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.
BACKGROUND : Bifurcational coronary lesions are
frequent and amounts to almost one fifth of routine
practice concerning up to 15 – 20 % of cases .
Revascularization by percutaneous coronary
intervention ( PCI ), of bifurcational lesion has
become easier by stenting yet it remains a frequent
challenge.
OBJECTIVE : To evaluate the success and hospital
complications of two most frequent technique of stent
deployment in bifurcational PCI.
METHODS : We prospectively analysed the data of
140 consecutive patients with bifurcational PCI at
Ibn_Al-Bitar Hospital for cardiac surgery for the
period from July 2008 to July 2009 .
Depending on whether the side branch was stented or
not, the patient has fa
Used cooking oil was undergoing trans-esterification reaction to produce biodiesel fuel. Method of production consisted of pretreatment steps, trans-esterification, separation, washing and drying. Trans-esterification of treated oils was studied at different operation conditions, the methanol to oil mole ratio were 6:1, 8:1, 10:1, and 12:1, at different temperature 30, 40, 50, and 60 º C, reaction time 40, 60, 80, and 120 minutes, amount of catalyst 0.5, 1, 1.5, and 2 wt.% based on oil and mixing speed 400 rpm. The maximum yield of biodiesel was 91.68 wt.% for treated oils obtained by trans-esterification reaction with 10:1 methanol to oil mole ratio, 60 º C reaction temperature, 80 minute reactio
... Show MoreBackground: Non-atherosclerotic spontaneous coronary artery dissection (SCAD) is defined as a non-traumatic and non-iatrogenic separation of the coronary arterial wall. SCAD is a highly uncommon cause of myocardial infarction (0.1 to 0.4 %).
Case presentation: 40-year-old African American woman, G1T1P0A0L2, with a past medical history of tobacco abuse and obesity who had uncomplicated cesarean section delivery for healthy twins two weeks prior presented with substernal, sudden onset chest pain. The pain radiated to left arm and back, pressure-like, and is associated with nausea, vomiting, and dyspnea.
On examination she was within normal limits except for a well-healed C-section wound. An electrocardiogr
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Abstract:
Humanitarian intervention has taken different forms included within the
peaceful and military means to stop the human suffering, whether caused by
natural disaster or humanitarian disasters.
Intervention can not be acquitted because it carries with it political cover,
but sometimes it may be legitimate cover for the occupation and the violation
of sovereignty. Therefore, the research worked to capture the legal and
political aspects of international law and the role of international organizations
to intervene and the right to use force.
The research concludes that international law had not been fairly
successful in controlling the behavior of some countries in the use of force,
and that there is
Internal Music is considered as a basis to form music melody that sends rapture and
ecstasy within ones selves since it occurs directly on ears ( hearing) and since it tightens the
meaning to make it penetrating into Heart. It is rhythmic organization occurred inside the text
due to movements of internal sounds since rhythm heavily depends on language and
pronunciation. Repetition adds music melody to the poetic text since it increases music in
poetry. The sounds that reoccurred either be letters or words are no more than confirmation.
Thus , repetition is artistic phenomena most poets resorted to as to diverse his subjects and
metaphors he depicts in his poetry. The repetition has achieved artistic aesthetics , mean
This study investigated the ability of using crushed glass solid wastes in water filtration by using a pilot plant, constructed in Al-Wathba water treatment plant in Baghdad. Different depths and different grain sizes of crushed glass were used as mono and dual media with sand and porcelaniate in the filtration process. The mathematical model by Tufenkji and Elimelech was used to evaluate the initial collection efficiency η of these filters. The results indicated that the collection efficiency varied inversely with the filtration rate. For the mono media filters the theoretical ηth values were more than the practical values ηprac calculated from the experimental work. In the glass filter ηprac was obtained by multiplying ηth by a facto
... Show MoreThis study investigated the ability of using crushed glass solid wastes in water filtration by using a pilot plant, constructed in Al-Wathba water treatment plant in Baghdad. Different depths and different grain sizes of crushed glass were used as mono and dual media with sand and porcelaniate in the filtration process. The mathematical model by Tufenkji and Elimelech was used to evaluate the initial collection efficiency η of these filters. The results indicated that the collection efficiency varied inversely with the filtration rate. For the mono media filters the theoretical ηth values were more than the practical values ηprac calculated from
the experimental work. In the glass filter ηprac was obtained by multiplying ηth by a
Metaphor has been occupied first place among eloquent methods to build metaphors;
poetry with the latter becomes senseless thing. Metaphor is necessary part of energy that
sustains the poetry. Sentence of metaphor regarded more eloquent than the reality since it
does not conduct directly to the meaning , but rather get to it indirectly. Metaphor is
considered one of the most tools for the poet since it is a means of expression about his
sensation and feelings . Andalus paid concerns over metaphors as that being incited by their
country beauty and nature. The poet might resort to contradiction as to picture contraries
within himself.
Through pictures of contradictions depicted by the poets , it has explained that t
The systems of governance in Europe are characterized by ancient democratic systems that have developed and developed through a long history of political conflicts that have emerged from a social reality that feeds them and receives the resulting effects. This is an achievement that has been achieved after the sacrifices and great efforts in formulating models of good governance through which to realize the aspirations of their peoples. . The democratic system operates within a balanced mechanism of two competing parties to manage and direct the work of the government and the parliament. The parties that achieve the majority in the elections carry out the functions of the government supported by their parliamentary base belonging to one
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