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 mix promotion important to any organization in general, has been selected promotional mix tools in this research to identify the role in maximizing the Organization of sales growth business, which included the research problem several fundamental questions about the role of each promotional tool of advertising, public relations and personal selling and sales promotion direct marketing within the promotional mix in the promotion of business sales organization. The research aims to provide theoretical and field organizations surveyed about the role played by the mix promo in sales growth, and importance of research on the identification of more than promotional tools impact on sales gr
... Show MoreThis study deals with the thems of "in-betweeness" in the modern Afro-American Drama, drawing upon the accumulated literature of the colonial and postcolonial studies. In-betweeness appears in these studies under the canopy of the terms mimicry, hybridity and liminality which refer to a transformative, in-between state of being. It also refers to themutual relations holdingbetween man and his cultural space.
This concept is fitting the Afro-American playwright Amiri Baraka's plays and his violent, revolutionary theatre. In his play Dutchman (1964), Clay, the protagonist, is a good example of the two-ness or in-betweeness. He finds difficulty choosing between the ethnocentric white culture and the black culture.He allows
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Muslim scholars have established fundamental rules for deriving rulings to be a methodology for every mujtahid who wants to extract rulings from his reliable sources, and one of the most prominent fundamental rules on which many rulings are built is the permissible and the many rulings related to it.
Leaving what is permissible on its own terms sometimes causes embarrassment and distress in some cases, so we need something that restricts it. In our Islamic law, many legal rulings are embodied in which the restriction of what is permissible is in the public interest, or to relieve embarrassment in public.
Because of the importance of this fundamentalist rule, and the difference in some
... Show MoreStudies were conducted from 1980 to 1989 to determine the insect pests infested animal museum collections in Iraq. Twelve species of Coleoptera were recovered, eleven belonged to the Dermestidae, and one to the Tenebrionidae. Of these Anthrenus coloratus Reitt. and Phradonoma nobile (Reitt.) were the most commonest and widely distributed species. Trogoderma bactrianum Zhant. and Orphilus niger (Rossi) were recorded here for the first time in Iraq.
In the current review, an updated list of dark beetle species (Coleoptera, Tenebrionidae) recorded in Iraq was given. The current paper is based on previous studies in the literature and contains all dark beetles referred to in Iraq, except for the species within the Pimelinae subfamily. The investigation of this review showed the presence of 89 species belonging to 34 genera within five subfamilies. This work included mentioning the basionyms and synonyms for genera and species with their global distribution, as well as, correcting the scientific names that were mentioned in the previous checklists.
Constructal theory plays a major role in the conceptual design stage of the structural system in architecture. It provides a conceptual framework for predicting the form depending on natural systems to model those systems geometrically according to the constructal law that works in two directions: the first is towards predicting the general form of the structural system, and the second is the physical application of the law in the process of detailed design of the parts of the system. The aim of this paper is to determine the mechanism adopted in the structural design according to the constructal theory, assuming that the structural design according to the constructal theory achieves
Praise be to God, who has seen uniting the wonders of manufactures, and pronounced Pthamidh oddity Alambdoat, and swam his creation in different languages, Glory is not equal to one in the earth and the heavens, praise Him, and I bear witness that there is no god but Allah alone with no partner certificate towering branches, and I bear witness that Muhammad is His slave and Messenger sent swage Arab government balance, and clearest statement, and the highest residence and Ohllagha words, and Oovaha Zmama, he pointed the way and advised the creation, and the month of Islam, breaking idols, and showed provisions, uncle Balanaam, God separated blessings and peace upon our Prophet Muhammad and the God of the good and virtuous and his compani
... Show MorePraise be to Allah, Lord of the Worlds, and prayers and peace be upon the prophet as a mercy to the worlds and on his family and companions. The phenomenon of suicide is one of the most expanding social phenomena in the world, where many groups of society of different ages try to put an end to their lives, especially young men and girls. The numbers always remain on the rise, and there is no doubt that the one who does this matter, that he has reasons that made him resort to suicide, and despite that, whatever those reasons. However, this is not a justification for the assault on the soul that God has forbidden to infringe on or lead them to perdition, or to what harms them. Modern psychology has tried to explain this phenomenon and try to
... Show MoreWe investigate the interaction of proton with a solid target, describing the wake effects by taking fitted parameters with experimental values of energy loss function ELF for copper using the dielectric function of random phase approximation (RPA). The results exhibited a damped oscillatory behavior in the longitudinal direction behind the projectile. In addition, the wake potential becomes asymmetric around the z-axis with proton velocity values higher than Fermi velocity, as well as it depends on the position of projectile in cylindrical coordinates.
After the use of trust in God, and after the completion of my research called (the legislative miracle in the light of Surat), which studies the miracle in general and then unique legislative miracle, which was the largest share of the research where I built my research on several topics dealt with in the first topic: definition of miracles language and terminology and address Also discussed the Quran and the challenge and miracles and the status of the Arabs in the eloquence and eloquence, and then the literature in the miracle and dealt with legislation based on the foundations of individual education, family building, community building, and the most important advantages of Islamic legislation and presented some examples of legislativ
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