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.
Degradation is one of the key processes governing the impact of pharmaceuticals in the aquatic environment. Most studies on the degradation of pharmaceuticals have focused on soil and sludge, with fewer exploring persistence in aquatic sediments. We investigated the dissipation of 6 pharmaceuticals from different therapeutic classes in a range of sediment types. Dissipation of each pharmaceutical was found to follow first‐order exponential decay. Half‐lives in the sediments ranged from 9.5 (atenolol) to 78.8 (amitriptyline) d. Under sterile conditions, the persistence of pharmaceuticals was considerably longer. Stepwise multiple linear regression analysis was performed to
Polycystic ovary syndrome (PCOS) is a significant cause of infertility due to ovulation dysfunction in women of childbearing age. Although the pathogenesis of PCOS is still not clear, many studies have shown that many factors within the ovary promote infection. With this syndrome, the disruption of the natural monthly ovulation process causes an imbalance in the body's hormones, and the high level of insulin in the body and the blood sugar imbalance leads to the occurrence of hyperandrogenism, which is the main factor for the occurrence of pathogens, in addition to genetic factors, if any. This study aims to identify this disease and its most important causes, symptoms, and modern treatments to prevent and get rid of it. Polycystic
... Show MoreThe paper proposes a methodology for predicting packet flow at the data plane in smart SDN based on the intelligent controller of spike neural networks(SNN). This methodology is applied to predict the subsequent step of the packet flow, consequently reducing the overcrowding that might happen. The centralized controller acts as a reactive controller for managing the clustering head process in the Software Defined Network data layer in the proposed model. The simulation results show the capability of Spike Neural Network controller in SDN control layer to improve the (QoS) in the whole network in terms of minimizing the packet loss ratio and increased the buffer utilization ratio.
Selexipag is an orally selective long-acting prostacyclin receptor agonist, which indicated for the treatment of pulmonary arterial hypertension. It is practically insoluble in water ( class II, according to BCS). This work aims to prepare and optimized Selexipag nanosuspensions to achieve an enhancement in the in vitro dissolution rate. The solvent antisolvent precipitation method was used for the production of nanosuspension, and the effect of formulation parameters (stabilizer type, drug: stabilizer ratio, and use of co-stabilizer) and process parameter (stirring speed) on the particle size and polydispersity index were studied. SLPNS prepared with Soluplus® as amain stabilizer (F15) showed the smallest particle size 47nm wi
... Show MoreThis paper aims to shed light on adaptive reuse in traditional architecture (TA) in Erbil, Iraq.
An inductive approach and qualitative method were used in this study. The inductive research approach was used because there was no clear image of adaptive reuse in traditional cafés (TCs) in Erbil. Besides, there are no studies of TCs in Erbil particularly. Thus, there is a lack of knowledge about what adaptations took place in TCs in Erbil. The qualitative method extracted themes and issues from case studies of four TCs in Erbil citadel'
The Islamic religion is a religion of tolerance and is pleased with worship and other legislation and the idea of peace is an authentic and profound idea related to the call for coexistence with all religions. The Prophet (PBUH) was keen to organize his relations with non-Muslims on the basis of cohabitation, On the basis of love and intolerance, God Almighty says: "If your Lord wants to make people one nation and they are still backward." Surah Hud: 118 Islam has taken care of the people and made them tolerant brothers who sympathize with their different beliefs. Which means that everyone has the right to live, believe and believe what he sees right and have the freedom to perform the acts of worship and beliefs he deems correct. The di
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