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 objective of the present paper is to examine the effect of Recycled Asphalt Pavement (RAP) on marshall properties and indirect tensile strength of HMA through experimental investigation. A mixture with 0% RAP was used as a control mix to evaluate the properties of mixes with 5%, 10%, and 15% RAP. One type of RAP was brought from Bab Al-moadam’s road in Baghdad for this purpose. The experimental testing program included Marshall and Indirect Tensile Strength tests. The results indicated that the bulk density, flow and VFA increase with the increasing of the percentage of RAP, while increasing in RAP results decreases in VTM and VMA values. Furthermore, the stability is changed from 10.1 kN for the control mix to12, 13.6 and 11.7 kN
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This paper aims to study Antonia's character and her mannish behavioral transition throughout the novel entitled My Antonia. Willa presents Antonia who shows her resolution and courage in facing and dealing with personal dilemmas and social circumstances. Willa portrays Antonia, who struggles in the new society and culture by working hard in changing the salty land of Nebreska and her destiny . Working in salty land day and night forces Antonia to lose her tender behavior and her beauty as a woman is changed too. She achieves her goals to live with her family in a new place with a dignity and respect though she looks like a man in her strength and body built . Willa Cather tries to explain that the major&
... Show MoreIn der Nachwendezeit erschienen im deutschen Buchmarkt zahlreiche Werke deutscher Autoren, die einen Trend oder Tendenz markieren können. Im Mittelpunkt der vorliegenden Arbeit steht die Analyse der Struktur und des Inhalts von drei erst nach der Wende erschienen Briefromanen: Alles, alles Liebe (2000) von Barbara Honigmann (geb. 1949), Die Liebenden (2002) von Gerhard Henschel (Jahrgang 1962) und Neue Leben (2005) des im Jahre 1962 geborenen Ingo Schulze. Dieser Beitrag macht sich zur Aufgabe zu erklären, ob der Briefroman ein neuer Trend in der deutschen Literatur nach der Wende ist.
Abstract
In the after( Wende) period a large collection of literary works for German writers has been p
... Show MoreTrickle irrigation is one of the most conservative irrigation techniques since it implies supplying water directly on the soil through emitters. Emitters dissipate energy of water at the end of the trickle irrigation system and provide water at emission points. The area wetted by an emitter depends upon the discharge of emitter, soil texture, initial soil water content, and soil permeability. The objectives of this research were to predict water distribution profiles through different soils for different conditions and quantify the distribution profiles in terms of main characteristics of soil and emitter. The wetting patterns were simulated at the end of each hour for a total time of application of 12 hrs, emitter disch
... Show Moreشهد العالم مع بداية القرن الحادي والعشرين تدشين مرحلة جديدة من التطور شملت مختلف الميادين لاسيما في مجال التطورات العلمية والثورة المعلوماتية.. كما إن مسار الديمقراطية في بعض دول العالم يصبح سالكا خاصة في تركيا, فمنذ اواسط الثمانينيات من القرن الماضي فتح المجال السياسي امام قوى كانت مسحوقة ومهمشة, ويكاد ان لا يكون لها وجود في الحياة السياسية للنزول الى ساحة العمل السياسي اسوة ببقية القوى ا
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The problem with research in the question of whether art forms in the religious icon Byzantine, heiress docility and tradition craftsman arts civilizations of the above? ... And if you are well, you helped a quotation on the entry of strange ideas rampant within religious traditions, and are prompted to do Movement rejected prohibition, and the outbreak of the icons war? ... Or is it, in fact - and as researcher finds - the result of a need communication between the religious and the recipient organization in the establishment of a deliberative speech, be visible, along with reading it and audible? .. And lies the importance of this study is being added technical knowledge of the library that will enrich researchers and scholars in this
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The conjunctive ''and'' and its Arabic counterpart ''و'' are discourse markers that express certain meanings and presuppose the presence of other elements in discourse. They are indispensable aids to both the text writers and readers. The present study aims to show that such cohesive ties help the writer to organize his main argument and communicate his ideas vividly and smoothly. They also serve as explicit signals that help readers unfold text and follow its threads as realized in the progression of context. The researcher has utilized the Quirk Model of Semantic Implication for data analysis. A total of 42 (22 for English and 20 for Arabic) political texts selected from different elite newspapers in both Arabic and English for the analy
... Show MoreTime series have gained great importance and have been applied in a manner in the economic, financial, health and social fields and used in the analysis through studying the changes and forecasting the future of the phenomenon. One of the most important models of the black box is the "ARMAX" model, which is a mixed model consisting of self-regression with moving averages with external inputs. It consists of several stages, namely determining the rank of the model and the process of estimating the parameters of the model and then the prediction process to know the amount of compensation granted to workers in the future in order to fulfil the future obligations of the Fund. , And using the regular least squares method and the frequ
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The wall of the esophagus in Mabuya aurata septemaeniata as in high vertebrates consists of four layers, mucosa, submucosa,muscularis and serosa. Mucosa forms many unorganized short and long folds penetrate inside the esophageal cavity. Mucosa contains two sub layers, first one is lining epithelium which includes two types of cells, simple ciliated columnar epithelial cells and goblet cells, second one is lamina properia. Mucosa does not have muscularis mucosa. There is no esophageal glands within esophagus. Many special stains were used as (Periodic Acid Schiff (PAS)) to detect Carbohydrates in goblet cells. Alcian blue were used to detect the amount of goblet cells within lining epithelium. Alcian blue + PAS together confirm that the
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