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 researcher highlighted the general budget in Iraq for the period (2003-2018) facing the challenges of administrative and financial corruption, in addition to the fluctuations in oil prices, the repercussions and many problems suffered and will suffer the Iraqi government in the process of preparing the general budget of the state and weak contribution of the agricultural and industrial sectors and other economic sectors and neglect altogether, oil has become the main supplier in funding Iraq's budget after 2003, and the impact on the unemployment rates in Iraq, which recorded fluctuating rates and then increased during the period (2012-2018) to achieve this, an inductive method was adopted, using theoretical and descriptive a
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هدف البحث الى بيان طبيعة ارتباط والتأثير بين الضغوط التنافسية (المتغير المستقل) والتجديد الاستراتيجي (المتغير التابع) ، تم تطبيق البحث في فنادق الدرجة الممتازة في بغداد. وبلغت عدد افراد عينة البحث (99) مديراً يعملون في (6) فنادق من الدرجة (الممتازة) ببغداد، وهي (فندق الرشيد، فندق عشتار، فندق ميريديان، فندق المنصور، فندق بابل، وفندق بغداد) وتم اجراء التحليل الاحصائي باستخدام البرنامج الاحصائي AMOS وظهرت وجود تنافسي
... Show MoreIt is often needed in demographic research to modern statistical tools are flexible and convenient to keep up with the type of data available in Iraq in terms of the passage of the country far from periods of war and economic sanctions and instability of the security for a period of time . So, This research aims to propose the use of style nonparametric splines as a substitute for some of the compounds of analysis within the model Lee-Carter your appreciation rate for fertility detailed variable response in Iraq than the period (1977 - 2011) , and then predict for the period (2012-2031). This goal was achieved using a style nonparametric decomposition of singular value vehicles using the main deltoid , and then estimate the effect of time-s
... Show MoreThe effect of chronic exposure to two different levels of cadmium chloride (CdCl2) 30 ppb and 40 ppb in drinking water for 12 weeks on thyroid function of mature male rabbits was studied. Eighteen mature male rabbits were randomly divided into three groups (each of six ) , control group (group I ): were offered ordinary tap water , and treated groups (II and III ) were offered tap water containing 30ppb and 40 ppb respectively for 12 weeks .Serum concentration of thyroxin (T4 ) and triiodothyronine (T3) were measured every six weeks ,as an index of thyroid function , further more , section of thyroid gland were prepared for histological studies. The results showed that chronic exposure of male rabbits
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This study is concerned with organizational learning and its impact on total quality management in the education sector. Organizational learning is a process that provides the educational sector with the ability to adapt and respond rapidly to developments and changes in a better way according to its main dimensions (Mental Models, Personal Mastery, Team Learning, Shared Vision, System Thinking) by adopting the philosophy of Total Quality Management (TQM) in accordance with its basic dimensions (leadership, customer satisfaction, participation of workers, continuous improvement, training and education). The main purpose of this study is to know (the impact of the Senge model of organizational learni
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Organizational learning is one of the most important means of human resource development in organizations, but most of the organizations, especially public ones do not realize the importance of organizational learning enough, and estimated his role accurately in building intellectual capital, the resource competitive importantly for organizations of the third millennium and who suffers is other end of lack of understanding of its meaning and how to prove its presence and measured in public organizations, so there is the need for this research, which aims to investigate the effect of organizational learning its processes (knowledge acquisition, Information transfer, Interpreting the information, Organizational me
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The Quality function deployment (QFD) tool is an important tool of total quality management because its a link between two important parts customer and production process of the product, using advanced House of quality, which contributed to provide more details about improving the product before it had a vision for the future of the product be improved. Also the identification of the two competitors (Alwazeer , Altouri) bases on the survey of retailers which they identified five competitors products (Alwazeer , Altouri , Ferry , Jif , Dina)for the product (Zahi). Then House of quality to product (Zahi) has been developed By using a Kano Model to classify of customer's requirements for the
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Abstract
quality issue is the only issue the interesting in recent years of the last century, but also came out of sync with the other issue is the issue of environment, Where they have become represent two sides of one currency, challenges faced by the world and raised by the environmental problems have made industrial organizations pay great attention to the environment by improving their environmental performance, and that's where the oil industry is one of the most dangerous industries, influential and damaging to the environment due to the organizations move away from oil for adoption The application of EMS then a tool to improve environmental performance has been chosen sam
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