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 historical center cities were exposed to change, which included its social and economical structures, Which led to sweeping changes in land use, causing a change in the result, in urban fabric and the physical structure and therefore to see visual. We have attracted these centers as a result of pressure from urban development and contemporary reflection of the agents of change which have been hit during the late period a development residential newly not sympathize mostly with the content of the historical and at the expense of removing large parts of the urban fabric and replace it with patterns of structural and styles of architecture has not been connected with reality. Which led to the loss of some historical and architec
... Show MoreMany critics suggest that Beckett’s early plays are comic because they focus their analyses on the use comic elements. Waiting for Godot is one of Beckett’s early plays, and it has been heavily analyzed and read as a comic text partly because its subtitle is “a tragicomedy in two acts” and also because of the comic techniques used in the play. The present paper, however, attempts to read the play as a piece in which comedy fails to produce any effects on the characters who remain apparently very desperate and frustrated throughout the play. The characters perform different comic acts, but they do not really feel amused or entertained. The paper suggests that the acts these characters put on stage are only means to pass t
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The tagged search (The aesthetic images in Mohammed Thanoun graphic) four chapters, Chapter I was concerned the statement of the research problem, the research importance and it’s needed, the goal of research in identifying the aesthetic images in the graphic of the artist's, the research limits, and identifying the most important terms, chapter II came with theoretical framework and included three chapters: chapter I was interested in the aesthetic concept. chapter II is the image aesthetic in the graphic, and chapter III is the artist experience, Chapter III specializes in research procedures: community, sample, curriculum, tool, and sample analysis. Chapter IV ended with results, including: dynamic research sample illustrated of the
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The philosophies don’t forgets the subject silence because it effecting in life human , the kinds artist don’t lost the silence , exactly the theatrical arts because if the actor don’t the select silence he is don’t effect in the audience , this study giving the important for active the select silence in Iraqis theatre , so this search composed of : the preface that composed of : the search problem , and important the search and need it , aimed the search , lines search it composed of the lines time , lines place , and lines subject , and the terms limited . the theatrical line that composed The second topic the first topic the silence in the philosophers, part , active the select silence in the theatre text. The Third topic acti
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This paper deals with one of important topics that serve the art movement music, which is looking at the stairs of Arab music in the process of reaching to the directory musical on the subject of so-called (Photo by stairs music) and that by comparing the method used previously and the proposed rules reached by the researcher and received the patent invention, the method is easier for the musician and the author in a directory of peace Arab music when used on grades and half grades voice, and to achieve its objectives researcher dealt with the problem that is determined by the multitude of stairs leading Arab and the difficulty of keeping its catalog of music, and for being an anchor and pillar of the music was taken up and put her impor
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The study aims at investigating the effectiveness of the Virtual Library Technology, in developing the achievement of the English Language Skills in the Center of Development and Continuous Education, in comparison with the individual learning via personal computer to investigate the students' attitude towards the use of both approaches. The population of the study includes the participants in the English Language course arranged in the Center. The sample includes 60 students who were randomly chosen from the whole population (participants in English Courses for the year 2009-2010). The sample is randomly chosen and divided into two experimental groups. The first group has learned through classroom technology; while the other group has l
... Show MoreThe research examines the extent to which government spending decisions can affect the level of the financial performance of the directorate. The research problem was based on the financial reality of the Directorate of Sewerage of Diyala province. Spending on the Directorate of the research area. To achieve a set of objectives: indicate the impact of government spending decisions on financial performance, the use of financial analysis to assess the performance of the Directorate. The research adopted financial analysis tools, a set of financial ratios, through which the spending decisions taken by the Directorate of the field of research will be evaluated, and during the period (2014-2018). The research also adopted statistical
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production of the spot in the news channels - a study of patterns of spot media used in the production of spring breaks Arab Al-Arabiya
The spacers news in Arabic, one of the messages that seek channel output are fit and policy on the one hand and meet the needs of viewers for information intensive and image influential to find out the latest developments on the Arab arena, especially the Syrian revolution on the other and thus The viewer for the type of coverage the stomach through a newsletter about the event on the one hand to keep following up on her and eager to watch the other hand
And sou
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The present study aimed to identify the availability of the National Council of Teachers of Mathematics (NCTM) standards in the content of mathematics textbooks at the basic education stage in the Sultanate of Oman. The study used the descriptive-analytical approach, adopting the method of content analysis through using a content analysis tool that included (43) indicators distributed on the four NCTM standards related to the field of geometry, after verifying their validity and reliability. The study population consisted of mathematics textbooks (first and second semesters) for ninth-grade students in the Sultanate of Oman in the academic year 2018/2019, while the sample consisted of Geometry units in the content of those books, which a
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