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.
One of the management accounting tools is responsible accounting. In this system, the organisation is divided into responsibility centres that help to connect an individual performance responsible to perform through a combined system of reports according to the implementation of the mechanism of exception tools which gives assistance in planning. The exploitation of the organisation's available resources is achieved through the application of responsible accounting. Also, the best exploitation will lead to the provision of low-cost products through the disposal of all types of waste or loss during the cost centres. By providing products at a lower cost and satisfying the wishes of the needs of customers, the result reflects the competitive
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In this study, the behavior of square helical piles models (5×5) mm2 embedded in expansive soil bed overlaying a layer of sandy soil was investigated. The sand layer 200mm thickness was compacted into four sub layers in a steel container with diameter 400mm in size. Sandy soil layer was compacted into two relative densities 40% and 80%. The bed of ثءحties 40% and 80%.The bed of o00mm in size.Sandy soil layer was compacted into two relative densities 40% and 80%.The bed of oexpansive soil 300mm thickness was compacted into six sub layers on sandy soil layer. Model tests are performed with helical pile length 350mm, 400mm and 450mm and with helix diameter 15mm and 20mm. Also, one helix and double helix were
... Show MoreReduction has been linked visually in art since man began making functional and aesthetic forms, and this beginning can be identified with cave paintings. Reduction is one of the clearest indications of intellectual presence in aesthetic experience. Modernism was greatly supported by the great transformations that the intellectual movement witnessed in the world in general and in Europe in particular. There, and their transfer of European artistic experiences, and the reflection of this influence in their aesthetic sculptures, and for this reason the researchers find that the study of the aesthetic references of the reductive forms in the Iraqi sculptural experience represents a great importance in the study of the history of contemporar
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Background: Tumor associated tissue eosinophilia (TATE) has been described in a variety of neoplasms. In regard to squamous cell carcinoma, some studies worldwide done to assess stromal eosinophilia in oral and cervical squamous cell carcinoma. The objectives of this study is to evaluate the association of stromal eosinophilic infiltration of cutaneous squamous cell carcinoma and to detect the significance of this association.
Aim of the study
The aim of our study is to establish the relationship between the degree of stromal eosinophilia and the level of invasion and the histological grade in cutaneous squamous cell carcinoma.
Methods: In this retrospective study
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(1)
The cartographic representation of geographical phenomenon considers the essential base in geographical analysis since as it supports the vertical house which is apartment houses consist of apartments which represent civil phenomenon , the aim of this study is to project the rule of cartographic representation methods in geographical analysis and make comparison in economic and social aspects for two approaches , the vertical and construction building methods.
The expand of city horizontally represent a problem in itself because it leads to loss of civil lands and overpass the agricultural lands as a result ,the ratio of habitation of land usage is so large in comparison with another usages of lands of the cities ; therefore ; many co
Abstract: In this work we demonstrate and investigate the optical pulse propagation in a photonic band gap fiber Bragg grating (FBG). The light propagates in opposite direction in FBG is explained and discussed by a Coupled Mode Theory (CMT). The photonic band gap (stop band gap) is created by fabricated, a Bragg grating in optical fiber. The results show the pulse spectrum falls entirely within the stop band gap, the entire pulse is reflected by the grating, while when the pulse spectrum is outside the stop band gap the pulses will transmitted through the grating. The group velocity (VG) becomes zero at the edges of the stop band and group velocity dispersion β2 is anomalous on the shorter side of stop band gap whereas β2 for uniform fi
... Show MoreThe research has arrived to the following results:
1. There were critical views that accompanied the beginnings of (Muwashah). These
views were derived from literary criticism that handled the ancient Arabic poetry, especially
its kinds that were concerned with artificiality in addition to the views based on rivalry
among makers of (Muwashah) in front of the audience so as to judje who is the best
according to artistic response.
2. There existed new critical views, their originality was shown through the new critical
theories that appeared especially those concerned with receiving the text and reading theory.
3. The Muwashah was one of the most important poetic arts that reproduced previous
text, not in the tra
The development in the presentation and presentation of the service in order to distinguish them from the same, was one of the most important reasons to choose the current issue to upgrade the level of service, especially in the Iraqi restaurant sector, which has become today of the important sectors successful. The problem of research was to try to answer a range of questions: to what extent are Iraqi restaurants interested in physical service factors? Do Iraqi restaurants apply physical factors in a way that leads to customer satisfaction? Are Iraqi restaurants interested in the satisfaction of their customers? The objective of the current research is to try to determine the extent to which the
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(1)
The corrosion of low carbon steel boiler tubes in demi water had been investigated. The purpose of this investigation was to determine the change produced in corrosion behavior of the carbon steel as a result of the specific presence of chloride and copper ions in the water under different temperatures. For low carbon steel experiments, the temperature was taken in three levels (125, 175, and 215°C) under about 27 bar pressure and 1500 rpm in autoclave. Using weight loss technique, the corrosion rate ranges from (85 to 789 gmd) for low carbon steel boiler tubes.