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 danger of the attacks of 9/11 in America, mainly on the WorldTrade Center at Ground Zero, had brought America into a position thatnever seen before. People who lived there faced a historical calamity marked a turning point in history and a beginning of a new era. Thepaper examines the behavior of traumatized individuals in relation tosociety that trauma involves both. The socio cultural approach willachieve the goal. It studied the responses of the individuals to the event and the motives behind these reactions. Don DeLillo, a member of apost 9/11 group of writers, an American novelist of Italian origin, through his portrayal of the characters, tries to present a vivid image t
... Show MoreRisk factors can be considered unique in construction projects, especially in tendering phase. This research is directed to recognize and evaluate the importance of critical risk factors in the tendering phase related to Iraq’s construction project. As a rule, construction projects are impacted by risk factors throughout the project life cycle; without identifying and allocating these risk factors, the project cannot succeed. In this paper, the open and closed questionnaires are used to categorize the critical risk factors in tendering phase. Research aims to recognize the factors that influence the success of tendering phase, to determine the correct response to the risk’s factors in this research article, (IBM, SPSS, V23) package has
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The features of strategic thought transformation in Russia based on attempt confirm the Russian influenced on Region of Eastern Europe through series of common defense treaties and mutual security between USSR and another states this treaties emphasis size on direct Russian supervision on these states in addition, Russia in trusted to formation communism regimes in its vital space, Russia inherited the status of former USSR in political and economic levels.
Shortly we can see that Russia witnessed large Transformation in political strategic thought as a result of change in internal strategic environment and change of nature understanding which influenced on Russia. This
... Show MoreThis research aims to test the relation and effect of the process of organizational change as an independent variable (change in human resources, technological change, change in tasks, change in organizational structure) in organizational performance as a variable of success (financial performance, operational performance, customer satisfaction, growth). And learning) in the Office of the province of Baghdad, as well as determine the existence of differences of statistical significance between the variables of research, and then try to come out with a set of recommendations to contribute to the strengthening of organizational performance, and carried out this research on the eye of the vertical number (75) individuals, The
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The research attempts to identify the pattern of punctuation in contemporary Iraqi poetry through delving into the poetry of an Iraqi poet belonging to the seventieth generation, Namik Abdul Deeb, who belongs to the poets of Arab modernity in general, the research has reached many results, including that the signs of deletion were vocabulary marks any They are located in the center of the poetic singular, or inline markers, which are those that fall within the poetic line of the prose poem separating its vocabulary, or cross-sectional marks located within the poetic passages that are part of the poetic text, and finally text marks which are located within the poetic text and fragmented into Parts. The research also found that the work of
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Numerous research studies have been conducted on why some learners acquire a second language more easily and quickly than others. Most of these studies have demonstrated that acquiring a second language does not depend only on learners’ cognitive ability or professional teaching strategies. The learning language process is more complicated than that. It is affected by crucial factors that are beyond the control of learners and teachers. These factors are known as sociolinguistic factors. These factors include culture, age, motivation, socio-economic status, and gender. This research paper mainly concentrates on the role of motivation in second language acquisition.
There are numerous ways to define the traits of influential professors, including behavior (such as warmth, civility, and clarity), knowledge (of subject matter and students), and beliefs, among many others. According to research; influential teaching can also defined as the capacity to improve student achievement. This; is only one way to express effectiveness, as stated. However; the preferred definition of high-quality teaching in the United States and many other countries is teacher effects on student achievement. Therefore; this study aimed to determine the characteristics of influential professors in Online Teaching at the English department. This study; believed to be significant for college professors who will show them how
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