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.
Lorraine Hansberry’s A Raisin in the Sun (1959) appeared at the beginning of renewed political activity on the part of the blacks; it is a pamphlet about the dream of recognition of black people and the confusion of purposes and means to reach such recognition. It embodies ideas that have been uncommon on the Broadway stage in any period. Situations such as a black family moving into an all-white neighborhood were not familiar before this time; they were just beginning to emerge. In depicting this so realistically, Hansberry depends more on her personal experience as an African American embittered by social prejudices and discrimination.
KE Sharquie, SA Al-Mashhadani, AA Noaimi, MY Abbas, Journal of the Saudi Society of Dermatology & Dermatologic Surgery, 2011 - Cited by 5
This piece of research deals with assimilation as one of the phonological processes in the language. It is a trial to give more attention to this important process in English language with deep explanation to its counterpart in Arabic. in addition, this study sheds light on the points of similarities and differences concerning this process in the two languages. Assimilation in English means two sounds are involved, and one becomes more like the other.
The assimilating phoneme picks up one or more of the features of another nearby phoneme. The English phoneme /n/ has t
... Show MoreGraphic design art depends on changeable cognitive systems which their relation and items relying on the accumulation of humane knowledge and thong and the humane look to the venality and his explanation to the relation between him and the venality , then the graphic design art becomes an important item of this accumulation knowledge besides , it is on kind of knowledge kinds . The technological advancement in communication lauds to increasing in communication media and design methods , where the computer and its application in graphic design promotes the design process because of it's capalebities which lead to in creasing in production process , minimizing the cost and time and achieving creative and aesthetic aspect because of it's fe
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The 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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We have studied theoretically the response of atomic three- level cascade scheme
of rubidium vapor to a strong laser under conditions in which electromagnetically
induced transparency would be induced on a weak probe beam. We show that the
medium that is an opaque to a probe laser can, by applying both lasers
simultaneously, be made transparent.
This study included nine patients with inactive carrier states of HBV and 14 healthy control groups. The number and the percentage of T-lymphocyte (CD3+ Cells) in the peripheral blood of these groups showed no significant difference. Similar trend was observed when number and percentages of T helper cells (CD4+ cells) and T cytotoxic lymphocytes (CD8+ cells). Moreover, no significant difference in CD4+ /CD8+ cells ratio (P > 0.05) in peripheral blood of patients with inactive carrier state of HBV as compared with healthy control group. The levels of total serum bilirubin (TSB) concentration and alanine aminotransferase (ALT) activity were similar to control group. The levels of immunoglobulin concentration (IgG and IgM) in patients g
... Show MoreBackground: Osteoid osteoma(OO) is a relatively common benign skeletal neoplasm of unknown etiology that is composed of osteoid and woven bone, usually seen in adolescent and young males Although, the clinical, radiological and scintigraphic features of OO have been well described, these features may be misleading or altered in the cases of lesser trochanter of the femur which is relatively uncommon location for OO with a few number of cases reported up to date.Case Presentation: We report a case of a 20-year-old man who presented with painful limpThe pain had begun six months earlier and was made worse by walking and by exercise., with normal initial X-rays .The diagnosis was made after six months when typical Computed tomography, magne
... Show MoreThat the diplomatic work and its importance in foreign policy planning assumes the following points: 1. Choosing the tool in the sense of choosing the most correct tool that reflects the reality of the situation on the one hand and the disposal of strong energy to reach the implementation of the political decision. The declaration of war and entering into a resolution that uses force merely to face insulting ambassadors does not mean Power of the State concerned. But an imbalance in its foreign policy. 2. The coordination of the tools, that the foreign policy scheme must be such a role, and on the external style, diplomatic work, military action and propaganda must complement each other, to the extent that each of them is the first attac
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Visceral leishmaniasis (VL) is a parasitic infection caused by an intracellular growth of Leishmania spp. in macrophage cells. The autoimmune disorder is a condition takes place when the immune system produces antibodies which incorrectly attacked its own body tissues. VL has been involved as an effect or on the autoimmune aspect. This study was conducted to identify the auto antibodies profile in patients infected with VL. The presences of auto antibodies in 21 Iraqi children infected with VL were tested for laboratory autoimmune aspect. The highest percentage of seropositive in Leishmania patients was observed for anti-ds DNA, anti-Mi-2, anti-Ku and anti-PCNA antibodies (90.5%, 90.5%, 90.5% and 61.9%) respectively, while the lowest percen
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