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.
This research has come out with that strategies made by Porter as generally strategies applicable to any size and type of economic units cannot be applied to many of the economic units in the world in generally and in Iraq especially not a lot of economic units have the resources and competencies that enable them to provide a unique product of its kind in the minds of customers and then adopt a differentiation strategy and not a lot of economic units have the resources and competencies that make them the cost leader. Differentiators and cost leaders are minority in the world while not differentiators and not cost leaders are majority in the world.
The economic units are not differentiators and not c
... Show MoreA total of 54 out of 67 (80.59%) of burn wound swab showed growth of one, or two, or three bacterial pathogens. Pseudomonas aeruginosa was the commonest pathogen, isolated in 48.14% of swab samples, followed by Klebsiella pneumoniae (31.48%), Staphylococcus aureus (27.77%), Acinetobacter baumanii (14.81%), Escherichia coli (7.40%), and Citrobacter freundii, Providencia stuartii, Enterobacter cloacae, with 1.85% isolation percentage for each. All bacterial isolates were tested against 19 antibiotics, and showed multi-drug resistance to 10 antibiotics, or more. The most effective antibiotics were the fifth-generation cephalosporin, ceftobiprole, and and antibiotic combinations, as Ceftazidime / clavulanic acid, and Cefoperazone /sulbactam, an
... Show MoreSustainable human development means meeting the basic needs of society and striving for continuous improvement in quality, as it seeks to increase economic well-being while providing adequate housing and nutrition, as well as providing electricity, water, health and education services . Ten centuries ago, Islam highlighted the importance of the development effort and the necessity of its sustainability before the West took it in the 1970s. There are a number of challenges that greatly affect the reality of achieving and ensuring Millennium Development Goals. The research recommends the importance of fighting administrative and financial corruption, as this is one of the biggest challenges facing the possibility of advancing the economy and
... Show MoreImprovisation is that spontaneous automatic achievement which is formed by a new cognition that is not based on something prior to it or a previous cognition. It is instantaneous. Whereas in art, improvisation also inters in all types of applied and performance arts as a foundation for launching and initiating it in music, painting, cinema, television and theater. In order to study the improvisation of the actor, the researcher put forward a theoretical study that included two sections. The first section is (the improvisation concept) and the second section is (improvisation in the show). The researcher, in the research procedures, took an intentional sample that was represented by the theatrical show (Rehearsal in Hell Play) and after t
... Show MoreThe purpose of this research highlight the achievement of the effectiveness of small and medium enterprises dimensions and conformable to analyze the relationship between business strategies and human resources management strategies , and launched search of a dilemma thought provoking fundamental questions revolve around the search is the lack of appropriate strategies in these enterprises to help them continuity and permanence in business and markets , as these enterprises lack the human resources management strategies appropriate , as well as business strategies that make them withstand the changes in the market environment is changing and volatile . It was to
... Show MoreThe banks mobilize savings and channel them to the economy, whether commercial or Islamic banks and thus both contribute to increasing financial depth, the objective of this paper is to measure the contribution of the Islamic banks in increase financial depth in Iraq, and compared the role played by private commercial banks in contributing to increasing financial depth in Iraq. The paper has been applying the most used indicators of financial depth that used widely in the literatures, especially those applicable with the Iraqi economy.
The paper found via using the Autoregressive Distributed Lag Model (ARDL) that Islamic banks did not contribute to increasing financial depth in Iraq, as well as for the p
... Show MoreThe present study addresses adopting the organic and nutritious materials in dairy wastewater as media for cultivation of microalgae, which represent an important source of renewable energy. This study was carried out through cultivation of three types of microalgae; Chlorella sp., Synechococcus, and Anabaena. The results shows the success the cultivation of the Synechococcus and Chlorella Sp, while the Anabaena microalgae were in low-growth level. The highest growth was in the Synechococcus farm, followed by Chlorella and Anabaena. However, the growth of Synechococcus required 10 days to achieve this increase that re
... Show MoreThe purpose of the research is to identify the role of Islamic banks in facing the financial crisis in Iraq for the period 2012-2014, and highlight the various factors that contributed to the emergence of the financial crisis, as well as to identify the problems and challenges facing the Islamic banking business in Iraq and identify the reasons and find appropriate solutions, And the development of treatments to avoid the occurrence of such problems and overcome them. The main findings of the research are as follows,Islamic banks (the sample of the study) were affected by the global financial crisis indirectly, as the financial crisis turned into an economic crisis affecting the real economy, because the activity of Islamic banks is more
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