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 Islamic Issue did not rise the “widespread arguments” in contemporary times, just as the issue of applying Islamic Law. Just as the Islamic forces used this purpose, or employed it during their march to reach to power by adopting the sacred as motivation towered the power, or control the governance. However, the reality show that this goal remained within the boundaries of slogans in the sense of a teleological slogan, and did not go beyond the limits of advocacy or arrangement as the primary source of legislation with differences of teleological reasoning, in a manner that reflected an intellectual problem about the validity of the use of this concept or the ability to apply and enforce the law in today's world, to impose
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Technology is an important factor for achieving architecture as an impact and vulnerability. It represents one of the significant elements in creating the intellectual framework, as well as having its own intellectual breakdown, while values constitute the most important and obviously factor of the community's intellectual. Research aims was determined accordingly by: investigating the role and impact of values and their relationship to technology in architecture.
In this context, the research investigated values and technology in architecture, through discussing their aspects and dimensions in architecture. In the context of values, the research discussed their concept and the related ones to have a concrete def
... Show MoreEfficient cuttings transport and hole cleaning are very important factors for obtaining an effective drilling operation. In an inclined and horizontal drilling, hole cleaning issue is a common and complex problem.
The scope of this research is to study the drilling parameters which affect hole cleaning in Iraqi directional wells through studying and analyzing some drilled wells ( vertical , directional (30 degree) , directional (60 degree) and horizontal ).An excel sheet is prepared to calculate carrying capacity index which represents an indicator for good hole cleaning in different sections. The study indicated through the field investigations, practical experiences and theoretical calculations tha
... Show MoreBackground: Pyogenic discitis most frequently occurs
after home delivery, hemorridectomy, and dilatation and
curettage. Discitis is generally due to blood borne bacterial
invasion of the disc from adjacent end-plate via
communicating vessels. Infective discitis remains an
uncommon, but potentially serious cause for back pain.
Delayed diagnosis can occur and a high index of suspicion
may occur.
Methods: The study included 30 patients suffering from
localized low back pain with limitation of movement.
Diagnosis was made by history, physical examination and
investigation mainly E.S.R and MRI.
Results: 50.3% of patient with discitis had a history of
vaginal delivery, 15% had a history of hemorridectomy
The theory of probabilistic programming may be conceived in several different ways. As a method of programming it analyses the implications of probabilistic variations in the parameter space of linear or nonlinear programming model. The generating mechanism of such probabilistic variations in the economic models may be due to incomplete information about changes in demand, production and technology, specification errors about the econometric relations presumed for different economic agents, uncertainty of various sorts and the consequences of imperfect aggregation or disaggregating of economic variables. In this Research we discuss the probabilistic programming problem when the coefficient bi is random variable
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The artistic signature of calligraphers has been regarded as a significant aspect of Arabic calligraphy since its inception. As the art form evolved and acquired an aesthetic dimension, the artistic signature became an integral part of this dimension. The calligrapher failed to include his name on the frames, a practice that has become customary among calligraphers nowadays. This tradition allowed to trace the evolution of Arabic calligraphy and identify certain gaps in the calligraphy composition. Additionally, the inclusion of calligrapher's name contributes to the achievement of visual balance within the calligraphy composition, signifying consistency or formal separation. The current study concentrated to investigate the aesthet
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Emily Bronte is born in Yorkshire on 30 July 1818. Her father, Rev. Patrick Bronte, is a man of intelligence and determination which enables him to gain an admission as a sizar to 81. John's Cambridge in 1802. He has six children where Emily is the fifth. The mother is a young beautiful girl who belong to an important family. Both Emily's parents try to teach
Their children well, support them all the time and elevate them to
"-.../
high levels. This causes an eagerness towards reading and writing, but the happiness of the children is affected by the sickness and later on by the death of their mother in 1821. After that things would
... Show MoreThe current research is concerned with the study of (aesthetic discourse in the significance of commercial advertisement designs), according to a knowledge structure defined by function and creativity, and the main goal is to interpret the reality of forms, their various sources, their essence, meanings, formal relationships, and design ideas in order to achieve the visual goal as a typographic achievement. It arises through the designer’s internal mental intuition to produce shapes based on subjective feelings that refer his preconceptions about those shapes with his feelings to creative formations. Aesthetic discourse is produced from the mind depending on the various symbolic, psychological and social functions, production methods,
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There is no doubt that the project control function is very important for administration, so the project Management depends on to monitor and control the project. The project control integrated to the planning which is the base of the administration functions; planning, organizing, directing, and controlling. Without project control cannot be insure to fulfill the plan of the project by the budget and specified time. The project management apply many methods of control to achieve the goals of project which are cost, time, and required specifications. Earned Value Management one of control methods that used in the project by international companies.
Earned Value Method is used in the project o
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System is one of the concepts that fused stages of human thought his contemplations , and the evolution of his ideas and know the universe and existence , was formed several systems and numerous multi- humanitarian field , for example : the political system , the economic system , the system of philosophical , scientific system ... etc. .The current research around trying to find the identity of the system aesthetic in general and theater in particular , the detection of compositions and how Cklath within shifts functional and conceptual , which confirms the importance of Altgria creative as characterized by the following heading towards experimentation and update ongoing , and in particular what we find in the discourse of postmodernism
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