Endoscopic Versus Open Radial Artery Harvesting Used in Coronary Artery Bypass Grafting, Our Experience at Queen Alia Heart Institute Endoscopic versus open radial artery harvesting used in coronary artery

Coronary artery stenosis bypass by using radial artery is good techniques which have longer outcomes. In coronary artery bypass grafting (CABG) the radial artery has several advantages. The radial artery has a thick muscular wall which is more susceptibleto contraction from the competitive flow. As compared to the open harvesting technique endoscopic harvest of the radial artery has long lasting cosmetic results it also reduces the post-operative complications. The purpose of the study is to compare the two harvesting techniques and compare the short term and long term results related to intra-operative and post-operative outcomes Methods: This is retrospective study (In Queen Alia Heart Institute, Amman, Jordan) to compare endoscopic radial artery technique versus open technique by reviewing patients files through a period between June 2013 and June 2018. Total 50 patients of CABG surgery was selected they were divided into two groups. Group A includes endoscopic radial harvest (n= 10) and Group B includes open harvest (n=40). Data was collected on predesigned Performa. Data were entered and analyze through IBM SPSS 22.0 Results: There was insignificant dissimilarity between the pre-operative outcomes between groups. The Post-operative outcomes were almost same in both groups except hand numbness (P-value<0.005). The comparison of intraoperative outcomes like harvest time between both groups indicate that the mean harvest time in group A was shorter than group B (39.20 + 3.73 Vs 51.90 + 2.09, P-value=0.000). The operative time in group A was higher than the group B (306.0 + 11.6 Vs 278 + 4.25 p-value=0.00). The hospital stays in both groups were insignificantly different (p = 0.09) Conclusions: Endoscopic radial artery harvest is best suited technique for CABG surgery as it significantly decreases the harvest time as well as hospital stay. It is also proven that it is safer, less painful and better wound appearance technique with exceptional outcomes based on positive surgical experience.

Enabling a Mathematics Teacher to Teach for Conceptual Understanding

For many years a great deal of emphasis has been given to school-based teacher development programs. Some of these ideas have been implemented in developing countries like Pakistan by involving teachers in different teacher training programs. However, the mentoring process for teacher development where an experienced teacher, teacher educator or a mentor works closely with teachers on a one-to-one basis over a period, is still an emerging idea in developing countries like Pakistan This study was conducted to explore how a teacher educator, working closely with a mathematics teacher for eight weeks can enable her to teach for conceptual understanding. In order to achieve this purpose an action research approach was adopted. The study indicates that the mentoring process does help the teacher to enhance the content and pedagogy. This would be possible if a teacher educator and the teacher have jointly identified the areas to work upon during the mentoring process. This process would involve clarifying the teacher's own mathematical concepts, raising awareness pertaining to significance of conceptual understanding and introducing ways and activities of representing mathematical concepts to the learners. The classroom provides an appropriate learning situation and mentoring is a suitable process to support the teacher to develop personally and professionally in this context. The study presents a model of mentoring based on an understanding of the process that the teacher and the teacher educator/ researcher had undergone during the study. The study emphasizes that the teacher educator and the teacher both support and challenge each other and that could lead them to enhance their own teaching and learning process. However, this working relationship cannot exist in isolation. The mentoring process does need support from the school environment. For instance, co-operation from the Head, Head of the Departments, colleagues, students, parents and available resources.