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 primary goal of the study is to practise some systematic strategies for foreign language instruction despite the fact that no single approach to language classroom instruction is inherently superior to others; instead the choice of an approach should be determined by the teacher, students, the subject matter, and the situation. The paper adopts certain strategies which may assist EFL teachers to excel in their work and continue their professional development. Hence, it is intended for language teachers who understand the value of good teaching and like to produce academically successful students. The study could also help college student teachers to acquire new strategies in order not only to succeed but also to excel in their learni
... Show MoreBecloud stupefy computing is solid buzzword in the trade. It is timeless in which the advantage seat be leveraged on sound out miserable take into consideration reducing the indict and complication of grant providers. Cloud computing promises to curtail truly and opinionated retrench and approximately specifically concede IT departments focusing on moral projects as contrasted with of misery datacenters contention, It is unconditionally with than on the up internet. Give are sundry consequences of this put together. For the actuality remodeling in turn flock cause get revenge buyer be attractive to. This implies ramble they chaperone custody of servers, they carry out software updates and assistant on the condense user pay
... Show MoreVisual discourse in cinema and television is an expressive medium that carries its audio and visual elements and is effective in influencing the memory of the recipient, according to multiple patterns of forms and representations aimed at persuasion, influence, entertainment, enjoyment and knowledge. This speech will not pass by the recipient without difficulty, as the multiplicity of forms and techniques of image presentation and the diversity of contents derived from different beliefs, concepts, ideas and perceptions may sometimes reach intersections and conflicts, which is reflected in the form of the screen and the theory of television. This motivates us to know the ways in which audio-visual discourse is produced on television, whic
... Show MoreThis research aims to investigate the impacts of Quranic readings on the meanings of antonyms in the Quran, with considering the practical aspects that clarify them. The importance of this topic lies in clarifying the importance of the science of Qiraʼat, its great value and its high status. Moreover, this research sheds light on the relationship between Quranic readings and the antonyms words, following the descriptive approach in the study. The research has found several findings, the most prominent of which was: antonyms are linguistic phenomena that are proven to occur in Quranic readings, so each reading deliver a meaning that is opposite to the meaning learned from the other reading.In addition, Quranic readings are considered as
... Show MoreThis study aims to show the markers of the Arabic noun(genitive, nun nation articles,
vocative, definite article and predication). These markers distinguish the noun from other
parts of sentence. It alsoaims at showing why these markers are peculiar to nouns.
Schemata are the underlying connections that allow new experience and information to be aligned with previous knowledge. When one reads a text he usually uses all his levels of schemata. Schemata enable us to make sense of what is perceived and experienced in the world.
In poetry, readers usually examine carefully and deeply what they are reading in comparison with other sorts of discourse. Coherence is achieved when a reader perceives connections among schemata. It is a connection between linguistic and textual features of the text, and reader's mental expectations as well as stored knowledge of the world. This paper discusses the role of schematic correlation in poetry, and the effect of different schematic background and diffe
... Show MoreBackground: Shock is a common clinical state, we face chocked patients in causality, surgical and gynecological specialties like stab wounds, road traffic accidents, placenta preavia, placenta accrete, placenta pericreta, ectopic pregnancy, perforated viscus etc. All such patients undergo surgical exploration and majority of them are shifted to ICU to complete monitoring and support. High percent of them they develop acute kidney injury intra and postoperatively and carry high mortality rate because of not so good nursing care in ICU in Iraq.
Objective: to clarify that Furosemide can protect kidney function during shock and reduce ICU admission and mortality rate.
Method: 100 shocked patient were enrolled in t
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Tuberculosis continues to be the leading cause of morbidity and mortality, with an estimated annual incidence of 10.4 million worldwide. It has been estimated that 10% of patients with extrapulmonary tuberculosis have musculoskeletal involvement, with the spine being the most common. Spinal tuberculosis (TB) accounts for 50% of cases of musculoskeletal tuberculosis.
Spinal tuberculosis is the result of infection with Mycobacterium tuberculosis. It is a secondary infection, the primary lesion of which is in the lungs, genitourinary system, or gastrointestinal tract and can be active or latent. Involvement of the vertebral segment is the result of hematogenous spread of infection along the arterial pathway or Batson's vei
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The present paper studies the use of adjectives in Shakespeare's Sonnets (4, 5, 6, & 9), which are chosen randomly, on the three levels: grammar, lexis and conversation. It tackles adjectives as a literary term with presenting their forms and functions. The presentation is done according to the themes, their forms and functions in conversation, the adjectives are shown in this paper as for their forms, frequency and meanings in the sonnets and their effects on studying. The analysis is done according to Quirk et al. (1985) and Quirk and Greenbaum (1973). Then, all adjectives have been calculated in the sonnets. The results of the analysis have shown that compound adjectives which occurred (31) are used more than the Suffixation
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