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.
Flexible pavement design and analysis were carried out in the past with semi-experimental methods, using elastic characteristics of pavement layers. Due to the complex interferences between various layers and their time consumption, the traditional pavement analysis, and design methods were replaced with fast and powerful methods including the Finite Element Method (FEM) and the Discrete Element Method (DEM). FEM requires less computational power and is more appropriate for continuous environments. In this study, flexible pavement consisting of 5 layers (surface, binder, base, subbase, and subgrade) had been analyzed using FEM. The ABAQUS (6.14-2) software had been utilized to investigate the influence of the base layer depth on ver
... Show More
(4)
(2)
Voice studies are one of the sensory studies of their first association with auditory taste, which broadcasts its connection to the most sensory point contained in the physical corners, and in order to satisfy our conscience from these fundamental voices, we searched for in modern contexts, high proportions related to the words of Muhammadiyah, so we are looking for (events In the hadiths of the Prophet (peace be upon him), to settle our journey when the true adhkaar received from the Prophet, peace be upon him, and to control us start a journey through which we repeat between the cities of audio repetitions, sometimes we find ourselves have stood at the entrance of what corresponds to the sounds between the title of the Hadith and its t
... Show MoreThe problem of poverty and deprivation constitute a humanitarian tragedy and its continuation may threaten the political achievements reached by the State. Iraq, in particular, and although he is one of the very rich countries due to availability of huge economic wealth, poverty indicators are still high. In addition, the main factor in the decline in the standard of living due to the weakness of the government's performance in the delivery of public services of water, electricity and sanitation. Thus, the guide for human development has been addressed which express the achievements that the state can be achieved both on a physical level or on the human level, so in order to put appropriate strategies and policies aimed at elimin
... Show More
Collective C2 transitions in 32S are discussed for higher
energy configurations by comparing the calculations of transition
strength B(CJ )with the experimental data. These configurations
are taken into account through a microscopic theory including
excitations from the core orbits and the model space orbits with nħω
excitations.
Excitations up to n=10 are considered. However n=6 seems to
be large enough for a sufficient convergence. The calculations
include the lowest seven 2+0 states of 32S.
Architecture forms theoretical summaries and multi systems that have the essence of change, and that what distinguishes Architecture from other sciences and their systems. Architecture means way of life via its expressional products and that appears through its systems. These systems are based on formative and technological properties in form, structure, services and materials as well as
their moral forms. All these are associated with techniques and facilities in order to establish integrated system.
Architectural creation does not come from void but it depends on a conception base to create a new condition for creative architectural product. The general problem of the research concentrated on limited theoretical and practica
Before the unit environmental problems serious the issues of the environment and conservation of contemporary issues important in the developed and developing worlds, it was natural that leads increasing global awareness to alert a group of intellectuals, scientists and politicians to the seriousness of this problem and the call to take steps deeper and more comprehensive with respect to the environment humanitarian based on the study of the various elements of this environment and a greater understanding of the relationships among them, and on this basis, steps have been taken to target the environment and to identify problems and make efforts to achieve the goals I: stop the deterioration of the environment and the second impro
... Show MoreThe present study attempts to give a detailed discussion and analysis of parenthetical constructions in English and Arabic, the aim being to pinpoint the points of similarity and difference between the two languages in this particular linguistic area.The study claims that various types of constructions in English and Arabic could be considered parenthetical; these include non-restrictive relative clauses, non-restrictive appositives, comment clauses, vocatives, interjections, among others. These are going to be identified, classified, and analyzed according to the Quirk grammar - the approach to grammatical description pioneered by Randolph Quirk and his associates, and published in a series of reference grammars during the 1970
... Show MoreA summary of zooplankton research done in Peruvian marine waters is presented. We first provide a brief overview of the evolution of zooplankton studies off Peru before reviewing zooplankton biodiversity, regional distribution, seasonal and interannual fluctuation, trophodynamics, secondary production, and modeling are some of these topics. We evaluate research on various meroplankton, macroplankton, mesoplankton, and microplankton groups and provide a list of species from both published and unpublished sources. Three regional zooplankton groups have been identified: A shelf group on the continental shelf dominated by Acartia tonsa and Centropages brachiatus; A slope group on the continental shelf with siphonophores, bivalves, foramin
... Show More
In this ˑwork, we present theˑ notion of the ˑgraph for a KU-semigroup as theˑundirected simple graphˑ with the vertices are the elementsˑ of and weˑˑstudy the ˑgraph ofˑ equivalence classesˑofˑ which is determinedˑ by theˑ definition equivalenceˑ relation ofˑ these verticesˑ, andˑ then some related ˑproperties areˑ given. Several examples are presented and some theorems are proved. Byˑ usingˑ the definitionˑ ofˑ isomorphicˑ graph, ˑwe showˑ thatˑ the graphˑ of equivalence ˑclasses ˑand the ˑgraphˑof ˑa KU-semigroup ˑ areˑ theˑ sameˑ, in special cases.