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.
In 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.
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
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This study presents the concept of communicating as criticism analytical vision of art in general and contemporary composition particularly. Art is a means of communication for that activity to participate in the information or meanings, where the artwork is the message that includes what the artist sends ideas ,to the recipient . Thus, the language of communication between the artist and the receiver are made through the artwork (whatever his specialty: theatrically, plastic art, musically) and the magnitude of the meaning of outwardly or inwardly, is determined by the relationship between the artist and the recipient of which lead us turn to the issue of communication between them . .
At that determined search through which we seek
The importance of this research lies in assessing the current state of media in Iraq based on international indicators and standards set by the Research and Scientific Exchange Council and UNESCO. That is to measure the strength and durability of media after 9 April 2003. These indicators are divided into five objectives that measure and describe each of the five research objectives that we seek to test through the points system.
Based on the foregoing, researchers in Iraqi media find that these conditions may lead to further decline unless measures are taken to help avoid mistakes, provide the requirements for development and progress. In addition, care from the State is needed to support this process, which would
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Renewal is generally considered an urgent requirement of life, and a section of its continuation, because renewal means that life exists and continues, and just as renewal is in life, renewal is in science, and in this research the issue of renewal in the science of interpretation, and showed through research that renewal in This science was an urgent demand throughout the Islamic ages, as the research showed the necessity of renewal in the material of interpretation, its method and methods, and the researcher presented the opinions of schools about renewal in the interpretation of the Noble Qur’an inferred by living models that refer to their owners.
<p>The speech act of request is face-threatening by nature and an inappropriate request can cause offence to the hearer, particularly when s/he has higher authority (Economidou-Kogetsidis, 2011). E-mail is frequently used to facilitate communication between student and professor in Iraq. Iraqi EFL (English as a foreign language) learners face pragmatic difficulty in making proper requests to individuals of higher authority via e-mail. Some studies have been conducted on Arab EFL learners to uncover the pragmatic behaviour of these learners in real-life requests using elicited data. This research fills a gap in Inter-language Pragmatics (ILP) literature in that it investigates the use of academic request in three diverse imposi
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Background:The document on hypertension in the elderly promoted by the American college of cardiology and the American heart association (ACCF/AHA) was written with the intent to be a complete reference at the time of publication on the topic of managing hypertension in the elderly. More recently, the European society of hypertension (ESH) and the European society of cardiology (ESC) issued the 2013 ESH/ESC Guidelines for the management of arterial hypertension, followed by The 2014 Canadian Hypertension Education Program (CHPE), and the Eighth Report of the Joint National Committee (JNC8), all of which has endorsed specific recommendations for the management of elderly hypertensive patients.
Cities have witnessed great changes since the planning of the first cities. This is due to the increase in population and problems in services that affect urban security. As such, urban security is directed and affected by the nature of city planning and the types of services. Besides, the kind of services plays an imminent place in providing urban security at all levels. Other factors that influence urban security can be limited to the increase of population, economic and social changes. This leads to losing urban control. This study will explore the historical chronology to identify weaknesses in urban planning since its dawn and reaching solutions to protect urban security. The importance of the research lies in achieving urban securi
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The title of the research (the occasion in Surat Maryam) highlights the importance of the subject because he is studying Surah from the wall of the Koran, and that the best times of preoccupation with this light shown, study and thoughtful, and the reason for choosing the topic that the occasion of science helps in understanding the Almighty God in his book, and not Falling in confusion or error, or exaggerated interpretations, and be the key to knowing the rule of the Koran and repeating it, but the results of the conclusion that the occasion has many benefits: including making parts of speech taking each other's necks, strengthens that link and the authorship becomes his case in the case of tight construction , And that the occasion of
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