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.
Success in selecting the best among the sources of supply is one of the most important factors in the efficiency of the procurement activity in the company, because the proper selection of the source of the supply significantly affect the achievement of what is desired by the factors of quality, quantity, price and service, and the ability of the competent supplier to meet everything associated with this Factors of commitments, hereby supporting the procurement function's efforts to fully discharge its responsibilities, and in view of adopting of Al-Furat company quality management system by applying the standards of ISO (9001: 2015) and purpose of getting the on-demand benefits from the application of international standards reg
... Show MoreThis study was conducted to determine the ability of water treatment system (Vortisand) to reduce some chemical and physical properties for tigris river raw water, It consisted of turbidity, electrical conductivity, pH, total hardness, calcium Hardness as well as temperature in order to determine the unit`s efficiency for reducing their concentration as compared to those in the water produced by some classical potable water projects (Dora and Wathba) in Baghdad. Samples were collected during the cold months (December 2016 and January 2017) and during the hot months (May and June 2017). The results showed that this system has the ability to reduce some properties such as turbidity, the values were 215NTU in raw water and decreased to NTU
... Show MoreThe aim of the research is to identify to what extent to which Malcolm Baldrige standards of total quality are applied in the after-sales services of a private sector company for electrical appliances, from the point of view of administrative leaders, in it. To achieve this aim a questionnaire has been used to measure the degree of application of Malcolm’s seven criteria for total quality, namely: (leadership, strategic planning, focus on the customer, measurement and analysis and knowledge management, focus in human resource and operation management and results of the company’s management), the research found that the company achieved a good level of the standard from the de
... Show Moreالحمدُ للهِ رب العالمين ، والصلاة والسلام على نبيه الأمين محمد r وعلى آله الطيبين الطاهرين ، وأصحابه الغر الميامين:
تعد الصورة السمعية مفهوما بيانيا نجده في البلاغة العربية واضحاً مؤثرا، مؤديا دورا جوهريا في إيصال الفكرة التي يروم الأديب إيصالها إلى المتلقي ولا تبدو السمعية واضحة إلاّ إذا نظر إليها في حالة أدبيه تهز كيان الشاعر  
... Show MoreCaryl Churchill's Top Girls (1982) reveals how women have achieved a point of strength and independence in their battle to face men's oppression throughout history. Churchill has replicated recent transitions in the 1980s and 1990s in works that depict these movements' central concerns and contradictions as they change. Similarly, her theater is a result of many problems and shifts in hegemonic modes of production during this time. This paper traces the achievements of the major character of Top Girls, Marlene, in her way of life and her handling of the struggles of other women around her. Because of this strength, Marlene is compared to the British Prime Minister, Thatcher. Therefore, this paper will shed light on the term of T
... Show MoreTotal of 170 samples were collected from Al-Chibayish Marsh reality in Dhi-Qar governorate southern of Iraq to study the epidemology of viral hepatitis in these areas and to detect the type of hepatitis viruses which include A ,B,C,D .The percentage of hepatitis A was 1.17% and most of them below age of ?10 (66.6%) while infection with hepatitis B account 5.29% and includes all age groups. There was no detected cases of hepatitis C,D. The laboratory study showed that the incidence of hepatitis B higher in male (4.11%) compared to female ( 2.35%)
Interval lies at rest in the speech; so as to improve to speak out, which is how Evaln Koran by other speech, called separators; for the secession of Alkalaman then, as the last verse separation between it and its aftermath in the Al-Jinn had a comma significant impact on the statement of the case of gin, as portrayed interval Gin and like the distraught after hearing of the Koran
This Sura carried various types of repetition represent wordy repeat itself and repeat some of the votes as well as the repeated sound of a thousand who remained in Sura breaks Bhaa also repeat the voice of the shredder breaks
Linguistic sounds of Koranic breaks played a significant role in a statement carried by the linguistic meaning of these interludes
The research focused on (balanced performance and structural mechanisms in industrial product design systems) by focusing on product development in a manner that is able to meet the human requirements through the effect of smart technology on the systems of product designs and its effectiveness in achieving the design and functional variables that have an effective effect in User and industrial products, correspond to the requirements of the user life at the level of daily interaction. The first chapter ensures the problem of research is the following question: What are the mechanisms to achieve balanced performance in some systems design to fit with the variables B N User and industrial products? The objective of the research was to ide
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