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.
Praise be to God, Lord of the worlds, and prayers and peace be upon our Prophet Muhammad and his family and companions. And after:
For one of the greatest blessings of God Almighty upon us is the blessing of Islam, which brought people from darkness to light and from injustice and fear to security, justice, stability, and the preservation of blood, symptoms, rights, and sacrifices, because pride, strength, and dignity are what God chose and pleases His servants - namely - adherence to the Islamic religion, and in light of This must be said that the private legal defense (pushing the person) with its Islamic provisions and legislations is one of the great aspects that guarantees the establishment of a safe
The research article deals with the process of building or rebuilding the state in Iraq after 2003 in its various dimensions, in light of the vision and foundational procedures that were developed and supervised by the United States in cooperation with the new leaders of Iraq based on the mechanism of sectarianethnic representation, and diagnosing the imbalances that arose out of that vision and the accompanying procedures, which led to the emergence of new variables in the political process, especially in the post-ISIS* phase, which produced important challenges to the political system and the Iraqi state. The political dynamics and balances emerging after ISIS* represented at the same time opportunities and risks in the process of
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The main process, for the elimination of cholesterol from the human body, involves the alteration of cholesterol into bile acid (BA), by the liver. The farnesoid X receptor (FXR), a member of the nuclear receptor superfamily, is essential for the regulation of BA, glucose, and lipid metabolism. It is largely found in the liver, intestines, kidney, and adrenal glands, and to a smaller degree in the heart and adipose tissue. The binding locations, of the FXR, are in close proximity to formerly undisclosed target genes, with distinctive activities associated with transcriptional regulators, autophagy, apoptosis, hypoxia, inflammation, RNA processing, and a number of cellular signaling pathways. The preservation of BA homeostasis, by the FXR, e
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Experiments were carried out to investigate natural convection heat transfer in an inclined uniformly heated circular cylinder . The effects of surface heat flux and angle of inclination on the temperature and local Nusselt number variations along the cylinder surface are discussed . The investigation covers heat flux range from 92 W/m² to 487 W/m², and angles of inclination 0° ( horizontal) , 30° , 60° and 90° (vertical) . Results show an increase in the natural convection as heat flux increases and as angle of inclination moves from vertical to horizontal position. An empirical equation of average Nusselt number as a function of Rayliegh number was deduced for each angle of inclination .
1.Chapter I (systematic framework) which includes: the research problem and the importance of the research, the need for it, the goals of the research, the temporal &spatial boundaries, determine the terms and defined procedurally.2.Chapter II - the theoretical framework: It consists of three sections are:•The first topic:- the concept of references and experimentation in the theater. •The second topic:- the director of academic and experimentation in Iraq. Two paragraphs in this section came after the introduction, in first paragraph to talk about the Iraqi theater academic and experimentation, and in the second paragraph the researcher spoke about the academic director of the Iraqi and experimentation. 3.Chapter III - Actions -
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The first chapter included the frame approach on research in which we discuss instigation in Iraqi drama as it as an active sign to enrich the structure of the speech so the researcher limits the problem of his research which is to follow the important of instigation in the Iraqi theatrical discourse. this chapter also contains the important of the research and its aim and limits. And reflected the importance of research in approaching the concept of instigation and effectiveness within the paths of the Iraqi, theatrical discourse.The 2nd chapter included the two sections and reviewed in the first section manifestations of incitement in the global theatrical discourse. the 2rd studied instigation in the Arab theatrical discourse. The 3rd
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Profiles of indignation and indiscretion in pre-Islamic poetry
The research aims to measure the impact of knowledge management processes individually and in total in the innovative marketing.
We depart search of a problem expressed in a number of intellectual and practical questions, the application of this research in the General Company for Vegetable Oil Industry, represented composed a sample of (63) (Director General and Deputy Director General and Director of the Department and the Division) in the company researched, it has been designed measuring instrument to collect the necessary data either statistical means they are the percentage and the arithmetic mean and standard deviation and coefficient of variation and the coefficient of simple correlation and model
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Abstract :
The present study aims at identifying the status of the two research variables in the organization under study and specifying the relationship and impact of the authentic leadership with all its four branch dimensions of (self-awareness, transparent relations, balanced processing of information and the moral perspective) on business process reengineering.
The basic problem of the study lies in the attempt to present a new leadership style that is more responsive to the dynamic changes surrounding it based on the authentic leadership behaviors. This is because this pattern has an impact on the nature of the organization's work and its progress.
The research
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Hardly a society is devoid of manifestations of imitating the opposite sex with the disparity between societies in quantity and quality, as imitating the opposite sex is an old phenomenon, and whoever follows what the old researchers wrote on this subject, finds various sayings, some of which lack evidence, being a kind of guesswork, A generalization that is not based on what is evidenced by it, and others consider resemblance to a behavior in which an animal resembles a human being. I will highlight in this research the resemblance to the opposite sex in the cultures of peoples, making the study into three sections. The manifestations of resembling men and women spread in Greek society greatly, and then the second study was devoted to the
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