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.
Background: Medical-surgical nurses are responsible of providing competent care to clients with a wide-array of acute and chronic health problems. This challenging task requires arming nurses with advanced competencies of health literacy to effectively educate their clients. However, evidence about medical-surgical nurse’s health literacy-related knowledge and experience is limited. Purposes: This study aimed to determine the level of the health literacy-related knowledge and experience among medical-surgical nurses.Design: A descriptive-cross-sectional study was conducted among a total sample of 177 nurses who were practicing in medical-surgical wards in teaching hospitals in Iraq. A convenience sampling method was used to sele
... Show More
(3)
(1)
The electron correlation for inter-shells (1s 2p), (1s 3p) and (1s 3d) was described by the inter-particle radial distribution function f(r12). It was evaluated for Li-atom in the different excited states (1s2 2p), (1s2 3p) and (1s2 3d) using Hartree-Fock approximation (HF). The inter particle expectation values for these shells were also evaluated. The calculations were performed using Mathcad 14 program.
Ureteric obstruction is rarely noted in cases of gastric cancer. Its involvement by distant metastasis from gastric adenocarcinoma without direct invasion is an exceptionally unusual occurrence. This is the story of a 58-year-old man who arrived at the emergency department with acute flank pain and fever. He was initially diagnosed with obstructive pyelonephritis after the discovery of a new onset, complete ureteric obstruction on the left side. Subsequent investigations and follow-up revealed the presence of gastric adenocarcinoma with possible ureteric metastasis bilaterally, flank pain and hydronephrosis were the first and only presentations of gastric cancer. The rarity of the condition and the unusual presentation encouraged us to r
... Show More
Background The traditional management of appendicular mass is an initial conservative treatment followed by interval appendectomy. Recently interval appendicectomy has been questioned.
Objective: The purpose of this study was to clarify the need and the role of interval appendicectomy after successful initial conservative treatment.
Method: This is a prospective study conducted in a major hospital in Basra from April 2006 to Septemper2010, included 65 patients with appendicular mass which subsequently proved postinflammmatory (phlegmonous) changes of the appendix were treated conservatively.
Results: Routine interval appendicectomy was not performed and needed after successful treatment in the majority of the patients (84.6%). F
The equation of Kepler is used to solve different problems associated with celestial mechanics and the dynamics of the orbit. It is an exact explanation for the movement of any two bodies in space under the effect of gravity. This equation represents the body in space in terms of polar coordinates; thus, it can also specify the time required for the body to complete its period along the orbit around another body. This paper is a review for previously published papers related to solve Kepler’s equation and eccentric anomaly. It aims to collect and assess changed iterative initial values for eccentric anomaly for forty previous years. Those initial values are tested to select the finest one based on the number of iterations, as well as the
... Show MoreThis paper focuses on developing a self-starting numerical approach that can be used for direct integration of higher-order initial value problems of Ordinary Differential Equations. The method is derived from power series approximation with the resulting equations discretized at the selected grid and off-grid points. The method is applied in a block-by-block approach as a numerical integrator of higher-order initial value problems. The basic properties of the block method are investigated to authenticate its performance and then implemented with some tested experiments to validate the accuracy and convergence of the method.
(1)
Unsaturated soil can raise many geotechnical problems upon wetting and drying resulting in swelling upon wetting and collapsing (shrinkage) in drying and changing in the soil shear strength. The classical principles of saturated soil are often not suitable in explaining these phenomena. In this study, expansive soil (bentonite and sand) were tested in different water contents and dry unit weight chosen from the compaction curve to examine the effect of water content change on soil properties (swelling pressure, expansion index, shear strength (soil cohesion) and soil suction by the filter paper method). The physical properties of these soils were studied by conducting series of tests in laboratory. Fitting methods
... Show MoreThe development of the television industry has led to the emergence of a new type of entertainment program in which producers have abandoned stereotypes in traditional programs, known as (Reality TV show). This type of program has spread rapidly in America, (where there are more than 40 series of these programs), as well as Europe and more than twenty countries around the world, including the Arab countries, where the number of these programs today to about 1000 programs and the number is increasing , Especially with the readiness of the production networks to produce more of these programs for the huge profits they derive from them (because of the high viewing rates and the large number of ads broadcast through them) in return for low prod
... Show More
(10)
(9)
This study aimed to provide a theoretical framework for the impact of the Turkish intervention in northern Syria and the extent of its impact on the relations between the two countries.
It also sought to answer the study's main question: What is the impact of the Turkish intervention in northern Syria on Turkish-Syrian relations during the period 2011-2019 ?.
In this study, the historical method, the descriptive method, and the systems analysis method were used, with the aim of arriving at an accurate and realistic understanding of the Turkish-Syrian relations.
The study reached a set of results, the most important of which was that the Syrian-Turkish relations are based on interests, and that all alliances and
... Show More