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 success of any institution must be based on means to protect its resources and assets from the waste, loss, misuse and the availability of accurate and reliable data by accounting reports to increase its operational efficiency, namely, that the internal control system is considered as a safety valve for top management in any economic unit. The problem is represented by the need for an efficient system, so to ensure its success, there must exist external parties which monitor and evaluate the performance because of its importance by following clear criteria. So, the research problem came to address performance evaluation indicators which are set by the Federal Board of Supreme Audit (FBSA) and identify the extent of its contribution t
... Show More
On of the direct causes which led to the global financial crisis 2008 is decrease or collapse in liquidity of large financial institutions which is reflected on investments of a considerable number of institutions and persons.
This study aim's through out its three sections to explain the disclosure level of financial institutions which affected by Financial Crisis from liquidity information which explained in the statement of cash flow according to Timeliness and Completeness.
The study concluded an important result the company of research sample was disclosure in Timeliness and Completeness from all of accounting information is related in liquidity or that related in result of operations and financial position. The more
... Show More
(1)
The principle of rights and duties is part of the reform project of the Commander of the Faithful Ali ibn Abi Talib, to build a state of institutions whose foundations have been built on Quranic rules, a prophetic biography, and his diligence in doing so in accordance with the requirements of interests and evil, and his certainty in determining the most important and important, and research analytical study of speeches Imam Ali and his career, in this study (the principle of rights and duties) of the ruler and the parish because of their role in the reform process, which depends on the demolition and construction together, as it is the responsibility of the ruler to demolish all constructed corrupt and contrary to the principles of Islam
... Show MoreThe purpose of this study is to investigate the histopathological response of dentinopulpal
response of human teeth to the Er: YAG laser cavity preparation in comparison with the conventional
class I cavity preparation. Thirty five sound human upper and lower first premolar teeth which were
needed to be extracted for orthodontic purposes were used in the study. Regarding to the method of
cavity preparation, the teeth were grouped into three groups; Group1; Control group which consists of
seven sound teeth without cavity preparation, Group2; Conventional cavity preparation group and group
3; Er: YAG laser cavity preparation group. Each of Group2 and3 consists of fourteen teeth that is
subdivided into: A. 7teeth that e
Abstract
The study aims to build a training program based on the Connectivism Theory to develop e-learning competencies for Islamic education teachers in the Governorate of Dhofar, as well as to identify its effectiveness. The study sample consisted of (30) Islamic education teachers to implement the training program, they were randomly selected. The study used the descriptive approach to determine the electronic competencies and build the training program, and the quasi-experimental approach to determine the effectiveness of the program. The study tools were the cognitive achievement test and the observation card, which were applied before and after. The study found that the effectiveness of the training program
... Show MoreAbstract
The research aims to investigate the private sector attitudes toward operational contracting in special education schools. The research adopted the qualitative approach by using personal interviews with a sample of (45) private school owners and managers in Oman. The results of the research revealed that there is an agreement among the majority of respondents on the ability of the private sector to manage special education schools, the advantages of the partnership, as well as the need for guarantees to support this partnership. The government should fully assume it. The role of the private sector remains to raise the operational efficiency of schools. Opinions vary about the level of powers granted to t
... Show MoreA CRITICAL OVERVIEW IN SELECTED POEMS
The research aimed at designing teaching sessions using the self-scheduling strategy with a competitive style in learning handball as well as identifying differences between pre and post tests in both groups in learning short and long passes in handball. The researchers used the experimental method on 2nd-grade secondary school students. The researchers concluded using the self-scheduling strategy due to its positive effect on learning short and long handball passes in handball. Finally, the researchers recommended applying strategies and styles in teaching different school levels as well as making similar studies using teaching strategies and styles for learning handball skills in students.
(1)
Delays and disruption are a common issue in both community and personal building programs The problem exists all throughout the world, but it is particularly prevalent in Iraq, where millions of dollars are squandered each time as a outcome. Delays and interruptions may have serious consequences not just for Iraq's construction plans, but also for the country's economic and social status. While numerous studies have been conducted to investigate the factors driving delays and disruption in Iraqi construction projects, slight consideration has been given to by what means project management implements and approaches have affected the occurrence of project delays and disruption. After analyzing the crucial reasons for delays and instability in
... Show More