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 world seen rapid developments in the field of information technology within all life fields, particularly the educational field. Usually, we find the traditional educational methods lack a sense of realism and interaction. Solving this problem is by utilizing virtual reality technology to make actual practice present in the classroom. As an interactive technology, it provides students with an accessible, reliable environment that was previously unavailable and offered an opportunity for learning by practicing instead of teacher-centered learning and within a vision that does not look at the past but looks to the future. Virtual reality technology will change the nature of the relationship between the teacher and the student. Thus, the c
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Harold Pinter often portrays the dilemma of obliterated figures that are incapable of feeling of their own existences. These figures feel exhausted and frustrated in a world that deprives them their humanity. They retreat into a limited world where they look for security and protection. The characters' feeling of security is threatened by outside forces represented by intruding persons who stand for the mysterious powers that are indefinable. The conflict between these intruders and the characters finally ends with the characters’ defeat. The reason for the intruders' attack on the victims remains ambiguous and is not explained. The element of mystery pervades Pinter's plays and represents one of
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To study and understand the mechanism of living systems, and how it works, it is quite important to investigate it at molecular level (like genomic, proteomic) as well as the methodologies, and how to apply and imply it on different branch of sciences and how can use it in developing medical diagnosis, treatments, drugs, and increased it in the future. Additionally it can also be applied in forensic techniques, food production and agriculture, as well as genetic profiling. This can be well understand by interfering and combinations of all branches of life sciences such as chemistry, physics, biotechnology, genetic evolution, and minimize the gap between them, this
... Show MoreLearning a foreign language is a highly interactive process, and a belief that communicative activities foster a great amount of linguistic production provides language practice and opportunities for negotiation of meaning during communicative exchanges. Thus, this study examines what benefits learner-centered classroom setting offers compared with that of teacher–centered classroom, and how less proficient learners accomplish their tasks and activities with scaffolded help during interaction with the help of proficient classmates and under the guidance of a skilful person, i.e., the teacher. The subjects participating in this study are 30 Iraqi 4th year college students in the Department of English, College of Arts , Univer
... Show MoreIn this work the parameters of plasma (electron temperature Te,
electron density ne, electron velocity and ion velocity) have been
studied by using the spectrometer that collect the spectrum of
plasma. Two cathodes were used (Si:Si) P-type and deposited on
glass. In this research argon gas has been used at various values of
pressures (0.5, 0.4, 0.3, and 0.2 torr) with constant deposition time
4 hrs. The results of electron temperature were (31596.19, 31099.77,
26020.14 and 25372.64) kelvin, and electron density (7.60*1016,
8.16*1016, 6.82*1016 and 7.11*1016) m-3. Optical properties of Si
were determined through the optical transmission method using
ultraviolet visible spectrophotometer with in the range
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A Forensic Accounting is represent science that deals with the application of knowledge in the areas of accounting, finance, tax and audit for the analysis, investigation, inquiry, inspection and testing issues in the civil law and criminal law in an attempt to reach the truth through which enable the Forensic Accountant to provide his Expert opinion , forensic accounting plays a major role by providing a range of important services in the field of investigation for fraud and litigation support, As one of the most important legal and accounting functions is to investigate allegations of alleged by the related parties, especially those allegations related to the existence of fraud, since the goal of judicial accountant will depend
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The present study aims at analyzing the polysemy of the English preposition in from the cognitive linguistic (CL) point of view using Evans' and Tyler's approach (2003). The perplexity faced by Iraqi second language learners (L2) due to the multi-usages of this preposition has motivated the researcher to conduct this study. Seventy-six second year university students participated in this experimental study. The data of the pre-test and post-test were analyzed by SPSS statistical editor. The results have shown the following: First, a progress of more than (0.05≤) has been detected as far as students' understanding of the multiple usages of the preposition in is concerned. Second, the results of the questionnaire have s
... Show More• Commercial papers are one of the most important tools of the contemporary monetary market, and many of those who deal with them are ignorant of the Shariah rulings related to them, hence the urgent need to know the most prominent Sharia rulings related to commercial papers, including the discount. It is an agreement between the bank and its customer requesting the discount (the holder of the commercial paper) under which the bank is required By accelerating the value of the paper to the customer, in exchange for the latter’s obligation to transfer the ownership of the fixed right in the paper to the bank by endorsing it to him as a transfer of ownership.
• The noble Islamic Sharia does not prohibit dealing in commercial papers
Words in a language do not exist in isolation but in close connection with each other ,teaming up in one way or another known to the Russian semasiology M. M. Pokrovsky , one of the first to realize the systematic nature of the lexicon, wrote about the second half of the nineteenth century : „the Words and their meanings do not live separate from each other life, but are joined together in our minds), regardless of our consciousness to different groups , and the basis for grouping is the similarity or direct contrast in the main value.