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.
Staphylococci are common commensals in human beings, yet certain species are pathogenic. Staphylococcus aureus, particularly, is a very virulent human pathogen. The capacity of staphylococci to sense the density of bacterial cell, i.e., quorum, and thereafter respond via genetic modifications is attributable to one primary mechanism known as accessory gene regulator (Agr). Agr's extracellular signal is a peptide that is posttranslationally modified with a thiolactone molecule. Agr is in charge of the upregulation of numerous exotoxins and hydrolyzing enzymes, as well as the downregulation of many colonization determinants, under circumstances of high cell density. This modulation is critical for the scheduling synthesis of virul
... Show MoreThe title of the research (the occasion in Surat Maryam) highlights the importance of the subject because he is studying Surah from the wall of the Koran, and that the best times of preoccupation with this light shown, study and thoughtful, and the reason for choosing the topic that the occasion of science helps in understanding the Almighty God in his book, and not Falling in confusion or error, or exaggerated interpretations, and be the key to knowing the rule of the Koran and repeating it, but the results of the conclusion that the occasion has many benefits: including making parts of speech taking each other's necks, strengthens that link and the authorship becomes his case in the case of tight construction , And that the occasion of
... Show MoreContemporary researchers realized the importance of the title. Many researches and studies concerned in titles and their analyses on the structural, semantic and pragmatic levels have been developed. Title gives a vital assistance to control the text harmony and to understand its vague aspects. It is the axis which re-generates itself, grows, and re-produces itself; as if it were a head for a body.
Title has strong relation to the reader- waiting horizon, multiplies as many levels of understanding are there. The horizon of waiting is limited by the title, basically, to be the first reason for the text entrance, as the first thing attracts the reader is the title.
Approaching title scientifically and objectively is impossi
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Abstract :
The study seeks to highlight the importance of moderate religious discourse and dialogue and the rejection of extremist discourse that renews the crises and wounds of history. And that is through the means and efforts exerted, which is changing the extremist religious discourse to a moderate religious discourse, as well as calling on religious figures, whether they are followers of Judaism, Christianity or Islam, to search for a common ground for understanding and coexistence, because extremism in the name of God is the enemy for all and not for countries or religions in particular.
Also, through the necessity of confronting terrorist threats by making more efforts
... Show MoreThe city of Jalawla is the administrative center of Jalawla district. It is located in the district of Khanaqin with a population of 62117 inhabitants in 2018. The city of Jalawla suffers from an imbalance in the geographical distribution of educational services among the residential neighborhoods. There are only two schools in the camp district According to the city's population, if the city of Jalawla needs eleven kindergartens and needs one primary school, eight middle schools, two preparatory schools, three secondary schools and two vocational schools. Despite the low share of the teacher or teacher for the number of students (25) students Enrollment in schools for the school of high school athletes and school students. Which determi
... Show MoreBackground:The document on hypertension in the elderly promoted by the American college of cardiology and the American heart association (ACCF/AHA) was written with the intent to be a complete reference at the time of publication on the topic of managing hypertension in the elderly. More recently, the European society of hypertension (ESH) and the European society of cardiology (ESC) issued the 2013 ESH/ESC Guidelines for the management of arterial hypertension, followed by The 2014 Canadian Hypertension Education Program (CHPE), and the Eighth Report of the Joint National Committee (JNC8), all of which has endorsed specific recommendations for the management of elderly hypertensive patients.
The research shows that the visual image plays an important role when Farzdaq in the issue of aesthetic perception, it enables him to feel a sense of artistic and mental perception to raise astonishment and admiration through his ability to link the optics through the suggestive image to carry us to a new vision imagined full of visual images.
Background: Bone cutter is widely used in the
Middle east area to cut the prepuce during circumcision.
Results :One hundred twenty one male neonates
were included in this study.The mean operative
time (MOT) was 6 minutes, mean time of
healing (MTH) was 5 days, 7 cases (5.9%)
developed early & late complications, 2 (1.7%)
had bleeding, 3 (2.5%) developed infection, 2
(1.7%) developed late complications in the form
of meatal stenosis.
Settings:Al-Yarmouk Teaching Hospital and a
private surgical clinic.
Aim of the study: To assess the safety of
circumcision using bone cutter.
Methods: Over 6 years period from Jan. 2000
till Dec. 2005, one hundred twenty one male
neonates were circumci
Although text document images authentication is difficult due to the binary nature and clear separation between the background and foreground but it is getting higher demand for many applications. Most previous researches in this field depend on insertion watermark in the document, the drawback in these techniques lie in the fact that changing pixel values in a binary document could introduce irregularities that are very visually noticeable. In this paper, a new method is proposed for object-based text document authentication, in which I propose a different approach where a text document is signed by shifting individual words slightly left or right from their original positions to make the center of gravity for each line fall in with the m
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هذا البحث يتحدى الافتراض القائل أن العراق بعد عام 2003 يجب دراسته بمعزل عن ديناميات التي سبقت عام 2003، اذ تبرهن هذه الدراسة على ان الشعبوية هي احدى الديناميات التي تمظهرت بصورة شعبوية استبدادية في النظام الديكتاتوري، نظرًا لأنه كان زعيم حزب علماني وعربي على نطاق واسع، لكنه استخدم الدين والقومية بشكل استراتيجي وانتقائي في ظروف معينة، مما خلق سياق الشعبوية الحديثة. الموجة الثانية هي الشعبوية العرقية والطائف
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