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 study sought to determine the impact of spreading the culture of quality in improving the quality of tourism service in some hotels in Erbil governorate. The theme of excellence in providing service and attention to it has become the concern of most organizations in general and tourism service organizations in particular. Tourists try to establish the mental status of customers about their tourism organizations had to pay attention to the quality of service provided to the customer and work to develop them to the advanced stages of satisfaction and happiness of customers and this will certainly positively affect the improvement of service in the tourism sector, Of the research variables were examined statistically by distrib
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Breast cancer is the commonest cause of cancer related death in women worldwide. Amplification or over-expression of the ERBB2 (HER/neu) gene occurs in approximately 15-30% of breast cancer cases and it is strongly associated with an increased disease recurrence and a poor prognosis. Determination of HER2/neu status is crucial in the treatment plan as that positive cases will respond to trastuzumab therapy. It has been used to test for HER2/neu by immunohistochemistry as a first step and then to study only the equivocal positive cases (score 2+) by in situ hybridization technique. The aim of our study is to compare between immunohistochemistry and silver in situ hybridization (SISH) in assessment of human epidermal growth factor (HER2/neu)
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Select the researcher discussed problem of asking the following : Do you use visual intelligence strategy effective in the collection of students in the Department of Art Education in the foreseeable material ? The research aims to " measure the effectiveness of the strategy in the collection of visual intelligence students in the Department of Art Education in the foreseeable material ". To verify the objective of this research was identify hypotheses zero to measure the level of achievement in the foreseeable material second grade students in the Department of Art Education - Faculty of Fine Arts . The population of the research students in the Department of Art Education / Faculty of Fine Arts at the University of Baghdad who are stud
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The development of the world, and in light of the intensity of competition highlighted the need to research and create a sustainable competitive advantage is sustained from an internal source in the company earned by the scarcity and difficulty of imitation by competitors, and this source is green innovation. In order to achieve the objective of the research, which is the diagnosis and analysis of the relationship between green innovation (in products, processes) and sustainable competitive advantage in the group of companies Kronji, was developed a default model of the research reflects the nature of the relationship and influence among its variables, the research adopted the questionnaire as a key tool for collecting data and i
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Abstract
The aim of the current research is to identify the level of administrative applications of expert systems in educational leadership departments in light of the systems approach. To achieve the objectives of the research, the descriptive-analytical and survey method was adopted. The results showed that the level of availability of the knowledge base for expert systems in educational leadership departments (as inputs) was low. The level of availability of resources and software for expert systems in educational leadership departments (as transformational processes) came to be low, as well as the level of availability of the user interface for expert systems in educational leadership departments (as outputs
... Show MoreThe research aims to find the impact of a proposed strategy according to the Luria model on realistic thinking among fifth-class scientific students and their achievement in mathematics. To achieve it, the experimental research method and the quasi-experimental design were used for two equal groups, one of them is a control group taught in traditional way and the other is an experimental one taught according to strategy based on Luria model. The research community represents the students of the fifth scientific class from the General Directorate of Education of Karkh First. The research sample (40) students were deliberately chosen and distributed equally between the two groups after making sure that they were equals in their previo
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One of the most significant elements influencing weather, climate, and the environment is vegetation cover. Normalized Difference Vegetation Index (NDVI) and Normalized Difference Built-up Index (NDBI) over the years 2019–2022 were estimated based on four Landsat 8 TIRS’s images covering Duhok City. Using the radiative transfer model, the city's land surface temperature (LST) during the next four years was calculated. The aim of this study is to compute the temperature at the land's surface (LST) from the years 2019-2022 and understand the link, between LST, NDVI, and NDBI and the capability for mapping by LANDSAT-8 TIRS's. The findings revealed that the NDBI and the NDVI had the strongest correlation with the
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The research aims to shed light on strategic cohesion and its dimensions represented by (strategic logic, organizational excitement, organizational founding, organizational synergy) and measure its impact on achieving organizational prosperity and its dimensions represented by (intellectual capital, innovation, infrastructure, organizational agility, sustainable competitive advantage). The research problem emerged by raising the main question, which is: Does the management of the researched company realize the importance of practicing strategic cohesion and its role in achieving organizational pros
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