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.
Means the current research study in the direction iconic structures plates Ottoman calligraphers , as they took turn in this area and because it excelled in the form of a strong incentive and motivation to seek calligraphers in this direction so as to simulate the skill of the artist and parallel to the side of his creativity as well.And iconography , RECEIVED of objective vision and aesthetic and semantic in the output of compositions written according to the specific significance and this has a clear impact on the propensity to develop technical and aesthetic and expressive in the output of the structure of synthetic iconography is limited by rules or building in the form of public panel linear . And that all forms , whether animal , h
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There are many events which causes nonproductive time (NPT) in the drilling industry. The mostly effective in this NPT is pipe sticking event. A considerable amount of time and resources can be spent in efforts to free a stuck pipe. In addition, Unsuccessful fishing operations results in costly alternatives including side-tracking. The drilling in Khabaz oil field poses many operational challenges among of them stuck pipe , lost circulation, flow of salt water during drilling, and hole caving. Stuck pipe can be considered the quite difficult problem in Khabaz oil field due to associated incidents which lead to NPT activities.Well Khabaz -34 was selected to study the problem of stuck pipe in this field. An analysis of stuck pipe even
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There are many events which causes nonproductive time (NPT) in the drilling industry. The mostly effective in this NPT is pipe sticking event. A considerable amount of time and resources can be spent in efforts to free a stuck pipe. In addition, Unsuccessful fishing operations results in costly alternatives including side-tracking. The drilling in Khabaz oil field poses many operational challenges among of them stuck pipe , lost circulation, flow of salt water during drilling, and hole caving. Stuck pipe can be considered the quite difficult problem in Khabaz oil field due to associated incidents which lead to NPT activities.
Well Khabaz -34 was selected to study the problem of stuck pipe in this field. An analysis of stuck pipe event
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One of the Iraqi geotechnical problems is the presence of gypseous soils covering about (27-36) percentage of Iraq soils containing gypsum between (10-70) ratios. The main reason for soil problematic is the gypsum dissolution when these soils are inundated. However, the soluble gypsum can be leached out of the soil particles, so these problems can be led to cracking, tilting, and collapsing the related soil structure and changing the soil properties. The aim of this work is to investigate the performance of under-reamed piles as a new, improved method to reduce the moisture sensitive and the primary triggering mechanism for the volume reduction of collapsible soil, which is considered as a non-elastic deformation; this was done by c
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he development of multidrug resistance in Gram-negative bacteria is a major problem faced antimicrobial therapy and management of infectious diseases. Too many resistance mechanisms were developed since the antimicrobial agents were produced and actually used. The mechanisms involved in antimicrobial agents' resistance are, modifying enzymes, alteration of the target site of antimicrobials and prevention of antimicrobials accumulation inside the bacterial cells. The latest is accomplished by two mechanisms: alteration of outer membrane permeability and efflux pumps. Efflux pumps are either chromosomal or plasmid-encoded although chromosomal encoded efflux pumps are common in Gram-negative bacteria. Resistance nodulation division (RND) efflu
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Nanofluids (dispersion of nanoparticles in a base fluid) have been suggested as promising agents in subsurface industries including enhanced oil recovery. Nanoparticles can easily pass through small pore throats in reservoirs formations; however, physicochemical interactions between nanoparticles and between nanoparticles and rocks can cause a significant retention of nanoparticles. This study investigated the transport, attach, and retention of silica nanoparticles in core plugs. The hydrophilic silica nanoparticles were injected into limestone core as nanofluid of different nanoparticles size (5 nm, and 20 nm), concentration (0.005 – 0.1 wt% SiO2), and base fluid salinity (0 – 3 wt% NaCl) at different temperatures (23, and 50 °C). D
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Purpose The purpose of this study was to evaluate the complications associated with the use of reconstruction plates with or without non-vascularized bone graft in reconstruction of mandibular segmental defects caused by trauma and tumor resection and to analyze various factors that are associated with the development of complications. Methods A retrospective observational study was conducted, and the investigated variables included the age and gender of the patients, etiology of the defect, the site of the defect, the size of the defect, whether bone graft was used or not, type of plate used, and whether the reconstruction was immediate or delayed. The outcome variables were the postoperative complications and the success rate. Results Fif
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