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.
Often requires the investor to know the result of the company's activity contribute to the investor or by wanting to invest in them because profit or loss of the company affect positively or negatively in the price of shares of the company and with the end of the fiscal year delayed companies often to issue its financial statements after it is approved and audited by an observer External Auditor, From here came the idea of research that appears to stakeholders of financial statements proactive appear, including actual figures for earlier stages have been prepared lists about lists and planned by the administration reflect the results of its phase remainder of the year as if they are (half a year or season or month) to offer At the
... Show MoreThe importance of research is to be considered by highlighting the tax policy in Iraq which extended for successive measurement of the amount of tax receipts for respective periods, the research problem represents security, economic and political issues that Iraq suffered which were very difficult since Nineties of the last century until now that led to a lake of clarity in tax policy trends, volatility in it and finally reflected on the tax revenues increase or decrease. One of the main recommendations of the research is: (The necessity to develop a deliberate strategy for tax policy in Iraq which should take into account financial, economic, and social goals in appropriate way).
Current research sought to evaluate the performance and results of employees in accordance with normative to people and people result for the European model of excellence EFQM 2013 quality management Foundation in the Inspector General's Office/Ministry of health, so as to pursue a modern and advanced management methods in evaluating performance and the performance of the Office's relationship with a citizen's life, since it takes him beyond the accepted service capabilities today, but it became budget duties between dealers servicing responsibilities and future planning, financial control, competitiveness, human resources needs and maintaining quality and continuous improvement and development as well as The primary role of the
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Background: The novel coronavirus disease (COVID-19) is caused by Severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) which utilizes angiotensin converting enzyme2 (ACE2) to invade the host cells. This membrane-bound peptidase is widely distributed in the body; its activity antagonizes the renin-angiotensin-aldosterone system (RAAS). Once SARS-Cov2 enters the cell, it causes downregulation of ACE2, resulting in the unopposed activation of RAAS. The unregulated activity of the RAAS system can deteriorate the prognosis in COVID-19 patients. A soluble form of ACE2 (sACE2) was reported to have a role in the SARS-Cov2 invasion of the susceptible cells.
Aim of the study: This study aims to inve
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This research aims to clarify the conceptual framework of social entrepreneurship shows the importance of the development of social entrepreneurship according to the contextual aspects and the social value achieved from these works. It also identifies the degree of level of a sample of women entrepreneurs in Iraq for the extent of the relationship between social entrepreneurship and women's empowerment. It also explains the impact of entrepreneurial work in empowering women and the extent to which there are individual differences between the average scores of the sample members’ estimation of the level of social entrepreneurship according to social status, age group, educational qualification, and specialization according to the s
... Show MoreAchieving goals effectively reflects the success of the institution. However, unless this indicator is coupled with efficiency when achieving goals, the institution will be equal in its achievements, and distinction will remain unachieved. Perhaps the role of the teaching staff in pushing the institution or college towards brilliance focuses on their ability to motivate people on the one hand and their interest in achieving brilliance for the institution. On the other hand, the importance of the research lies in the institution’s reaching a prominent position through the brilliance and creativity of teaching and achieving competition between institutions that make it more brilliance. The study seeks to achieve the goal of the real
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Darcy-Weisbach (D-W) is a typical resistance equation in pressured flow; however, some academics and engineers prefer Hazen-Williams (H-W) for assessing water distribution networks. The main difference is that the (D-W) friction factor changes with the Reynolds number, while the (H-W) coefficient is a constant value for a certain material. This study uses WaterGEMS CONNECT Edition update 1 to find an empirical relation between the (H-W) and (H-W) equations for two 400 mm and 500 mm pipe systems. The hydraulic model was done, and two scenarios were applied by changing the (H-W) coefficient to show the difference in results of head loss. The results showed a strong relationship between both equations with correlation coefficients of 0.999,
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Abstract
The logistic regression model is one of the nonlinear models that aims at obtaining highly efficient capabilities, It also the researcher an idea of the effect of the explanatory variable on the binary response variable. &nb
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The study aims at studying and analyzing the subject of marketing vigilance as it is one of the modern approaches in the marketing field that can be used to face changes in the competitive and strategic environment and that represents quick reactions on the part of the institution to ensure its survival and distinctiveness other aims are: Consolidating the strength of the marketing organization and its success continuously, represented by changes in the market share, awareness of the institution's position in the market and its relations with competing tourism companies, diversification of tourism services, as well as an analysis of the competitive strategic position of tourism institutions for the purpose of conducting a r
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