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.
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 MoreAnti-Neutrophil Cytoplasmic Antibodies (ANCA) are a heterogeneous group of autoantibodies with a broad spectrum of clinically associated diseases. The diagnostic value is established for Proteinase 3 (PR3)-ANCA as well as Myeloperoxidase (MPO)-ANCA. To estimate the frequency of anti-neutrophile cytoplasmic antibodies (ANCA) in sera from a group of Iraqi patients with some autoimmune diseases compared with a healthy control group. Serum samples were collected from one hundred patient, 47 males and 53 females; with age range of 16-70 years; 20 specimens from patients with systemic lupus erythematosus (SLE), 30 from patients with ulcerative colitis (UC), and 50 from patients with rheumatoid arthritis (RA). A group of 40 apparently healthy b
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Increasing requests for modified and personalized pharmaceutics and medical materials makes the implementation of additive manufacturing increased rapidly in recent years. 3D printing has been involved numerous advantages in case of reduction in waste, flexibility in the design, and minimizing the high cost of intended products for bulk production of. Several of 3D printing technologies have been developed to fabricate novel solid dosage forms, including selective laser sintering, binder deposition, stereolithography, inkjet printing, extrusion-based printing, and fused deposition modeling. The selection of 3D printing techniques depends on their compatibility with the printed drug products. This review intent to provide a perspecti
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Background: Clubfoot, or talipes equinovarus, is a congenital deformity that consist of; supination and adduction of the forefoot and midfoot; equinus of hindfoot and varus. It was found that more than 100,000 babies are born each year with congenital clubfoot
Objectives: The purpose of this study was to investigate the complications of ponseti method for treatment of children with idiopathic club foot.
Subjects and Methods: 50 children with 74 clubfeet were managed by Ponseti method from May 2019 to July 2020 in Al-Wasity teaching hospital with primary correction of the deformity followed sometimes by elongation of Achilles tendon then the pati
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Rutting in asphalt mixtures is a very common type of distress. It occurs due to the heavy load applied and slow movement of traffic. Rutting needs to be predicted to avoid major deformation to the pavement. A simple linear viscous method is used in this paper to predict the rutting in asphalt mixtures by using a multi-layer linear computer programme (BISAR). The material properties were derived from the Repeated Load Axial Test (RLAT) and represented by a strain-dependent axial viscosity. The axial viscosity was used in an incremental multi-layer linear viscous analysis to calculate the deformation rate during each increment, and therefore the overall development of rutting. The method has been applied for six mixtures and at different tem
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In our world, technological development has become inherent in all walks of life and is characterized by its speed in performance and uses. This development required the emergence of new technologies that represent a future revolution for a fourth industrial revolution in various fields, which contributed to finding many alternatives and innovative technical solutions that shortened time and space in terms of making Machines are smarter, more accurate, and faster in accomplishing the tasks intended for them, and we find the emergence of what is called artificial intelligence (artificial intelligence), which is the technology of the future, which is one of the most important outputs of the fourth industrial revolution, and artificial inte
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Although language research has focused on blackmail in general, less attention has been paid to emotional blackmail. To date, researchers could not locate any literature that examines emotional blackmail from a linguistic standpoint. The current study is intended to fill this gap by scrutinizing emotional blackmail from a pragma-stylistic point of view by examining the style of the characters in selected episodes extracted from the American Breaking Bad series. To carry out the study, an eclectic model comprising kinds of emotional blackmailers by Forward and Frazier (1997), Searles’ speech acts (1979), Grice’s maxims (1975), Brown and Levinson’s politeness (1987), Culpeper’s impoliteness (1996), and Simpson’s stylistic le
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