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 Iraq, more than 1031 school projects have been halted due to disputes and claims resulting from financial, contractual, or other issues. This research aims to identify, prioritize, and allocate the most critical risk factors that threaten these projects’ success for the duration (2017-2022). Based on a multi-step methodology developed through systematic literature reviews, realistic case studies, and semi-structured interviews, 47 risk factors were identified. Based on 153 verified responses, the survey reveals that the top-ranked risk factors are corruption and bribery, delaying the payments of the financial dues to the contractors or sub-contractors, absence of risk management strategy, multiple change orders due
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The launch of the EU’s Eastern Partnership in 2009 intended to signal a new, elevated level of EU engagement with its Eastern neighborhood. Yet there remain several long-simmering and potentially destabilizing conflicts in the region, with which EU engagement thus far has been sporadic at best. The Union’s use of its Common Security and Defense Policy (CSDP) in the region and to help solve these disputes has been particularly ad hoc and inconsistent, wracked by inter-institutional incoherence and undermined by Member States’ inability to agree on a broad strategic vision for engagement with the area.
The three CSDP missions deployed to the region thus far have all suffered from this incoherence to various extents. In particu
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The treatment of migraine headache targets the neurovascular mechanism and involves the use of serotonin receptor antagonists. Some of these drugs are used for the treatment of acute attacks; while others are effective as prophylactic measures to decrease the duration and frequency of attacks. Pizotifen, a 5-HTA antagonist, is one of the prophylactic drugs for which the clinical use resulted in low outcomes in reducing migraine symptoms. Melatonin, a serotonin derived neurohormone, was reported to exert many functions like sleep induction, anti-inflammatory, neurovascular regulation, cytoprotection and modulation of neurotransmitter release. In the view of the involvement of serotonin in the pathophysiology of migraine a
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Olanzapine (OLZ) is classified as a typical antipsychotic drug utilized for the treatment of schizophrenia. Its oral bioavailability is 60% due to its low solubility and pre-systemic metabolism. Hence, the present work aims to formulate and evaluate OLZ nanoparticles dissolving microneedles (MNs) for transdermal delivery to overcome the problems associated with drug administration orally. OLZ nanoparticles were prepared by the nanoprecipitation method. The optimized OLZ nanoparticle formula was utilized for the fabrication of dissolving MNs by loading OLZ nanodispersion into polydimethylsiloxane (PDMS) micromould cavities, followed by casting the polymeric solution of polyvinylpyrrolidone(PVP-K30) and polyvinyl alcohol (PVA) to form
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This research focuses on detecting the financial corruption cases in Iraq in light of adoption the strategic audit, the paper deals with the problem of the proliferation corruption cases particularly financial in Iraq and dramatically in the presence of audit and control devices as well as inspection and integrity devices, which indicates the existence of deficiencies and weaknesses in those devices in the implementation of audit and control functions in order to detect the corruption cases in the economic units in Iraq.
Stems objective of this research through the provision of approach of strategic audit concepts and indicate the extent importance of adopting of strategic audit as a means to detect the f
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Determination of the level of adipokines (obestatin, vaspin, tumor necrosis factor-? and interleukin-6)in hypo-and hyperthyroid patients from Educational Baghdad Hospital in Baghdad City was investigated. Fifty patients with hypothyroidism and Fifty patients with hyperthyroidism were selected. A control group of thirty euthyroid persons was included. Blood was collected by vein puncture and serum was separated and stored at –20C. Adipokines (obestatin, vaspin, tumor necrosis factor-? and interleukin-6) were estimated using ELISA method. The findings show a significant (p<0.05) increase in obestatin level in hypothyroid patients, while there is no significant difference in hyperthyroid patientsas compared with the euthyroid subjects.
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This research theme of the pressures of work , which is one of the important topics in order to recognize the reality of( influencing the pressures of work in the performance of employees in the General Company for Vegetable Oil Industry in Baghdad )through the statement of the existence of the correlation and influence whether or not the statement of the strength of this relationship and its impact in the case of its existence has been provided as part of my Search for variables and their removal in front of the Sub- scientific aspect has been the distribution of the questionnaire on a sample of( 62) people working in the company Mint distributors on several sections where.
Formed resolution of two sets
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Technology developed at very rapid paces in the last decade of the twentieth century and what followed, especially communication technology, as the World Wide Web appeared in the mid-nineties of the last century, Facebook in 2004 and 2006, the mobile phone, 1993, 1994, and social networking sites. The other. These technological developments have had an impact on societies, whether among individuals in one country or among different peoples. The citizen in any part of the world has become a journalist who practices the work of a specialized or professional journalist, even if he does not know how to read and write, or has a low level of education, as he can now transmit events from wherever he is to the world, through his personal page, or v
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