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 study investigates the phonological adaptation of diphthongs within English loanwords in Iraqi Arabic (IA). In contrast to earlier small-scale descriptive studies, this study used quantitative content analysis to analyse 346 established loanwords collected through document review and direct observation to determine the diphthong adaptation patterns involved in the nativisation of English loanwords by native speakers of IA. Content analysis results revealed that most GB diphthong adaptations in English loanwords in IA occur in systematic patterns and thus may be ascribed to particular aspects in both L1 and L2 phonological systems. More specifically, the results indicate that the IA output forms tend to maintain the features of the GB i
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Soil compaction is one of the most harmful elements affecting soil structure, limiting plant growth and agricultural productivity. It is crucial to assess the degree of soil penetration resistance to discover solutions to the harmful consequences of compaction. In order to obtain the appropriate value, using soil cone penetration requires time and labor-intensive measurements. Currently, satellite technologies, electronic measurement control systems, and computer software help to measure soil penetration resistance quickly and easily within the precision agriculture applications approach. The quantitative relationships between soil properties and the factors affecting their diversity contribute to digital soil mapping. Digital soil maps use
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The main challenge of military tactical communication systems is the accessibility of relevant information on the particular operating environment required for the determination of the waveform's ideal use. The existing propagation model focuses mainly on broadcasting and commercial wireless communication with a highs transceiver antenna that is not suitable for numerous military tactical communication systems. This paper presents a study of the path loss model related to radio propagation profile within the suburban in Kuala Lumpur. The experimental path loss modeling for VHF propagation was collected from various suburban settings for the 30-88 MHz frequency range. This experiment was highly affected by ecological factors and existing
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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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Communication and media technologies have seen several changes in the last two decades. These changes put the basis for the emergence of communicative and media practices on several levels including political, economic, technological and artistic. And these, in turn, led to the emergence of new media trends and phenomena in various areas of media worthily to be studied and researched for example online advertisings. Online advert
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