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 internet is a basic source of information for many specialities and uses. Such information includes sensitive data whose retrieval has been one of the basic functions of the internet. In order to protect the information from falling into the hands of an intruder, a VPN has been established. Through VPN, data privacy and security can be provided. Two main technologies of VPN are to be discussed; IPSec and Open VPN. The complexity of IPSec makes the OpenVPN the best due to the latter’s portability and flexibility to use in many operating systems. In the LAN, VPN can be implemented through Open VPN to establish a double privacy layer(privacy inside privacy). The specific subnet will be used in this paper. The key and certificate will
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Translation is a vital process that needs much more understanding and mutual background knowledge on the part of ESL or EFL learners in terms of grammar , meaning and context of both the SL and TL . Thus , the main aim of the current research paper is to identify and figure out the techniques used by ESL or EFL learners when translating English barnyard verbs into Arabic . The main problem of this study is attributed to the fact that ESL or EFL learners may not be able to identify and understand the connotative meaning of barnyard verbs since these verbs are onomatopoeic (i.e,) a word that phonetically imitates, or suggests the source of sound that it describes. Therefore they may be unable to translate these verbs appropriately and accura
... Show MoreBackground: One of the most common problems that encountered is postburn contracture which has both functional and aesthetic impact on the patients. Various surgical methods had being proposed to treat such problem. Aim: To evaluate the effectiveness of square flap in management of postburn contracture in several part of the body. Patients and methods: From April 2019 to June 2020 a total number of 20 patients who had postburn contracture in various parts of their body were subjected to scar contracture release using square flap. The follow up period was ranging between 6 months to 12 months. Results: All of our patients had achieved complete release of their band with maximum postoperative motion together with accepted aesthetic outcome. A
... Show MoreBackground: The early detection of oral cancers gives the greatest chance of curing and the delay in presentation has a significant impact on the associated morbidity and mortality. The lack of general dental practitioners (GDP) knowledge in early cancer detection has been shown to contribute to delays in referral and treatment. The aim of this study was to investigate the oral cancer awareness among a group of GDP by assessing their knowledge of detection and prevention of oral cancer. Materials and methods: A questionnaire based study was designed. The questionnaire was delivered to 200 GDP assessing oral examination method, knowledge of oral cancer risk factors, clinical appearance and the most common site, point of referral and requests
... Show MoreThe study aims at showing the active role of the internal auditors through explaining what they should be obliged to in writing the reports and financial and non financial statements according to the international standards of accounting to be transparent and integral. It also aims at giving the independence that the auditors should enjoy through connecting them to an Auditing Commissions to submit additional services in addition to assessing the instrument of control to evaluate risks, give consultations and the services related to the governance and independence of Supervising Council.
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Linguistic studies present a distinguished place among modern human studies, as we find this clear in the scientific research institutions of the developed nations, it is the main pillar in the strengthening of links and consolidation pillars between individuals and groups. It is a language and between people's thoughts, feelings and actions, and has been able to show that language is not only a tool of expression but is closely linked to the intellectual, emotional and social life of these people individuals and groups.
The derivation is a major step in Arabic in classifying formulas into weights with special morphological values; these are of great importance in sentences and structures that are the domain of the searc
This study is at the heart of the pragmatic theory, as this research seeks to highlight the concept of necessity, and what the researchers have tended to do is that the development that has acquired integrated pragmatics is only for the development of the subject of necessity, as it is one of the contents of the saying, and this is what made Decroux define it as the semantic element that Concerning the saying, as for Grace; He paid great attention to the conversational imperative, and understood the requirement by clues or suggestions, as it is an element known for its absence and presence in the linguistic structures included in the text when reading or when understanding. This study has paved the way for clarifying the concept of necessi
... Show MoreIn this research a recent developed practical modeling technique is applied for the glucose regulation system identification. By using this technique a set of mathematical models is obtained instead of single one to compensate for the loss of information caused by the optimization technique in curve fitting algorithms, the diversity of members inside the single set is interpreted in term of restricted range of its parameters, also a diagnosis criteria is developed for detecting any disorder in the glucose regulation system by investigating the influence of variation of the parameters on the response of the system, this technique is applied in this research practically for 20 cases with association of National Center for
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