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 current research is concerned with a pragmatic study of attack and defense acts that are used by President Donald Trump in the American Presidential Debate in 2020. Attack is an attempt to harm or defeat someone, and it is a bold message that the speaker or attacker does not like or disagree with the other antagonist. On the contrary, defense means a person responds to an attack of his or her opponent. After an attack, the politician either negates or fact-checks claims made by his opponents or tries to set the record straight. By the end of the study, it is expected to answer the following questions: What are the most frequent strategies of attack and defense that utilized by President Trump to formulate his speech? What are the reason
... Show MoreThe Collapse of the Dreams in Ayad Akhtar’s Disgraced (2012) is a study that examines the theme of shattered dreams within the context of the play. Focusing on the protagonist Amir Kapoor, a successful Pakistani-American lawyer, and his journey from assimilation to self-discovery. This study explores the consequences of denying one's cultural heritage and the disintegration of personal aspirations. Through a close analysis of Amir's interactions with his wife, friends, and colleagues. This research investigates the underlying factors that contribute to the collapse of dreams and the unraveling of identity. By employing literary analysis and cultural criticism, the research sheds light on the complexities of cultural assimilation, racial i
... Show MoreTennessee Williams' The Glass Menagerie is peopled with powerless and defenseless characters. These characters are hypersensitive and in a constant search for protection. They are highly pressurized by life and its bitter reality. Adding to that they are haunted by their fear from the future. They are escapist who try their best to hide behind a protective shield. Their tireless search for security is never smothering. Their only possible defensive mechanism is to flee from their immediate hostile and aggressive surrounding. To achieve this aim, each character has improvised a method that suits him / her best. For example, one of the characters (Tom) sought refuge in alcohol and late night shows. While the other (Amanda) chose to re-live th
... Show MoreResults: it was found that labelled cells participated in the formation of myotubes, which formed mature muscle fibers, and possibly new satellite cells. The results of this experiment may eventually revolutionized therapeutic procedures for some form of muscle diseases
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The research, entitled: "The Development Theory of Women's Empowerment in Islamic Sharia Law ", aims to show the means of human development for women through the texts of the Quran and Sunnah. It talked about the concept of human development for women, the goals of women's empowerment in legislative texts, the goals of human development in empowering women, the developmental aspect of women in the Sunnah of the Prophet, the integration of development in Islamic Sharia Law , and then the conclusion and sources.
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