planning.
And in view of the circumstances that our country went through, which negatively affected various sectors and aspects of life, in
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