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 lack of active 2019 coronavirus disease (COVID-19) pandemic treatment creates a challenge for researchers and scientists to find the most appropriate treatment for this disease. Dexamethasone, according to the findings of the RECOVERY clinical trial, declared mid-June 2020 in print media was one of those therapies. Although the results from retrospective studies are not strongly supportive of corticosteroid routine use in COVID-19 despite the signals for some benefits, the dedicated RECOVERY trial found a significant reduction in death with dexamethasone only in severe cases on a ventilator or moderate cases on supplemental oxygen therapy nevertheless, no benefit observed in mild to moderate cases requiring no oxygen. More studi
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The notion of presupposition has been tackled by many linguists. They have found that the term ―presupposition” is being used in two different senses in the literature: semantic and pragmatic. As for semantic sense, Geurts (1999) has isolated some constrictions as sources of presupposition by making lists of presupposition triggers. Concerning the pragmatic sense Kennan (1971:89) uses the term pragmatic presupposition to refer to a class of pragmatic inferences which are, in fact, the relation between a speaker and the appropriateness of a sentence in the context. In spite of the fact that there are many researches that have been done in the field of presupposition but few of them in the field of short stories up to the researcher's kno
... Show MoreIn this work gold nanoparticles (AuNPs), were prepared. Chemical method (Seed-Growth) was used to prepare it, then doping AuNPs with porous silicon (PS), used silicon wafer p-type to produce (PS) the processes doping achieved by electrochemical etching, the solution etching consist of HF, ethanol and AuNPs suspension, the result UV-visible absorption for AuNPs suspension showed the single peak located at ~(530 – 521) nm that related to SPR, the single peak is confirmed that the NPs present in the suspension is spherical shape and non-aggregated. X-ray diffraction analysis indicated growth AuNPs with PS. compare the PS layer without AuNPs and with AuNPs doped for electrical properties and sensitivity properties we found AuNPs:PS is more
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A general mathematical model for a fixed bed immobilized enzyme reactor was developed to simulate the process of diffusion and reaction inside the biocatalyst particle. The modeling and simulation of starch hydrolysis using immobilized
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Undoubtedly, rutting in asphalt concrete pavement is considered a major dilemma in terms of pavement performance and safety faced by road users as well as the road authorities. Rutting is a bowl-shaped depression in the wheel paths that develop gradually with the increasing number of load applications. Heavy axle loadings besides the high pavement summer temperature enhance the problem of rutting. According to the AASHTO design equation for flexible pavements, a 1.1 in rut depth will reduce the present serviceability index of relatively new pavement, having no other distress, from 4.2 to 2.5. With this amount of drop in serviceability, the entire life of the pavement in effect has been lost. Therefore, it is crucial to look at the mechani
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Hydrodynamics is the interpretation of subsurface fluids and pressures to explain and predict hydrocarbon occurrence and trapping. Different models of fluid flow and hydrocarbon entrapments were constructed for the Mishrif Formation in (Rumaila South RU, Rumaila North R, West Qurna WQ, Majnon MJ, and ZubairZB) oilfields in Basra, southern Iraq. The dynamic flow within the oil reservoir was analyzed by measuring the specific gravity, hydrostatic pressure, hydrodynamic pressure, pressure gradient, salinity and hydraulic head. Fluid saturation in the pore space, hydrodynamic parameters, density, permeability and buoyancy influence fluid flow. The hydrodynamic model indicates that the oil fields are non-isolated reservoirs with a unifor
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Introduction: Syphilis is a sexually transmitted disease, that may be transferred from mothers to infants during pregnancy if it is left untreated. Method: This study was conducted among 65 women who suffered from recurrent abortions in Iraq. Syphilis screening recombinant (IgM + IgG) level by ELISA, RADIM (Italy) and rapid plasma reagin (RPR) (positive and negative results) tests were used to analyse the data. Results: A non-significant association was observed with age (p=0.989), and the number of healthy births (p=0.643). Non-significant differences were observed in comparisons between smoker and non-smoker percentages in the study group. The rapid test for syphilis confirmation was applied using Rapid Plasma Reagin (RPR) tests.
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Aromaticity reversals between the electronic ground (S0) and low-lying singlet (S1, S2) and triplet (T1, T2, T3) states of naphthalene and anthracene are investigated by calculating the respective off-nucleus isotropic magnetic shielding distributions using complete-active-space self-consistent field (CASSCF) wavefunctions involving gauge-including atomic orbitals (GIAOs). The shielding distributions around the aromatic S0, antiaromatic S1 (1Lb), and aromatic S2 (1La) states in naphthalene are found to resemble the outcomes of fusing together the respective S0, S1, and S2 shielding distributions of two benzene rings. In anthracene, 1La is lower in energy than 1Lb, and as a result, the S1 state becomes aromatic, and the S2 state becomes anti
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The implementation of decentralization in Iraq was asymmetrical, leading to different forms and paces of implementation. Comparing four cases of Basra, Kirkuk, Nineveh, and Sulaymaniyah indicate that these cases differ in their political stability and autonomy in a way that led to a different forms of decentralization. This paper argues that the higher the level of political autonomy from the federal government, the more efficient the governance model, and the more efficient the governance model, the more legitimate the system (trust), and the more legitimate a system, the more accountable elected officials. Therefore, it recommends reforming the institutional setup of decentralization by having districts, instead of provinces, as t
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