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.
Search came (the employment of Arabic calligraphy in gold jewelry styles) four chapters, the first chapter of which dealt:A/research problem B/importance of research C/targets search D/ Define termsAs the aim of the research (to identify the employment of different forms of Arabic calligraphy on gold jewelry styles).It came in the second quarter (the theoretical framework and previous studies), some of the topics reviewed in which diversities researcher aesthetic and functional, and various uses that filled Arabic calligraphy.The third chapter outlining the researcher methodology and the research community, has a special form for the analysis of the samples are designed as form is offered on a number of experts in the field of jurisdicti
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This study aims to examine how the lives of blacks are reduced and eliminated in Brother (2017) by David Chariandy. Black Lives Matter is a hash tag that appears after the killing of Trayvon Martin (17 years old African American) in 2012 by the savage hands of George Zimmerman (white person). This hash-tag has become a social movement that calls for equality in order to stop the violence against black people because their live is as valuable as white’s. The movement comes into being to highlight the “hypocritical democracy in service to the white males whose freedom are openly depended upon the oppression of blacks” (Lebron, 2017, P. 1). Those who have started this movement try to redeem a state and its arbitrary actions again
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Abstract
What the research come to:
1- The presentation of the image of the proud person in this
mortal life appeared in several styles such as (conversation)
arousing the insert once and convincing in other time,
(confirmation) in all its types، (argument) scolding with the
gradual progress of time of the discourse .Interview and
parallelism are two of these styles with the presences of the
repetition style especially in the topics that has a reference to
the theme of (pride) being implied not directly stated. The
Koran discourse varied in its reference to the theme of pride
according to the context which is mentioned directly
(eighteen times) which formed one third of the number of
The aim of the study was comparative between oxidative stress in diabetes mellitus using the measurement of some biophysical and biochemical parameters on two groups of diabetic patients, were conducted in the Al-Yarmuk Teaching Hospital,30 patients insulin dependent diabetes mellitus (IDDM) or type 1 ,their ages ranged between (15-45) and30 patients non- insulin dependent diabetes mellitus (NIDDM) or type 2,their ages ranged between (42-65).This study has been compared with 30 healthy subjects. The present study was demonstrated to evaluate the alteration in oxidative stress as measured by plasma and red blood cells Malondialdehyde (MDA) andchanges in antioxidant mechanism as measured by plasma and red blood cells Glutathione (GSH)
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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 the bu
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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 d
R. Vasuki [1] proved fixed point theorems for expansive mappings in Menger spaces. R. Gujetiya and et al [2] presented an extension of the main result of Vasuki, for four expansive mappings in Menger space. In this article, an important lemma is given to prove that the iteration sequence is Cauchy under suitable condition in Menger probabilistic G-metric space (shortly, MPGM-space). And then, used to obtain three common fixed point theorems for expansive type mappings.
<p>In this paper, we prove there exists a coupled fixed point for a set- valued contraction mapping defined on X× X , where X is incomplete ordered G-metric. Also, we prove the existence of a unique fixed point for single valued mapping with respect to implicit condition defined on a complete G- metric.</p>