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.
An evaluation for the performance of model pile embedded in expansive soil was investigated. An extensive testing program was planned to achieve the purpose of this research. Therefore, special manufactured system was prepared for studying the behavior of model pile having different length to diameter ratios (L/D). Two types of piles were used in this research, straight shaft and under reamed piles. The effect of model pile type, L/D ratio and number of wetting drying cycles were studied. It is observed that significant reductions in pile movement when under reamed piles were considered. A proposed design charts was presented for straight shaft and under reamed piles to estimate the length of both types of piles that is requi
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Pinter's play One for the Road (1984) is considered one of his important plays because
it focuses on political issues, which he has not presented overtly before. Generally speaking,
Pinter's early plays describe man's existential fear of an unnamed danger which might be
represented by an intruder who invades the characters' solitude , threatens their peace, and
brings their hidden fears to the surface. Pinter began to write political plays as a result of his
political attitudes and his involvement in political activities over the last three decades.
Pinter's One for the Road deals with the oppressive and authoritarian operations of
state power. This play and Pinter's political plays which followed it, like Mountain
The loss of dental hard tissue as a result of odontoclastic activity is known as root resorption. It is unwanted and pathological in permanent teeth. Root resorption may happen within the root canal called internal root resorption or on the outer surface of the root called external root resorption. Regardless of where it occurs, root resorption is irreparable, can cause pain for the patient, necessitates treatment, and in some circumstances, resulting in the early loss of the affected tooth. It might be challenging to precisely diagnose and treat root resorption. There is limited information within literatures on root resorption therefore this review aims to understand the radiological and clinical characteristics of r
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This research tackles the play of Synge "Rider to the Sea" to find out whether the theories of Leech (1983) and Brown and Levinson (1987) can be applied or not to this study. The model of Leech (1983) consists of seven principles and for Brown and Levinson (1987),it consists of two principles of politeness where one of them is positive and the other is negative politeness. It is hypothesed that: 1. There is a relation between the two theories. 2. Synge deals with these theories in such a way to depict his characters. 3. It is also hypothesed that every character deals with these principles in such a way to show the events of the play. The study concludes that there is a relation between the two theories in depicting the characters then it s
... Show MoreThe problem of independent motion control of mobile robot (МR) in conditions when unforeseen changes of conditions of interaction of wheels with a surface are considered. An example of such changes can be sudden entrance МR a slippery surface. The deployment of an autonomous unmanned ground vehicle for field applications provides the means by which the risk to personnel can be minimized and operational capabilities improved. In rough terrain, it is critical for mobile robots to maintain good wheel traction. Wheel slip could cause the rover to lose control and become trapped. This paper describes the application of fuzzy control to a feedback system within slippery environment. The study is conducted on an example of М
... Show MoreThe Civil Rights era has been an era of struggle for the African American in the
Unites states. Thus, many writers devoted their writing to reflect the racism and
discrimination that many have suffered from, among them is Ralph Ellison.
Ralph Ellison is a 20th century African-American writer and scholar best known for
his renowned, award-winning novel Invisible Man. He illustrates the powerful
social and political forces that conspire to keep black Americans in their place,
denying them the right to life, liberty, and the pursuit of happiness guaranteed to all
Americans. Invisible Man is a 1952 novel that addresses many of the social and intellectual
issues facing African-Americans in the twentieth century. It exa
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