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 world of Contemplations is a controversial concept among scholars, writers, thinkers and the public. The theory of the dialogue of souls indicates that souls communicate and think with each other despite the distances. Islamic studies have researched this concept, and this research paper aims to explain the concept of the world of Contemplations and what is the dialogue between God Almighty and the souls that God brought forth from the back of Adam and took from them the covenant and pledge to unify Him, and its effects on human life in this world. The researcher found that scholars and writers differ in proving the existence of the world of Contemplations despite the existence of examples of it in verses of the Holy Quran, and that the
... Show MoreThe current rasearch which is entitled " The stylistic change in Kandinsky and Mondrian paintings – A Comparative Analytic study-" deals with the nature of change concept, its mechanisms and its constructive disciplines. The research has four chapters: The first chapter deals with the methodological Framework represented by the problem of the research which is concerned with the stylistic change and its role in activating formative disciplines. The research aims at, finding out the stylistic change in Kandinsky and Mondrian Paintings.&
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The paper tries to explore the grammatical phenomenon of rankshift in Systemic Grammar, a functional grammar that establishes five units or the rank scale , : namely sentence, clause phrase, word and morpheme .Rankshift a Hallidayan term , occurs when a given unit is downgraded or shifted down the rank scale and operates further down its rank or a rank equal to itself as when a clause which has to operate in sentence structure operates at q “ qualifier” in a nominal group. The paper , quite significantly, introduces the systemic background that enunciates the systemic theory whose organising concept system rather than structure. The paper then, grammatically explores rankshifted elements, successive rankshifting, degrees of rankshifting
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AL- Shaam Bathrooms in the later Abbasyat Ages
Document clustering is the process of organizing a particular electronic corpus of documents into subgroups of similar text features. Formerly, a number of conventional algorithms had been applied to perform document clustering. There are current endeavors to enhance clustering performance by employing evolutionary algorithms. Thus, such endeavors became an emerging topic gaining more attention in recent years. The aim of this paper is to present an up-to-date and self-contained review fully devoted to document clustering via evolutionary algorithms. It firstly provides a comprehensive inspection to the document clustering model revealing its various components with its related concepts. Then it shows and analyzes the principle research wor
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G. tuberculosa is a newly recorded species from the Caryophyllaceae family for Iraqi flora, collected from the Arbil district from May to August. Morphological descriptions with macro and micro features illustrated with plates and dimensions, the species is related to G. pallida and distinguished from calyx properties, especially the presence of large prominent druses crystals. Keywords: Caryophyllaceae, Gypsophila, Iraq, New record, pallida.
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In this paper we generalize some of the results due to Bell and Mason on a near-ring N admitting a derivation D , and we will show that the body of evidence on prime near-rings with derivations have the behavior of the ring. Our purpose in this work is to explore further this ring like behavior. Also, we show that under appropriate additional hypothesis a near-ring must be a commutative ring.