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.
In this paper, a Modified Weighted Low Energy Adaptive Clustering Hierarchy (MW-LEACH) protocol is implemented to improve the Quality of Service (QoS) in Wireless Sensor Network (WSN) with mobile sink node. The Quality of Service is measured in terms of Throughput Ratio (TR), Packet Loss Ratio (PLR) and Energy Consumption (EC). The protocol is implemented based on Python simulation. Simulation Results showed that the proposed protocol provides better Quality of Service in comparison with Weighted Low Energy Cluster Hierarchy (W-LEACH) protocol by 63%.
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Flexible paving is the most popular type of paving used in road building and one of the biggest problems facing the world's paving business is the rising demand for scarce natural resources. Uncontrolled. Numerous studies have shown that secondary materials reduce the need for traditional materials, offer efficient waste disposal technology and lower the overall cost of paving. The current study aimed to evaluate the efficiency of both fibers and dust on the sustainability and cost of flexible pavement by studying each of polyester fibers as a waste of the textile industry and fibers or rubber particles as one of the rubber waste products, in addition to studying the efficiency of using cement dust and marble dust on the paving proc
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This study deals with strategic maneuvering in advertisement from a pragmatic point of view found in some commercial advertisements in order to investigate and analyze the pragmatic devices that are used in the strategic maneuvering and stages. The study attempts to shed light on the most fuzzy areas in advertisements that is probably how the language of advertisements employed by advertisers to affect consumers positively. The primary goal of strategic maneuvering is to discover how the pragmatic devices have persuasive techniques that are used to gain a competitive advantage and more sales. This study is a contribution to the field of research in the language used in advertising. In this research, the effectiveness of strategic man
... Show MoreThe research aims at identifying the level of imaginative thinking skills in mathematics among fourth scientific grade students.For this purpose, the researcher adopted the descriptive (survey) approach, as an imaginative thinking test was built and applied to the research sample that consists of (301) students from fourth scientific grade students who are distributed to secondary and Preparatory schools,they are Al-Furat Preparatory, Al-Hindiya Preparatory school and Al-Rajiba Preparatory school , who are affiliated to the Al-Hindiya Education Department of the General Directorate in the Holy Karbala Governorate for the academic year (2021-2022). The imaginative thinking test consisted of (36) items of four alternatives multiple-choice obj
... Show MoreThe aim of the research is to identify the role of university education management in achieving sustainable environmental development.
In this paper, the using of Non-Homogenous Poisson Processes, with one of the scientific and practical means in the Operations Research had been carried out, which is the Queuing Theory, as those operations are affected by time in their conduct by one function which has a cyclic behavior, called the (Sinusoidal Function). (Mt / M / S) The model was chosen, and it is Single Queue Length with multiple service Channels, and using the estimating scales (QLs, HOL, HOLr) was carried out in considering the delay occurring to the customer before his entrance to the service, with the comparison of the best of them in the cases of the overload.
Through the experiments
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This study examined the effect of elements of internal marketing activities on customer satisfaction through an exploratory study of banking services in the city of Baghdad, if the research problem crystallized by asking a group of questions, the most important (is there a correlation and impact between the dimensions of internal marketing and customer satisfaction, this study aims to determine The effect of internal communication, training and internal market research on customer satisfaction, represented by the quality of service, loyalty and market share, and embodied the objective of this study to identify the level of availability of internal marketing activities and programs in the research banks, data were collected using
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The reality of the field of construction projects in Iraq refers to needing for the development of performance in order to improve quality and reduce defects and errors and to control the time and cost, so there is needing for the application of effective methods in this area, one of the methods that can be applied in this area is the manner of Six Sigma. This research aims to enhance the performance and quality improvement for the construction projects by improving performance in the work of the implementation of the concrete structure depending on the Six Sigma methodology, and for the purpose of achieving the aim of the research, the researcher firstly depends on the theoretical study that include the concepts of qual
... Show MoreThe Current research aims to identify ( the effect of Carin model in the achievement of the first intermediate Grade Students and their Reflective Thinking in physics Subject ) the researcher selected the experimental design with a partial adjust , The research sample consisted of ( 47 ) Students with ( 23 ) Students in the experimental group and ( 24 ) Students in the control group , The two groups rewarded in the variables chronological age in months , Reflective Thinking and the degrees in physics in the first course. The researcher coined the purposes of behavioral which belong to chapter fifth, sixth, and seventh of physics books scheduled of the school year ( 2015-2016 ) and prepared appropriate lesson plans for the two experimenta
... Show MoreThe present research deals with the spatial variance analysis in Jwartadistrict and conducting a comparison on the spatial and seasonal changes of the vegetation cover between (2007-2013) in order to deduce the relationship between the vegetation density and the areas which are exposed to the risk of water erosion by using Plant Variation Index NDVI) C (coefficient and by using Satellite images of Landsat satellite which are taken in 2/7/2007 and Satellite images of Landsat satellite taken in 11/1/ 2013, the programs of remote sensitivity and the Geographic Information Systems.
The study reveals that there is a variance in the density of vegetation cover of the area under study betwee 2007 and 2013. Howev
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