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.
The study aimed to explore the school principals’ servant leadership practices for primary teachers’ perspectives in the Sultanate of Oman, furthermore to investigate the differences in those practices attributable to variables (gender, qualification, educational stage, years of experience, governorate). The study relied on the descriptive approach, by employing the survey research design using the questionnaire as a main tool for data collection, which included five dimensions of servant leadership (altruism, humility, enhancing teacher development, emotional healing, commitment to community development), Data collected from (1094) teachers in basic education schools, and they were chosen randomly. The results of the study indicated
... Show Morehe present work, among other previous studies done in our lab, aimed to highlight the histopathological effect of S. xylosus peptidoglycan in comparison to LPS of E. coli. Materials and methods: One hundred and fifty urine specimens were collected from urinary tract infection patients visiting Baghdad hospitals. The histopathological effects of S. xylosus S24 peptidoglycan was studied in the urinary tract of female mice by injecting 5 animal groups at the following concentrations: 1000, 2000, 3000, 4000, and 5000 µg/mL. Another 5 groups were injected with 10, 25, 50, 75, and 100 ng/mL of E. coli (serotype 0128:B12) LPS. Results: Ten isolates were confirmed to be Staphylococcus xylosus. Histopathological study showed different pathological
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Internal control is system,defined and implemented under its responsibility , which aims to ensure that; laws and regulations are complied with; the instructions and directional guidelines fixed by Executive Management or the Management Borad are applied; the company internal processes are functioning correctlly , particularly those implicating the security of its assets; Financial Information is reliable; and generally contributes to the control over its activities , to the efficiency of its operation and to the efficient utilisation of its Resources. By helping to anticipate and control the risks involved in not meeting the objectives the company has set for itself, the internal control system plays akey role in conducting & monito
... Show MoreMany economic entities working in multiple industrial fields suffer fromlow techniques in using modern administrative means in their works. The mostused tool in measuring required procedures is to adopt and use quality costs. inspite of complications and bronchial of operations in construction projects, Theresearcher was able to find a structure to quality costs according to traditionclassification (prevention, Appraisal, failure) which enables the calculation ofthese costs and then analyze results and setting standards which can beimplemented in evaluating strategic performance for targeted project. and theforge research in theoretical fly to quality and costs concerning it inconstruction section , as well as strategically performance a
... Show MorePlanning budgets are one of the methods used by the administration in controlling the elements of costs represented by (direct material costs, direct wage costs, and indirect manufacturing costs), and their importance lies in that they reflect what the activity of the economic unit should be in the future. In order to achieve the objectives of the economic unit and to solve this problem, the research was based on the following hypothesis (the role of planning budgets in controlling the elements of costs). , and thus the ability to reduce these costs and thus achieve profits by increasing sales and increasing market share, and the need to urge the state to support the company and the manufacturing sector, which helps and contributes
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The current research aims to focus on strategic vigilance dimensions and contained (environmental vigilance, technological vigilance, competitive vigilance, vigilance marketing) to improve nursing services, which include a) the quality, timeliness, problem-solving and decision-making, relationships with others, leadership skills) and measure the degree link and influence between strategic vigilance in the hospital respondent and improve nursing service that the problem of the research lies in the weakness of strategic plans and health organizations in general and the hospital surveyed (martyr Ghazi al-Hariri), in particular, the lack of awareness of the hospital researched strategy vigilant management to improve nursing services,
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The current study was designated to investigate the effect ofAllium sativumon some physiological and immunological parameters in rats. thirty adult rats were divided into three groups (10 rat for each). G1: served as healthy control, G2 :rats were treated with 150 mg\kg of Allium sativum, G3: treated with 300 mg\kg of Allium sativum. All treated animals were givenorally for 30 days. The aspartate , ) ALT ( alanine transaminase on some parameters were investigated such as garlic effects of total and differential counts of white blood , ) LDH ( lactate dehydrogenase ), AST ( transaminase cells(WBC) like Lymphocyte, Monocyte, Neutrophil, Basophil, Eosinophil,as
... Show MoreThe anatomical study of the epidermis leaflet for seven species and variety wild belonging to the genus Medicago L. species are: M. constricta Dur., M. coronata L., M. intertexta L., M. intertexta.var. ciliaris L., M. laciniata L., M. lupulina L., M. minima L. and M. sativa L. were studied, The search included epidermis characters and stomatal complexes addition to venation system in leaflets. It is revealed through the study, epidermis leaflet type Amphistomatic (the stomata spread on the upper and lower surface) as well as the presence of three types of stomatal complexes namely: Anisocytic (the guard cells surrounded by three unequal cell size), Anomocytic (not differential from subsidiary cells in epidermis) and Anomotetracytic (four ce
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In recent years, the positioning applications of Internet-of-Things (IoT) based systems have grown increasingly popular, and are found to be useful in tracking the daily activities of children, the elderly and vehicle tracking. It can be argued that the data obtained from GPS based systems may contain error, hence taking these factors into account, the proposed method for this study is based on the application of IoT-based positioning and the replacement of using IoT instead of GPS. This cannot, however, be a reason for not using the GPS, and in order to enhance the reliability, a parallel combination of the modern system and traditional methods simultaneously can be applied. Although GPS signals can only be accessed in open spaces, GP
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