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.
Meditationsuggetsthat the theatrical world and the receiptindicatethattherie a thread connection or relationshipbetweenthembecausetheateris an art thatfailsinto the abyss of the humanfield ,receivingis a practice thatisreffered to by corners of society and islocated in the context of thisfield. Thus, the relationshipbetweenalgeriantheater and the recepientissanctified by the nature of theaterwhichisbased on a social basis thatbuildsitsexistance and continuityfrom the recepient.Its impossible to imagine a real theaterthatwillbeestablishedunlessit’sassociatedwith an audience so one hand never claps to makesound. This connectionis the first phenomenonthatcanbecome accessible to all people and itremains the second phenomenonthatrequires th
... Show MoreThe research aimed to shed light on the impact of international Accounting Standard No (21) on tax obstacles represented by (tax evasion, double taxation) The financial statements of a group of banks operating in the private sector were relied upon to know the impact of the standard on tax obstacles, as well as knowing the amount of amounts, The researcher relied on the method of financial analysis of that data, which was obtained from the website of the Securities Commission, and conducted personal interviews with a number of university professors, chartered accountants, financial experts, banks, and the General Authority for Taxes to benefit from their
... Show MoreIn order to investigate the presence of methicillin or multidrug resistant Staphylococcus aureus in food-chain especially Cows raw milk and white raw soft cheese and its whey, a total of 30 samples were collected randomly from different markets in Baghdad Province during December 2012 till February 2013, in which samples were analyzed by a standard isolation protocols of food microbiology with some modification processing by new, modern and rapid technology tools such as chromogenic medium Baird-Parker agar, Electronic RapIDTM Staph Plus Code Compendium Panel System (ERIC®) Dryspot Staphytect Plus and Penicillin Binding Protein (PBP2') Plus assays; as well as, studying the susceptibility of isolates to different selected antibiotics. The r
... Show MoreThat internal control is particularly important in improvingperformance and tax reform، they play an important role in the regularity ofwork and development and the anti corruption and activating the decisionsand tax legislation، as contained in the organizational plan and the means،procedures and components designed from which to ensure a policy andimplementation plans The research aims to review the reality of the internalcontrol in the General Commission for Taxes and stand on the deficiencies init, with the strengthening of the role of internal control in the GeneralAuthority for taxes based on the laws and regulations and by using modernmeans to work as well as developing the performance of employees in thebody، including helpin
... Show MoreAbstract
The current research sought to demonstrate the effect of material flow cost accounting on reducing products through the application of material flow cost accounting technique, which works on the optimal utilization of materials and energy and the reduction of environmental impacts.The research aims to clarify the knowledge foundations for material flow cost accounting, in addition to studying the material flow cost accounting technique that helps reduce the cost of products and make them environmentally friendly. To achieve this, the research relied on the descriptive approach with regard to the theoretical aspect of the resea
... Show MoreThe steady consumption of fish led many researchers to study it preferences over other foods, especially for radioactivity content. The specific activity concentration (S.A) of natural occurring radioactive materials (NORM) have been measured for Cyprinus carpio fishes collected from several industrial fishes' lakes located in Baghdad governorate using gamma spectroscopy doped with high purity germanium coaxial detector (HPGe). Thirteen fishes' samples were collected from industrial lakes, three samples were collected from cages, and two samples were collected from Trigger River. The last two types of samples were collected in order to compare the results with it. The measured overall averages of S.A for Ra-226, Th-232, and K-40 were 58.
... Show MoreIt has been an increase concern of scientific and professional accounting sides on disclosure especially after appearance of business firms and accounting development with its relationship to financial statements which are considered to be outputs of the activity results. The preparing of financial statements and auditing of those accounts according to normal principles and standards of accounting on both local and international levels. Accounting disclosure can be seen an importance through discover all fundamental and necessary information for proper supply. Therefore, the research will highlight on public companies commitment in Iraq for basis and standards which have taken disclosure in financial data. The conceptual frame of t
... Show More