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.
This research has come out with that strategies made by Porter as generally strategies applicable to any size and type of economic units cannot be applied to many of the economic units in the world in generally and in Iraq especially not a lot of economic units have the resources and competencies that enable them to provide a unique product of its kind in the minds of customers and then adopt a differentiation strategy and not a lot of economic units have the resources and competencies that make them the cost leader. Differentiators and cost leaders are minority in the world while not differentiators and not cost leaders are majority in the world.
The economic units are not differentiators and not c
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Cytokines are A type of protein that is made by certain immune and non-immune cells and has an effect on the immune system. Some cytokines stimulate the immune system and others slow it down. Interleukins (ILs) can be divided into several families with more than 40 subfamily members. They can interact with a variety of cells that alter the immune system and act on a wide range of cancers. In the past several years, ILs have attracted substantial attention because of their distinct roles in CRC that provide a new and promising strategy for CRC. In general, ILs facilitate CRC by promoting tumorigenesis, tumour growth, angiogenesis, and cancer cell invasion and metastasis and inhibit CRC via complex pathways. The Bioassay Technology Human Inte
... Show MoreSome may think that the games, especially the folk games, are just a means of entertainment and fun and children may resort to them to alleviate the tension they are experiencing at home or school, but the truth is that they carry values and meanings that can be invested in education because they contribute to the development of the personality of the child and enhance self- confidence. The objective of the research is to learn how to use folk games to develop children's acting and performance skills in the kindergartens.
The research included a theoretical introduction of three sections: the first section: education through play. The second section: the folk tale and the development of imagination and the
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Summary Kidney transplantation is widely performed nowadays as an optimal treatment of end stage kidney diseases. Complications such as stenosis in graft renal arteries anastomosis may occur. Different suturing techniques are available for renal artery anastomosis. We aimed to compare the incidence of renal artery stenosis of the transplanted kidney when two suture techniques (continuous or interrupted) used for renal artery anastomosis. Therefore, a retrospectively comparative study was conducted on 44 patients managed with kidney transplantation during the years 2009-2011. Patients assigned into two groups; first group included 20 patients namely, continuous suture group, and the second group included 24 patients in whom the allograft art
... Show MoreThe objective of this study is to analyze the difficulties faced by intermediate-level Iraqi students in the use of Spanish unstressed pronouns as a foreign language (ELE). Through a mixed methodology, a descriptive and explanatory analysis was conducted based on written and oral productions of B1-level students at the University of Baghdad.The results show that factors such as interference from the native language (Arabic) and English, as well as grammatical differences between Spanish and Arabic, generate difficulties in the correct use of unstressed pronouns. A contrastive teaching approach is proposed that takes advantage of students' cognitive abilities to highlight similarities and differences between both languages.This stu
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This reaserch seeks To answer Wondering :(Is there a possibility employ strategic agility In companies sample Serving in Iraq ?)
This reaserch aims: explore Strategic Agility rely upon Dimensions that interact with each other to form the intcllectual frame Strategic Agility, These dimensions are: (Clarity of vision, Selected
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The research aims to determine the principles of total quality management (commitment of senior management, product planning, customer satisfaction, process improvement) and its role in promoting employee loyalty through a sample survey of the opinions of managers in public redemption Company. Which amounted to (45) individuals adoption of the questionnaire as a tool head in collecting data and information and their responses were analyzed using several statistical methods, which included (arithmetic mean, standard deviation, correlation coefficient, and the coefficient of simple regression) depending on the program (spss). The research found a group of the most important conclusions from the presence
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Technology developed at very rapid paces in the last decade of the twentieth century and what followed, especially communication technology, as the World Wide Web appeared in the mid-nineties of the last century, Facebook in 2004 and 2006, the mobile phone, 1993, 1994, and social networking sites. The other. These technological developments have had an impact on societies, whether among individuals in one country or among different peoples. The citizen in any part of the world has become a journalist who practices the work of a specialized or professional journalist, even if he does not know how to read and write, or has a low level of education, as he can now transmit events from wherever he is to the world, through his personal page, or v
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