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.
Background: The demand for esthetic orthodontic appliances is increasing; so the esthetic orthodontic archwires were introduced. Among them, Teflon and Epoxy coated stainless steel archwires. The amount of force available from the archwire depends on the structural properties and susceptibility to corrosion. All metallic alloys are changed during immersion in artificial saliva, chlorhexidine mouthwash andtoothpaste, but their behaviors differ from one type to another. They corrode at different rates, which lead to decrease the amount of force applied to the teeth. This in vitro study was designed to evaluate the corrosion pits in stainless steel archwires coated with Teflon and with Epoxy in dry and after immersion in artificial saliva, chl
... Show MoreService companies always working to increase their competitiveness and efficiency of the survival, growth and development in the present and the future, including insurance companies, so as to increase competition, especially after the emergence of the civil companies dramatically after 2003, has become the goal of recent studies carried out by the organizations is the human capital, because its success and excellence and achievement its objectives depends on the human, and this does not mean that the other components are not important, but also rely on the rights which has increased interest in the search for the way in which they can guide the behaviors and values and their own language in line with the organization's strategy an
... Show MoreThe digital communication of a product of communication and information revolution. It is characterized by accurate and comprehensive in its services and its effects, which brought changes in the structure of many communities and their organizational structures. They have significant impacts on the social systems and social relations, especially in the Arab societies, which are the focus of the globalized Western media, for many reasons: economical, political , cultural and social.
According to this perception, the Arab identity has become in an encounter with big challenges by the globalized media of trade and the media, which aims to achieve greater profits because of identity and its importance to the communities. This occurs par
The goal of current research is to identify the difficulties in the application of modern physics in the middle schools of the province of Baghdad schools from the perspective of teachers of physics trends, sample search of (127) teachers, Karkh Third Directorate, and use Researcher questionnaire data collection tool after applying it to teachers who have experience (5) years and more after confirmation of the validity and reliability of the scale (the tool) researcher has used the averages for the purpose of interpreting the results. the results showed that the difficulties have been in the order following: (difficulties related educational environment of modern trends of teaching, curriculum-related dif
... Show MoreMarketing Intelligence is one of the important methods of collecting information about competitors ' products and changes in customers ' tastes and needs that contribute to determining the policies to be followed in product development.
The problem of research, which seeks to be answered by the extent to which the companies in question have the appropriate and effective mechanisms to develop their products, and the nature of the relationship between the components of marketing intelligence and new product development policies. The importance of research is determined by the importance of obtaining important and necessary information to make the appropriate decision on the development of the new product an
... Show MoreThe aim of the research is to identify the role of public relations in promoting tourism by the Palestinian tourism and travel companies in Gaza from the public relations officer’s point of view in those companies.
The researcher used the descriptive analytical method as the most appropriate for such studies and implemented the questionnaire as a tool to obtain the required data from the respondents.
The Researcher reached several conclusions:
1- There is a low percentage of women working in the field of public relations in Palestinian tourism establishments in the Gaza Strip, where the percentage did not exceed 5%.
2- The interpersonal communication counted as one of the elements of integra
The aim of the present study is to examine the effectiveness of a proposed unite in voluntary work in enhancing critical thinking skills and the attitudes towards responsible citizenship among eighth grade female students in the Sultanate of Oman. In order to collect the study data, the researchers employed a quasi-experimental research design with twenty female students from Al-Sideeqah bint Al-Sideeq for basic education school. The research data were collected via a critical thinking test that consisted of twenty-five items and a scale of twenty items under three different dimensions, which aimed to measure students' attitudes towards responsible citizenship. The researchers implemented these two instruments as pre- and post the experi
... Show Moreإن تجسيد الشعراء للجمال واقامته تمثالا مصورا مرئيا ، كان الهدف منه اولا اشاعة جو نفسي مريح في مقدمات قصائد المديح ، فهو الجزء البصري الممتع لمدركات حسية اخرى ترافقه، وأما المرامي الاخرى
ﻓﮭﻲ إﻣﺘﺎع اﻟﻨﻔﺲ إﻣﺎ ﺑﺎﺳﺘﺮﺟﺎع أﺟﻤﻞ ﺻﻮرة أو أﻧﻤﻮذج ﻗﺎﺋﻢ ﻓﻲ اﻟﺬاﻛﺮة، وﺟﻌﻠﮫ ﯾﺤﯿﺎ ﻣﻦ ﺟﺪﯾﺪ ﻟﺪواﻋﻲ اﻟﺤﻨﯿﻦ للاماكن والازمنة الاثيرة . أو الميل للتعبير عن الوعي الجمالي الذي يتصل بموضوع الج
... Show MoreMost real-life situations need some sort of approximation to fit mathematical models. The beauty of using topology in approximation is achieved via obtaining approximation for qualitative subgraphs without coding or using assumption. The aim of this paper is to apply near concepts in the -closure approximation spaces. The basic notions of near approximations are introduced and sufficiently illustrated. Near approximations are considered as mathematical tools to modify the approximations of graphs. Moreover, proved results, examples, and counterexamples are provided.