Back ground: Chronic total occlusion (CTO) of coronary arteries remains one of the most challenging lesion subsets in interventional cardiology even with the development of medical devices and operator expertise. Successful revascularization results in improved in angina status ,increased exercise capacity and reduces the need for lat CABG surgery .
Objectives: This study sought to determine the overall procedural success rate of percutaneous coronary intervention (PCI) for CTOs and to examine the relation between variables such as; patients’ characteristics, risk factors, lesion characteristics and procedural success rate.
Methods: In this study ,clinical and coronary angiography data of (80) patients with CTO who underwent PCI between May 2009 and May 2010 in Ibn Al-Baitar Hospital for cardiac surgery and Al-Nassryia cardiac center were prospectively analyzed . The clinical data were collected using the patients files and angiographic data by review of their films.
Results: There were (80) Patients with CTO ,They included 62 men (77.5%) and 18 women (22.5%) ,Age range 36-76 year with mean age 55±8.75 and male to female ratio was 3:1 .The procedural success rate of PCI was 66 patients (82.5%). All 23patients(100%) with lesionlength less than 15 mm had successful PCI compared to 43 out of 57 patients in whom the lesion was more than 15mm (75.4%) p value < 0.01. The procedure was successful in 54 patients out of 60 with tapered stump(90%) compared to 12 out of 20 patients with abrupt stump(60%) p value <0.005.In CTO lesion with angulations less than 45 degree ,the procedure was successful in 27 patients out of 28 (96.4%)compared to 39 out of 52 patients in whom the angulations was more than 45 degree 52(75%) p value<0.01. The most common cause of procedural un success was inability of guide wire crossing through the totally occluded segments which represented 11(78.5%), Inability to cross the lesion with a balloon in 2 patients(14.2%) and inability to dilate balloon in one patient (7.1%) P<0.001.
Conclusion: Percutaneous coronary intervention of chronic total occlusion is an effective therapeutic procedure with high success rate 82.5%. The length of chronic total occlusion ,degree of angulations and stump morphology are strong predictors of success procedure.
Background:The most common pattern of dyslipidemia in diabetic patients is increased triglyceride (TG) and decreased HDL cholesterol level, The concentration of LDL cholesterol in diabetic patients is usually not significantly different from non diabetic individuals, Diabetic patients may have elevated levels of non-HDL cholesterol [ LDL+VLDL]. However type 2 diabetic patients typically have apreponderance of smaller ,denser LDL particles which possibly increases atherogenicity even if the absolute concentration of LDL cholesterol is not significantly increased. The Third Adult Treatment Panel of the National Cholesterol Education Program (NCEP III) and the American Heart Association (AHA ) have designate diabetes as a coronary heart dis
... Show MoreBackground: Recurrent laryngeal nerve injury is
an important post-thyroidectomy complication for
which different modalities of treatment were
practiced to lower its incidence.
Objectives: To estimate the incidence of
recurrent laryngeal nerve injury in thyroid surgeries
in relation to type of surgery, type of gland diseases
& nerve identification.
Methods: Different types of goiters prepared
preoperatively by indirect laryngoscopy, operated
upon with different types of surgeries, postoperative
direct laryngoscopy by the anaesthetist were done
and indirect laryngoscopy done as needed.
Results: Of of 200 patients, the overall incidence
of recurrent laryngeal nerve injury was 9
Patients (4.5%
The aim of the research is to know the level of time management application and its impact on the performance of the job, a survey search in the general company for communication and information technology and provide recommendations that help employees to optimize the use of time and improve performance, which is an important element in controlling the various functions of the company. In order to achieve the objectives of the research, the questionnaire was based on two main variables and distributed to a random sample of (44) employees in the company out of (308) employees, thus the proportion of the sample (14%). After collecting the samples from the sample, there are (6) incomplete forms that have been retri
... Show MoreChronic renal failure (CRF) is progressive irreversible destruction of kidney tissue by disease which, if not treated by dialysis or transplant, will result in patient's death. This study was carried out on 30 patients (17 male and 13 female) with chronic renal failure. The aim of this research was studied the changes in the level of total protein ,albumin, calcium ,ionized calcium, phosphorous , iron ,ALP, LDH ,CK and FFA in patients with CRF before and after hemodialysis .The obtained results have been compared with 30 healthy subjects as control group (18male and 12 female). The results showed that there was significant increase in the level of calcium ,ionized calcium, phosphorous ,iron ,ALP,LDH,CK and FFA ,while there was a signifi
... Show MoreThe purpose of this interview study was to explore teachers’ perceptions of Response to Intervention (RtI) implementation in their school. Particularly, the study explored teachers’ knowledge of RtI, teachers’ perceptions of RtI their intervention/instruction in school, and teachers’ suggestions of RtI implementation in their school. The study design was a qualitative interview in nature and data were collected from face-to-face interviews with four teachers in one school. The findings revealed that RtI means to identify students’ problems; the positive teachers’ perceptions of their implementation included: (a) students who demonstrate progress through RtI are those who receive private education services, (b) progress monito
... Show MoreOrganizational learning is one of the most important means of human resource development in organizations, but most of the organizations, especially public ones do not realize the importance of organizational learning enough, and estimated his role accurately in building intellectual capital, the resource competitive importantly for organizations of the third millennium and who suffers is other end of lack of understanding of its meaning and how to prove its presence and measured in public organizations, so there is the need for this research, which aims to investigate the effect of organizational learning its processes (knowledge acquisition, Information transfer, Interpreting the information, Organizational me
... Show MoreBackground: Mental health is integrated into PHC as a strategy of WHO to fill the gap in mental health treatment. Part of this strategy needs a level of task shifting so that mental health care is provided by different level of PHC workers and not only specialists such as psychiatrists and psychologists.
Objectives: To assess the knowledge and attitudes of family doctors regarding the provision of psychological health in PHCC and if there is an association between the certificates of these family doctors and their Knowledge and attitudes to psychological health.
Subjects and Methods: A cross-sectional descriptive study with analytic elements was conducted in 8 famil
... Show MoreSome physical and chemical characteristics of Jurf Al- Sakar drinking water plant in Babylon governorate have been studied. Seven locations for this plant were selected. These were the drinking water treatment plant source on Euphrates River before entering the plant, precipitation, filtration and collection tanks, and also after leaving the plant at distances of one meter, 4 and 8 km. The samples were collected bimonthly from October, 2002 to August, 2003. Some results match with the national and international standard characters while the other characters (Turbidity, total hardness, calcium, nitrate, phosphate and the biological oxygen demand values) were not match. The present study showed that drinking water treatment plant is undrinka
... Show MoreBackground: Patients with decompensated cirrhosis are often given therapeutic and prophylactic drugs. Polypharmacy raises both the likelihood of prescription errors and the complications associated with drugs. Clinical pharmacists are excellent at recognizing, addressing, and preventing clinically significant drug-related problems.
Objectives: Identification types of pharmacist interventions to address drug-related problems in patients with decompensated cirrhosis and assess the acceptance/implementation of these recommendations. And identify patient factors associated with accepting pharmacist recommend
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