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.
Socio-scientific issues provide a great platform to both engage students in scientific topics and assess their understanding of scientific concepts. Nancy R. Singer, Amy Lannin, Maha Kareem, William Romine, and Katie Kline report on the STEM Literacy Project, a three-year National Science Foundation grant that aimed to improve STEM teachers’ knowledge and integration of literacy in their classrooms. They describe teachers’ professional learning, scenario-based assessments and other strategies they incorporated in their STEM classrooms, and how writing enables students to understand real-world issues.
Nanofluids (i.e. nanoparticles dispersed in a fluid) have tremendous potential in a broad range of applications, including pharmacy, medicine, water treatment, soil decontamination, or oil recovery and CO2 geo-sequestration. In these applications nanofluid stability plays a key role, and typically robust stability is required. However, the fluids in these applications are saline, and no stability data is available for such salt-containing fluids. We thus measured and quantified nanofluid stability for a wide range of nanofluid formulations, as a function of salinity, nanoparticle content and various additives, and we investigated how this stability can be improved. Zeta sizer and dynamic light scattering (DLS) principles were used to invest
... Show MoreThe subject of divine attributes is one of the most important Islamic tenets, which must be
To stand up to its accuracy and multiplicity unlike the difference of speech, which led the teams to disbelieve
The other, when they were engaged in the issue of divine attributes, but they are agreed and assembled on
That God is one in himself and his qualities and actions. It is not similar to Himself and does not have two qualities of sex
One . It has no similar or real similarity between its qualities and the qualities of the creatures, as well as the acts of God
God is one in His actions and does not share it with anyone, and they have based their consensus on belief
In the unity of God and the unification of Raboubiya and t
The neo – realism school confirms the using of soft instruments in foreign policy which replaced martial means . this is the age of economies that based on in formatting and interdependence which overpass the national boundaries . The power becomes less trans fer able and trans fordable. It becomes tangible and less coercive . The former American minister Henry Kissinger , despite his deep belief in the policy of the traditional power balance, argued in 1975 by saying “we are now witnessing a new Ara. The new global patterns are falling apart … we are living in a new world of inter deepen dense in the economy communications and human tartan aspirations” The priority of economy in concern of war was the mean reason behind the winn
... Show MoreStaphylococci are common commensals in human beings, yet certain species are pathogenic. Staphylococcus aureus, particularly, is a very virulent human pathogen. The capacity of staphylococci to sense the density of bacterial cell, i.e., quorum, and thereafter respond via genetic modifications is attributable to one primary mechanism known as accessory gene regulator (Agr). Agr's extracellular signal is a peptide that is posttranslationally modified with a thiolactone molecule. Agr is in charge of the upregulation of numerous exotoxins and hydrolyzing enzymes, as well as the downregulation of many colonization determinants, under circumstances of high cell density. This modulation is critical for the scheduling synthesis of virul
... Show MoreThat water is the lifeblood and without it no life on our planet, he says in the Holy Koran: In the Name of God {{And We made from water every living thing}} truth of God Almighty (the prophets verse 30) The basis of the existence of settlements served human and a source of fresh water close to it easy access to it is used for domestic, agricultural, on a daily basis, even closer look at the map of Iraq to human settlement to find it is a signatory to both sides of the river are thick and less as we moved away from the source of water until they make up a scene like a necklace the river and the stones of cities and settlements served, was the ancient civilizations, countries and capitals Throughout history, choose sites near sour
... Show MoreIn the field of research in the investment of gas fields, this requires that we first look at the center of the contracting parties in terms of the guarantee means granted to them under the contract, which constitute a means of safety and motivation to enter as major parties in the investment project. In turn, we will discuss the minimum guarantees, which are the most important guarantees granted to each of the two parties to the contract, namely the national party and the investor.
The development of better tools for diagnosis and more accurate prognosis of cancer includes the search for biomarkers; molecules whose presence, absence or change in quantity or structure is associated with a particular tumour or prognosis/therapeutic outcome. While biomarkers need not be functionally relevant, if cell survival, then they could also provide new targets for therapeutic drugs. In recent years attention has been applied to a group of proteins known as cancer testis antigens (CT antigens) [1]. These proteins are products of genes whose expression was normally confined to the testis, yet they are expressed in tumour cells. CT genes are bound to serve a wide array of roles in the testes, which have many highly differentiated cel
... Show Moreيتنامى يوما بعد يوم استخدام السيارات وتتعاضم اعدادها ، فهذا هو عصر السرعة، وخاصة في مجال النقل والمواصلات، والتي تتحقق باستخدام وسائل النقل المختلفة ومن بينها السيارات، وبالتالي اصبحت هذه الوسيلة ضرورية لتحقيق هذه السرعة ومن ضرورات الحياة في انجاز الاعمال.
وتتبارى مصانع السيارات فيما بينها لانتاج انواع السيارات بمواصفات عالية من المتانة والامان والراحة، وفي ذات الوقت اصبحت هندسة الطرق
... Show MoreThe difference and pluralism among members of the same society is a fact undeniable and ignored, passed by the Quran, and confirmed by the Sunnah of the Prophet Mohammed in more than one occasion, so that the Apostle r placed a document included in its terms an agreement with the Jews, and recognized the coexistence between Muslims and Jews, which stems from the great principle of a tolerance, which recognizes the rights of others and the freedom to believe what is believed to be right, so it was incumbent upon us, and we live in rivalry repulsion and jealousies to recognize the principle of coexistence with the other, and accept it in accordance with the legitimate controls with pride of belonging to the Islamic religion, in this sense
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