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 search aims to find out the most important requirements for the success of marshes investment and maximize the expected returns of investment was marked by a problem find aquestion for availability requirements necessary for the success of marshes investment has a research community owners decision in the province Maysan the most important conclusions to the search is that the investment great importance in support of the economy and raising the cultural and social level, there is no investment successful but only with configure the investment environment appropriate economic, social, cultural, political, and security ways. the most important recommendations are working on the provision of the investment environment appropria
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BACKGROUND: In pregnancy, several physiological changes occur that lead to decrease in the level of hemoglobin. Anemia during pregnancy is a major public health concern in underdeveloped nations, with a high rate of morbidity and death among pregnant women. Inadequate prenatal care, a lack of information about the nutritional requirements of pregnant women, and general low socioeconomic circumstances all contribute to these high rates of morbidity and death. As pregnant women’s and husbands’ education levels increased, the frequency and severity of anemia decreased in the investigated community of pregnant women. AIM: This study aims to find out the level of knowledge about anemia in pregnancy among adult females attending pr
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This study concerned with phytochemical investigation and methods of extraction and separation of active constituents from Valeriana officinalis plant cultivated in Iraq. Due to the large number of active constituents in Valeriana officinalis, it was necessary to make analytical study of its constituents to determine the chemical nature of these constituents and then determine the main classes (terpenes and iridoids) using chemical reagents specific for each class. Different organic solvents like ethanol (70%) used in soxhlet apparatus and hexane, ethyl acetate and methanol were used separately to extract the main active constituents by maceration. Through comparison between these solvents using thin layer chromatograph
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Abstract
This paper deals with the concept of electronic reference services in academic
libraries , showing forms of communications , training needs for reference librarians
and the role of the librarian in the new technological environment.
مع ان افلاطون في الفصلين السابع والعاشر من جمهوريته يعري المسرح بوصفه عالما زائفا يعج بالأخيلة التي يتوجب على المرء ان ينبذها ويتمسك بعالم الحقيقة، الا إن هذا لا يعدم الأثر البالغ الذي تركتهُ أرائهُ على المسرح، قديمهُ وحديثهُ،تجربهً وتنظيرا .إن حكايته الإستعارية للكهف ،والتي تعد مسرحةً للأفكارِ، إن هي إلا وسيلة ينفذ من خلالها الى جوهر المسرح. لذا فان مسرحية ونظرية الكهف قد اصبحت حجر الزاوية في ما قد اص
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Abstract
Through social service tasks for the elderly, it natural for elder people to have some attitudes about the quality and nature of provided services, whether negative or positive. Accordingly, the current research is an attempt to investigate the attitudes of the elderly toward the social service provided to them in the nursery homes. The research sample included 60 elderly people chosen from the nursey home at Al-Karrada district and then a scale of attitudes was administered to them that had proved its reliability and validity. The study concluded with a set of recommendations and suggestions were.
The need to create the optimal water quality management process has motivated researchers to pursue prediction modeling development. One of the widely important forecasting models is the sessional autoregressive integrated moving average (SARIMA) model. In the present study, a SARIMA model was developed in R software to fit a time series data of monthly fluoride content collected from six stations on Tigris River for the period from 2004 to 2014. The adequate SARIMA model that has the least Akaike's information criterion (AIC) and mean squared error (MSE) was found to be SARIMA (2,0,0) (0,1,1). The model parameters were identified and diagnosed to derive the forecasting equations at each selected location. The correlation coefficien
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The reserve estimation process is continuous during the life of the field due to risk and inaccuracy that are considered an endemic problem thereby must be studied. Furthermore, the truth and properly defined hydrocarbon content can be identified just only at the field depletion. As a result, reserve estimation challenge is a function of time and available data. Reserve estimation can be divided into five types: analogy, volumetric, decline curve analysis, material balance and reservoir simulation, each of them differs from another to the kind of data required. The choice of the suitable and appropriate method relies on reservoir maturity, heterogeneity in the reservoir and data acquisition required. In this research, three types of rese
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