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.
Diyala Governorate has many unique and diverse geomorphological features that the region enjoys, which are among the attractions for natural tourism, as the natural environment is considered a maker of tourism. The importance of geomorphological aspects as components of natural tourism is due to their association with tourism and entertainment, as a result of the enjoyment of many geomorphological aspects of the beauty of its natural landscape on the one hand, and on the other hand, the association of these manifestations with different types of tourism activity. Any tourist area as it is the main factor for tourist attractions, such as the presence of the Hamrin hills, and sand dunes. Planning for the development of tourism activity in the
... Show MoreThis research began by explaining its variables and dimensions especially the digital gap, which the authors explained it elaborately beginning with the concept, the reasons blind its emergence of its measurement, and how to treat it. The authors supposed the potentiality of relying on enforcing knowledge in general and the groups suffer from this gap in particular, especially the targeted knowledge to treat its subject.
As enforcing knowledge usually depends on some strategies or choices of organizational orientation among them is learning and training from one side, and communication, as an indicating factor for organizational effectiveness as the authors refer from the other side.
في البداية اود الاشارة الى ان فهم حقيقة الازمة هو ذو جانب فني يتعلق بالجينات الوراثية لنظام يملك في احيناته قدرة عالية على تفريخ المشتقات. هذا النظام الذي يزداد عقما وتدميرا يزداد قدرة على خلق النقود الائتمانية/المشتقات، وكلما اقتربنا اكثر من فهم هذا الجانب كلما اسقطت في ايدينا تلك التوصيفات الاكاديمية الجاهزة في نقص الرقابة والاشراف، تركيز المخاطر،....الخ التي تناولتها الكتابات الشائعة في معظم طروحات
... Show MoreThis study was conducted at the Poultry Research Station of the Agricultural Research Department/Ministry of Agriculture in Abu Ghraib for the period from 25/2/2019 to 7/4/2019 (42 days) with the aim of using several levels of Spirulina (SP)
The research aims to achieve proof of convergence between optimal costs and standard costs in calculating costs for the economic unit, support efforts aimed at adopting optimal costs in cost accounts and accounting thought in general, and achieve benefit from the theory of convergence between optimal costs and standard costs in the field of achieving actual costs in The economic unit in order to reduce and converge, and this came to address the possibility of adopting the concept of optimal costs in the production costs calculations for the purposes of rationalizing administrative decisions, and rationalizing the preparation of financial statements within management accounting.
The research concluded that
... Show MoreAcademic writing is a key skill for success in academic life, particularly for graduate students of a foreign language. The importance of writing to academic culture, practice, and knowledge building has led to a great deal of research in many fields, including rhetoric and composition, linguistics, applied linguistics, and English for Academic Purposes (EAP). Often, studies and research investigating academic writing are motivated by the need to inform the learning of writing to native and non-native English-speaking students, through both descriptions of professional academic writing as well as through comparisons of novice writer (native and non-native Englishspeaking) and expert production. However, while learning about academic writing
... Show MoreThe aim of the research: To identify the trends of students of the College of Physical Education and Sports Sciences towards modern teaching methods. To determine the type of strategies used that students prefer in practical lessons. In light of the research results, the researcher adopted the descriptive method because it is appropriate for the study. The research community is represented by students of the College of Physical Education and Sports Sciences (fourth stage), amounting to (320) students. Conclusions: The research results indicate that students of the College of Physical Education and Sports Sciences have positive and strong attitudes towards using modern teaching methods, and they realize their reality in improving interaction
... Show MoreThis research sheds light on the development that has occurred on the use of press pictures in the Iraqi press by analyzing the form and content of the images used in (Al-Sabaah) newspaper for the 2012 model. The researcher's interest in this topic for what represented by the press picture of a way to highlight and attract the reader's attention to the substance journalist who represents the goals behind the newspaper publishing.
This research is divided into three sections. The first one dealt with the methodological framework of the research, and the second part addressed the aspect of press pictures and its history and technological development, while the third section devoted to the study of the development of the form and co
... Show MoreIraqi industrial units face strong competition due to many problems including1- high production costs2- weak interest in studying the market3- lack of government support for their products4- dumping the market with imported products with specifications and a competitive price as well as adopting the traditional cost system in calculating costs that do not provide appropriate information for pricing decisions Which requires studying and analyzing these problems and dealing with them by adopting modern technologies so that they can compete, so the research aims to show the knowledge bases of technology Activity- Based Costing, with an indication of the role of technology Activity- Based Costing in rationalizing the tax In, and the
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