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 this paper, three approximate methods namely the Bernoulli, the Bernstein, and the shifted Legendre polynomials operational matrices are presented to solve two important nonlinear ordinary differential equations that appeared in engineering and applied science. The Riccati and the Darcy-Brinkman-Forchheimer moment equations are solved and the approximate solutions are obtained. The methods are summarized by converting the nonlinear differential equations into a nonlinear system of algebraic equations that is solved using Mathematica®12. The efficiency of these methods was investigated by calculating the root mean square error (RMS) and the maximum error remainder (𝑀𝐸𝑅n) and it was found that the accuracy increases with increasi
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Natural frequency under initial stresses for simply supported cross-ply composite laminated plates (E glass- fiber) are obtained using Refind theory (RPT). This theory accounts for parabolic distribution of the transverse shear strain through the plate thickness and satisfies the zero traction boundary conditions on the surfaces of the plate without using shear correction factors. The governing equations for Eigen value problem under initial stress are derived using Hamilton’s principle and solved using Navier solution for simply supported cross-ply symmetric and antisymmetric laminated plates. The effect of many design factors such as modulus ratio, thickness ratio and number of laminates on the Natural frequency and buckling stresses
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Background: Coronary Artery Disease (CAD) is one of the largest causes of mortality worldwide. Clopidogrel, antiplatelet drug, has been widely used for management of CAD. The current study aimed to investigate the effect of clopidogrel on the oxidative stress in CAD patients. Methods: One hundred CAD patients, who were followed-up for 5 days after receiving clopidogrel, and 50 healthy volunteers were included in this study. Parameters include catalase (CAT), total antioxidant capacity (TAC), total oxidant capacity (TOC), total protein, albumin, and globulins were determined before and after treatment with clopidogrel. Results: CAT, TAC, and Tp were significantly decreased (P<0.0001) in CAD patients compared to healthy control and
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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
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Credit risk assessment has become an important topic in financial risk administration. Fuzzy clustering analysis has been applied in credit scoring. Gustafson-Kessel (GK) algorithm has been utilised to cluster creditworthy customers as against non-creditworthy ones. A good clustering analysis implemented by good Initial Centres of clusters should be selected. To overcome this problem of Gustafson-Kessel (GK) algorithm, we proposed a modified version of Kohonen Network (KN) algorithm to select the initial centres. Utilising similar degree between points to get similarity density, and then by means of maximum density points selecting; the modified Kohonen Network method generate clustering initial centres to get more reasonable clustering res
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Abstract- Asymptomatic or clinically silent kidney stones are possibly serious because, in their expected passage, they may cause infection, obstruction and renal impairment. The purpose of this study was to determine the prevalence of silent kidney stones in a sample of Baghdad population and consider how this value could affect the justification for a screening system. To our best knowledge, this is the first study of its kind conducted in Iraq. We investigated 714 consecutive patients who sustained an abdominal ultrasound at our hospital with further kidney screening. All these patients did not have clinical signs and symptoms of nephrolithiasis. Age, sex, the indication for ultrasound, the size, side, and the number of the disco
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Unstable angina pectoris often leads to acute myocardial infarction. Since uric acid is thought to be risk factor for cardiovascular disease and considered a major antioxidant in human blood .The level of uric acid and lipid peroxidation in the sera of patients with unstable angina and myocardial infarction were measured and compared to the healthy individuals. Twenty-nine patients with unstable angina and twenty-nine patients with myocardial infarction were studied and compared to twenty-five healthy individuals. Uric acid was measured by using Human Kit. Malondialdelyde (MDA) a lipid peroxidation marker, was measured by thiobarbituric acid method .Significant elevation of uric acid and MDA were observed in the sera of pati
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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
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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.