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.
This study addresses the issue of academic writing in English by comparing pragmatic argumentation in the writing of 40 graduate students studying at Iraqi universities (SSIU) with the writing of 40 graduate students studying at American universities (SSAU). In these 80 theses, six selected aspects of academic writing were analyzed: (a) paragraph structure, (b) length and construction of sentences, (c) organization of information in sentences, (d) vocabulary, (e) topic sentences, and (f) discourse markers. This study seeks to go beyond the traditional and often onedimensional analysis of pragmatics of argumentation in English academic writing to distinguish and describe different aspects of academic writing and their results when used by EF
... Show MoreThis research is an attempt to develop exercise with weights to strengthen some of the striking muscles in the shoulder and arm and to develop the accuracy of the smash and rectum skills. The importance of this paper lies in the study of moments of force to achieve the ability to control muscular work and to explore the impact of physical and skill exercises with weights to develop moments of force for some muscles. The experimental method on a sample of players, selected according to the intentional method, including ( 9) advanced players representing Air Force Club participating in the Premier League for season 2011-2012. It is concluded that the exercises proposed have their effective impact on developing the variables of moments force f
... Show MoreLas 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 MoreThis research seeks to study the role of proactive leadership as an essential element that helps all federations that lead the wheel of sports, including the Iraqi Handball Federation, so that it builds a correct environment that helps manage the organizational errors that the Handball Federation may fall into, and this in turn helps in early detection of errors and obstacles that may occur. It is likely that the Federation will fall into the process of managing and organizing the Iraqi Handball League, in addition to increasing the clubs’ ability to assist the Iraqi Handball Federation by being proactive so as not to make mistakes. The research community included the administrative bodies of the clubs participating in the Iraqi E
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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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The research deals with one of the urban problems facing cities, namely the existence of neglected urban spaces that need to be activated , These spaces give a negative image of the city, is not conducive to life and social interactions or the city has a one distinctive urban experience, leading to a reduction peoples' confidence in revisiting of those areas, hinder the rest of the activities in that region . Because these spaces are of the basic components of the city and give it its identity through the elements and entities that constitute it , The idea of research emerged in the reclaiming of these spaces within contemporary urban trends and the activation of flexible , short-term and inovation for that purpose with
... Show MoreAlthough Israel's national security strategy, shaped by Ben Gurion in the 1950s, has remained steadfast, Israeli leaders have been keen to adapt and change some of its means and tools to maintain its national security. These changes were a response and adaptation to the complex and geostrategic transformations in the region since the end of the cold war. Traditional challenges to Israel's national security have declined as unconventional challenges have increased. This shift has adversely affected the efficiency and effectiveness of Israel's national security strategies. It has become necessary for Israel to confront regional actions taken by minor states and regional actors that have ensured the accumulation of its military capabilities. M
... Show MoreDiversity the terms and practice the organizational filed with different concepts and environment, which Iraqi environment part from them. Some organizational in Iraqi environment leave its basic oriented to agreement with the leader desire, their fore this research focus tow basic variable (organizational citizenship behavior & transparence), we supposition which is dependent to explanation the response variable (strategic leadership). The results justification in part and not justification in another part. For example the organizational citizenship behavior effect on some parte of the strategic leadership. The transparence have faraway to fly from the relation with organizational citizenship behavior and strategic leadershi
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The research aimed to identify the level of reality of administrative values of sports activities in the Faculties of the university of Baghdad from the point of view of the leaders and those related to the divisions and units of student's activities and the case study method was adopted from the descriptive approach.