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
Background: 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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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 MoreAbstract:
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
Several methods have been developed for routing problem in MANETs wireless network, because it considered very important problem in this network ,we suggested proposed method based on modified radial basis function networks RBFN and Kmean++ algorithm. The modification in RBFN for routing operation in order to find the optimal path between source and destination in MANETs clusters. Modified Radial Based Neural Network is very simple, adaptable and efficient method to increase the life time of nodes, packet delivery ratio and the throughput of the network will increase and connection become more useful because the optimal path has the best parameters from other paths including the best bitrate and best life link with minimum delays. The re
... Show MoreInternal 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
Background: The association between oral microbial infection and systemic disease is not a new concept. A major confounding issue is that oral infections often are only one of the many important factors that can influence systemic diseases .Objective: This study was conducted to evaluate the periodontal health status of patients with acquired coronary heart disease. Type of the study: Cross-sectional study.Methods: The study group consisted of 200 patients with an age range (35-70) years, having coronary heart disease .This study group were compared to a control group of non-coronary heart disease (200 individuals ) matching with age and gender. The oral parameters were examined including the periodontal conditions, assessment of periodo
... Show MoreBackground: Acute coronary syndrome (ACS) is a common disease, and a major determinant of morbidity and mortality in all races. The pleiotropic effects of the receptor activator of nuclear factor-kappa B ligand (RANKL) such as modulation of cell survival, mineralization and inflammation, make it an interesting candidate mediator in the progression and destabilization of atherosclerotic lesions.Objectives: This study was performed to investigate the role of RANKL in the pathogenesis of ACS.Methods: The levels of RANKL were measured by ELISA method in sera of 60 ACS patients, 31 patients with unstable angina (UA) and 29 patients with myocardial infarction (MI) in comparison with 20 apparently healthy controls.Results: Current data indicate
... Show MoreThe aim of this paper is to approximate multidimensional functions by using the type of Feedforward neural networks (FFNNs) which is called Greedy radial basis function neural networks (GRBFNNs). Also, we introduce a modification to the greedy algorithm which is used to train the greedy radial basis function neural networks. An error bound are introduced in Sobolev space. Finally, a comparison was made between the three algorithms (modified greedy algorithm, Backpropagation algorithm and the result is published in [16]).
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