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.
AL- Shaam Bathrooms in the later Abbasyat Ages
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The process of risk assessment in the build-operate transfer (BOT) project is very important to identify and analyze the risks in order to make the appropriate decision to respond to them. In this paper, AHP Technique was used to make the appropriate decision regarding response to the most prominent risks that were generated in BOT projects, which includes a comparison between the criteria for each risk as well as the available alternatives and by mathematical methods using matrices to reach an appropriate decision to respond to each risk.Ten common risks in BOT contracts are adopted for analysis in this paper, which is grouped into six main risk headings.The procedures followed in this paper are the questionnaire method
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Objective: The aim of this study to detect the correlation between trace elements such as zinc, copper and
spermatogenesis, sperm viability and motility.
Methodology: Serum and semen samples were collected from one hundred twenty patients with age ranged (20-
50 years) attending the high institute for Embryo Research and Infertility Treatment/ Baghdad University, in
addition to thirty fertile males their age comparable to that of patients. The period of this study was from June
2004 until the end of October 2004.
Results: The result of routine seminal fluid analysis of all infertile males was divided according to WHO, (1999) limit
into four groups: Asthenospermia(A), Asthenoteratospermia(AT), Oligoasthenoteratospermi
Infrastructure projects take a long time, are complex, multidisciplinary, use different materials and products, and have high risk. These characteristics affect the process of supplying materials. The current paper studies the ability to improve the supply chain process and decrease its cost by identifying the factors that affect it. These factors are used as variables in the mathematical model, which is working under uncertain conditions when the consumption rate of materials is not constant. The information used in this model is obtained from Building Information Modeling (BIM) and Geographical Information System (GIS) techniques and the genetic algorithm is utilized to determine the optimal supplier and the quantities of supplies
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An experimental of kinetics investigation of the solution free radical polymerization of isopropylacrylamide (IPAM) initiated with potassium persulfate (PPS) was conducted. The reactions were carried out at constant temperature of 60 °C in distilled water under unstirred and inert conditions. Using the well-known conversion vs. time technique, the effects of initiator and monomer concentration on the rate of polymerization (Rp) were investigated over a wide range. Under the conditions of our work, the orders 0.38 and 1.68 were found with respect to initiator and monomer, respectively. However, the rate of polymerization (Rp) is not straight forwardly corresponding monomer concentration. The value 46.11 kJ mol1 was determined as the o
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Genetic algorithms (GA) are a helpful instrument for planning and controlling the activities of a project. It is based on the technique of survival of the fittest and natural selection. GA has been used in different sectors of construction and building however that is rarely documented. This research aimed to examine the utilisation of genetic algorithms in construction project management. For this purpose, the research focused on the benefits and challenges of genetic algorithms, and the extent to which genetic algorithms is utilised in construction project management. Results showed that GA provides an ability of generating near optimal solutions which can be adopted to reduce complexity in project management and resolve difficult problem
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