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.
Multiple myeloma (MM) is a heterogenous plasma cell malignancy with various complications. Sclerostin is a Wingless-type (Wnt) inhibitor specifically expressed by osteocytes; it acts as a negative regulator of bone formation.
To assess plasma sclerostin level in MM patients and find its correlations with clinical and laboratory data, including osteolytic bone disease and international staging system (ISS).
This cr
The intellectual approach is manifested in communicating information and achieving it in the best ways and methods, and that the philosophy of the approach falls under the sociological dimensions on the one hand and on the other hand is linked to the visual language presented by graphic design through an informative visual discourse that includes behavior and prophecy as two main axes for integration in presenting social, guiding and indicative educational topics to complete the picture of the achievement. In front of the recipient, the goals of the design were achieved in addressing the topic (Corona Pandemic), which took a social and cultural turn, and also included politics and economics, and went beyond the limits
... Show MoreCoronary heart disease (CHD) is the leading cause of death in United State (U.S.). Controlling of modifiable risk factors such as smoking, hypertension (HT), diabetes mellitus (D.M.), dyslipidemia, physical inactivity & obesity will prevent other serious cardiovascular complications
The research aims to shed light on the role of SAIs and the nature of their work, with the definition of the concept of quality reports and to clarify the reality of quality in the FBSA reports, the researchers reached to conclusions, including: The quality of the SAI reports is a requirement seeks to achieve any regulatory system in order to develop audit work output of the form in which its impact is reflected positively on the performance of the entities controlled, and researchers gave a set of recommendations, including: the need to increase community awareness of the importance of the FBSA Supervisory reports through conferences, seminars and workshops and that FBSA to follow-up reports, and check the quality continuously to the fa
... Show MoreAcinetobacter baumannii (A. baumannii) is a major opportunistic nosocomial pathogen, mostly resistant to several groups of antibiotics. Colistin is now used as a last-line treatment for isolates that are highly resistant. The purpose of this study is to identify the importance of LptD; which is involved in the translocation of LPS from the inner membrane to the outer membrane in compartment with LptA and LptC of A. baumannii and its indispensable role as a virulence factor, and the efficiency of colistin as a monotherapy. In the current research, two isolates of A.baumannii were used, the local isolate HHR1 isolated from urine sample and the global strain ATCC 17904, and three antibiot
... Show MoreThe aim of this research is to identify the role of strategic agility achieving organizational excellence in one of the formations of the Ministry of Municipalities (Dhi Qar Sewage Directorate), as important service organizations that have a key role in serving and developing the society which faced many administrative challenges and issues and as a result of the changes in the environment is continuing and accelerating, so the adoption of modern administrative concepts such as strategic Agility and knowledge of their role in achieving organizational excellence can help them in facing these changes and achieve what they aspire to. In order to achieve research objectives, two main hypotheses have been formulated. The first hypothe
... Show MoreThis paper suggesting a new modern method to evaluate the performance of hotel industry at Jordan instead of the classical method used by the industry and that is Bench Marking , this method can be done by comparing the performance of hotel industry at two serial years which helps in calculating a standard performance .
The industry can use this standard to identify the variance, which make the evaluation of performance easier and support the efforts to develop the hotel industry at all levels and enable to give high quality services to customers.
The study believed that this situation would not be achieved unless the hotel industry will app
... Show MoreThe research aims to measure the relationship and impact of the operations of the knowledge of management of the six dimensions (diagnosis knowledge, define knowledge objectives, knowledge generation, knowledge storage, distribution of knowledge, application of knowledge) in the fiscal performance of the General Authority for taxes of the four dimensions (financial, customers (taxpayers), Operations Interior, learn and grow), the research aims also to the use of computerized programs for training and career development of the Authority that helps to add knowledge workers in the Authority, and to reach an appropriate arrangement for knowledge management processes in the Authority, as well as analysis of the reality of the Authority to get
... Show MoreAs Albizia lebbeck is one of the important species in Iraq and the region, its wood has subjected to investigation through the assessment of differences in its element dimensions and specific gravity under Baghdad conditions. Variations of fiber length, fiber width, cell wall thickness, vessel diameter, and density of wood were examined along the stem and horizontally. Results showed that fiber lengths were within the normal range, but their widths were narrower than common range of hardwoods. There were little increase in fiber length, width, wall thickness as the height position increased. Vessel diameter has been affected contrarily. No significant effects of height on specific gravity could be
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