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.
September 11th attacks held the biggest tragedy in American history. It was a day of grief, and it proved that America was not immune to attacks and threat. Afterwards life has changed not only for the American Muslims but also American Christians and Jews and to people from other religions. The cruelty of that day has left its shed particularly on the Muslims’ life in America who in reality had nothing to do with the attacks. Arab American Muslim writer Laila Halaby’s novel, Once in a Promised Land, intensely displays the problems that Arab Muslims went through after September 11th attacks. This paper discusses this issue through analysing Halaby’s novel, where she deals with the issues such as discrimination, stereotype, and prejudi
... Show MoreThe study aims to indicate the role of the agricultural initiative in building agricultural development, mediated by activation of the role of internal and external audit on agricultural initiative projects, for the purpose of meeting the challenges of abuses on agricultural land and lack of water used in agriculture and proportions of high poverty, which led to the rural people of the migration to the city and leave agriculture and livestock, and that of the main conclusions reached by the researcher. When comparing the work of the external auditing agencies (the Federal Office of Financial Supervision) on the initiative of agricultural projects with internal audit services in the Directorate of Agriculture and branches of the Agricultu
... Show MoreThe study aims to identify the impact of the round-robin strategy on the logical thinking of fourth-year middle school students in chemistry. Two groups were employed: an experimental group consisted of (30) students who were taught according to the round-robin strategy, and the control group consisted of (30) students who were taught according to the traditional method. The researcher adopted the experimental design with partial control by preparing the visual thinking test tool, which consists of (20) multiple-choice items, it was applied as a post-test on the research sample. The result showed that there was a statistically significant difference in favor of the experimental group, which was taught according to the Round Robin s
... Show MoreSystemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by the production of autoantibodies against nuclear antigens and a systemic inflammation that can damage a broad spectrum of organs. SLE patients suffer from a wide variety of symptoms, which can affect virtually almost any tissue. As lupus is difficult to diagnose, the worldwide prevalence of SLE can only be roughly estimated to range from 10 and 200 cases per 100,000 individuals with dramatic differences depending on gender, ethnicity, and location. Although the treatment of this disease has been significantly ameliorated by new therapies, improved conventional drug therapy options, and a trained expert eye, the underlying pathogenesis of lupus still
... Show MoreThis study concerned with phytochemical investigation and methods of extraction and separation of active constituents from Valeriana officinalis plant cultivated in Iraq. Due to the large number of active constituents in Valeriana officinalis, it was necessary to make analytical study of its constituents to determine the chemical nature of these constituents and then determine the main classes (terpenes and iridoids) using chemical reagents specific for each class. Different organic solvents like ethanol (70%) used in soxhlet apparatus and hexane, ethyl acetate and methanol were used separately to extract the main active constituents by maceration. Through comparison between these solvents using thin layer chromatograph
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Increased epidemic when Akbari in his book Explanation in the expression of the Koran
This study was designed to investigate the effect of the Clenbuterol drug in some physiological parameters of Liver, Kidney function and lipidprofie concentration. Fourty adult male rabbits were used in this study. The animals were randomly divided into four groups,the first group was given distilled water (control) ,while the other third groups were given (2,4,6 µg/kg) of Clenbuterol drug for 30 days. Blood samples were collected after 14 and 30 days of the treatment for biochemical study. Drug caused non significant increase(P<0.05)in the AST and ALT enzymeactivity in second and third groups during treatment period ,while we note a significant increase(P<0.05) in both AST,ALT enzyme level in fourth group compared with control group , as
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This research consists of two parts, the first part concern with analyzing the collected data of BOD and COD values in discharge waste water from Al-Dora refinery during 2010 to find the relationship between these two variables The results indicates that there is a high correlation between BOD and COD when using a natural logarithm model (0.86 ln(COD)) with correlation coefficient of 0.98. This relationship is useful in predicting the BOD value using the COD value. The second part includes analyzing collected data from the same site in order to find a relationsip between BOD and other parameters COD, Phenol(phe), Temperature(T), Oil, Sulphat(SO4),pH and Total dissolved solids( TDS) discharged from the refinery. The results indicated that th
... Show MoreThis study illustrates in vitro effect of cold atmospheric plasma (CAP) on the treatment of Leishmania. In addition, the study evaluated the effect of drug treatment (pentostam) and the combination treatment of pentostan and CAP at different doses and incubation time 24 h in order to assess the most effective treatment. The duration of the cold plasma doses was 1 min, 2 min and 3 min, while the pentostam doses were 2.5 µg/ml and 5 µg/ml. The combinations therapies included combining the three cold plasma doses with the pentostam doses to test 6 combinations of treated in vitro. The maximum growth inhibition was given by combination treated 46% and 44% for donovani and tropica leishamnia respectively; these results give an indi
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