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.
Reinforced concrete (RC) slabs strengthened with carbon fibre reinforced polymer (CFRP) and subjected to flexural actions may experience many types of failure, including FRP debonding, FRP rupture and concrete crushing. Of these different types of failure modes, FRP debonding stands out as the most predominant type of failure because of its dependence on the relatively weak bond interface between the soffit of the RC member and the FRP sheet attached to it. Many anchorage systems have been developed to enhance the performance of strengthened systems, one of which is the hybrid anchor, which combines the effects of patch anchors and spike anchors. Hybrid anchors have shown significant enhancement when used with RC members subjected to shear
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ABSTRACTBackground: cochlear implants are electronic devices that convert sound energy into electrical signals to stimulate ganglion cells and cochlear nerve fibers. These devices are indicated for patients with severe to profound sensorineural hearing losses who receive little or no benefit from hearing aids. The implant basically takes over the function of the cochlear hair cells. The implant consists of external components (microphone, speech processor and transmitting coil) and internal components (receiver stimulator and electrode array). The implant is inserted via a trans mastoid facial recess approach to the round window and scala tympani.Objectives: to determine the effectiveness and safety of non fixation method in cochlear imp
... Show MoreReactive oxygen species (ROS) are produced as a result of biochemical processes that are not in balance with the body's antioxidant defense mechanism. This metabolic dysfunction is referred to the oxidative stress (OS). Metabolic dysfunction-associated diseases are affected by changes in the redox balance. It is now widely recognized that oxidative stress significantly affects diabetes mellitus (DM), particularly type 2 diabetes. The biochemical changes associated with DM could disturb the oxidative milieu, leading to several microvascular complications in diabetic patients. Thus, DM is a perfect disease to explore the harmful consequences of oxidative stress and how to treat it. Oxidative stress triggered by hyperglycemia is
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Studied Seen fungi water in nine stations or selected sites along the Tigris River began from the city of Mosul in the north to Qurna in episodes were measured some chemical agents and Alvezaúah water ranged pH values ??(11p) between 7.0 to 8.3 either temperatures ranged between 10to 28 m study showed isolated 22 species of 14 genera of fungi
Christianity rejected abortion, since its inception, it took a luck against abortion, although there is no mention of it in the Bible, as there is no explicit text for abortion in the Old or New Testament and that the early Christians considered abortion a sin in all stages, and beliefs included abortion as an act of murder. What is forbidden in the Ten Commandments is “Thou shalt not kill”, and it is understood that killing here is either plundering one’s personal life (suicide) or stealing another person’s life (killing), or stealing the life of a person who has not yet been born (aborting fetuses). Based on the above, it was necessary for individuals to search for (Abortion in the Christian Religion / Descriptive Study) The resea
... Show MoreIntelligent or smart completion wells vary from conventional wells. They have downhole flow control devices like Inflow Control Devices (ICD) and Interval Control Valves (ICV) to enhance reservoir management and control, optimizing hydrocarbon output and recovery. However, to explain their adoption and increase their economic return, a high level of justification is necessary. Smart horizontal wells also necessitate optimizing the number of valves, nozzles, and compartment length. A three-dimensional geological model of the As reservoir in AG oil field was used to see the influence of these factors on cumulative oil production and NPV. After creating the dynamic model for the As reservoir using the program Petrel (2017.4), we
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The present research focuses on the study of the effect of mass transfer resistance on the rate of heat transfer in pool boiling. The nucleate pool boiling heat transfer coefficients for binary mixtures (ethanol-n-butanol, acetone-n-butanol, acetone-ethanol, hexane-benzene, hexane-heptane, and methanol-water) were measured at different concentrations of the more volatile components. The systems chosen covered a wide range of mixture behaviors.
The experimental set up for the present investigation includes electric heating element submerged in the test liquid mounted vertically. Thermocouple and a digital indictor measured the temperature of the heater surface. The actual heat transfer rate being obtained by multiplying the voltme
... Show MoreThe methodology of the concept of sovereignty in contemporary Islamic thought
لم تعد ظاهرة غسل الأموال ظاهرةً محلیة أو إقلیمیة، فكل دولة معرضة لهذه الظاهرة لانتأثیراتها تستهدف الإنسان أینما كان باستهدافها الأوضاع الاقتصادیة والمالیة والاجتماعیة وحتىالأخلاقیة، سواء على المستوى الوطني أم على المستوي الدولي، فضلاً عن استغلال الاندماج الحاصلفي أسواق المال الدولیة والتطور التقني في الأنظمة المالیة لنقل الأموال المراد غسلها وتحریكها إلى إيمكان في العالم، وهو ما