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.
Background: Insulin resistance is present in 50% or more of patients with primary hypothyroidism. Metformin can decrease TSH levels in these patients by a complex matter, this can be of great help in clinical practice.
Objective: This study was designed to evaluate the effect of metformin in reducing TSH levels in patients with primary hypothyroidism.
Methods: Hundred patients with primary hypothyroidism, 82 females, 18 males were included in this study, everyone was followed up for two months after adding metformin 850 mg twice daily in addition to thyroxin.
Results: 36 patients (36%) have a normal baseline TSH and no change after 2 months, 64 pa
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Theatrical art, from (Plato) to (Heidegger), passing through (Husserl) and (Husserl) has propagated the parallel relations between the overlapping formal patterns in the world of hypotheses crowded with diaspora and scattering, leading to the manifestations of implicit meaning in the intellectual and aesthetic discourse, through the deconstructive pattern that restructures The aesthetic image according to the aesthetic data to be employed, so the effectiveness of the deconstructive system had an important role in authorizing the Ghanaian logic and continuity on which the Western meta meaning was based, and the artistic scene was subjected to it in line with literature and art to be able to pay attention to the achievement and clarify it
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With the increasing rate of unauthorized access and attacks, security of confidential data is of utmost importance. While Cryptography only encrypts the data, but as the communication takes place in presence of third parties, so the encrypted text can be decrypted and can easily be destroyed. Steganography, on the other hand, hides the confidential data in some cover source such that the existence of the data is also hidden which do not arouse suspicion regarding the communication taking place between two parties. This paper presents to provide the transfer of secret data embedded into master file (cover-image) to obtain new image (stego-image), which is practically indistinguishable from the original image, so that other than the indeed us
... Show MoreMetaheuristics under the swarm intelligence (SI) class have proven to be efficient and have become popular methods for solving different optimization problems. Based on the usage of memory, metaheuristics can be classified into algorithms with memory and without memory (memory-less). The absence of memory in some metaheuristics will lead to the loss of the information gained in previous iterations. The metaheuristics tend to divert from promising areas of solutions search spaces which will lead to non-optimal solutions. This paper aims to review memory usage and its effect on the performance of the main SI-based metaheuristics. Investigation has been performed on SI metaheuristics, memory usage and memory-less metaheuristics, memory char
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The communication inspiration formed an essential foundations for contribute the influence individuals and recipients, whether negatively or positively, through the messages that were published and presented in them with multiple themes and viewpoints that covered all parts of the world and all age groups; it is directed to children addressing the various stages of childhood, as it simulates many goals, including what is directed through the digital use of educational data in television production, as it is considered an intellectual and mental bag to deliver ideas and expressive and aesthetic connotations to children, where the songs and cartoons carrying data on education; within adjacent relations and in a mutual direction, both of th
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Some have considered the dialectic in form and meaning from different points of view, and dismantled them from each other, and this view is correct if we adopt according to the logic of Aristotle when it comes to dialectic, the dialectic of form and meaning has different aspects and does not share a single line in terms of conceptual meaning, the form is the appearance What the recipient sees with the help of cognitive tools, the content or content is the mental meaning, which in turn depends on his own tools, and to this extent this view is correct, and the intellectual content or meaning of the artwork or the human message that the artist wants to convey to the viewer.
The research included four chapters. The first chapter included
The idea of this research is the basis of the role exercised by the dimensions of performance management (Performance Planning- performance evaluation- improve the performance and development- feedback - Review and Performance Monitor) In order to achieve the success Organizational Is through the (strategic vision- the operational activity- development of the company- selection of personnel- the company's culture- Leadership and Management- Personal Development - Assessment and Review).And The research aims to identify the extent of the responsibility of performance management in achieving success Organizational through main hypotheses branched out by the sub-hypotheses to knowing out the&nbs
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Specialized hardware implementations of Artificial Neural Networks (ANNs) can offer faster execution than general-purpose microprocessors by taking advantage of reusable modules, parallel processes and specialized computational components. Modern high-density Field Programmable Gate Arrays (FPGAs) offer the required flexibility and fast design-to-implementation time with the possibility of exploiting highly parallel computations like those required by ANNs in hardware. The bounded width of the data in FPGA ANNs will add an additional error to the result of the output. This paper derives the equations of the additional error value that generate from bounded width of the data and proposed a method to reduce the effect of the error to give
... Show MoreThis research aims to investigate the extent to which the Iraqi audience relies on interactive television programs as a source of information regarding national issues and their resulting impacts. It seeks to identify the types and nature of attitudes developed among the public towards national issues through these programs and determine the prominent topics and issues highlighted to the audience. The researcher employed a field survey as the primary research method, employing a questionnaire for data collection along with scientific observation and the Likert three-point scale to measure attitudes. The study was guided by the media dependency theory. A sample of 520 questionnaires was distributed to residents in
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