Background: Laparoscopic cholecystectomy has many difficulties which include port Insertion, Dissectionof the Calot’s Triangle , Grasping of the Gallbladder , Wall thickness, Adhesion and extraction of theGallbladder. Aim of the Study: To predict how difficult cholecystectomy will be from assessing the patientpreoperatively which, in turn, help in decreasing the risks on the patients and preventing post-operativecomplications. Patients and Methods: A prospective study conducted in the department of General Surgeryat Al-Ramadi Teaching Hospital for the period of nine months from 15th of May 2018 till the 15th of February2019. It included 60 patients, all of them were undergone laparoscopic cholecystectomy for Gallstone. Patientswith common bile duct calculus, dilated common bile duct, current attack of acute cholecystitis, those withabsolute contraindications to laparoscopic cholecystectomy, The data were collected prospectively to predictthe significance of association with patients’ characteristics. The time of operation was calculated from thefirst port site incision until the last port closure. All the intra operative events were recorded. Conversionsto open cholecystectomy were done by median or subcostal laparotomy according to the surgeon’s decisionand each patient’s condition. Results: In this study, the highest proportion of operations was categorizedas easy (58.3%), 28.3% of operations were considered difficult and 13.3% of them were very difficult. Asignificant association (P < 0.05) between operation difficulty and all of the following characteristics: Aging,obesity, history of previous biliary hospitalization, thickened bladder wall, pericholecystic collection, andlarge stones. Conclusions: The difficult laparoscopic cholecystectomy can be predicted preoperativelybased on number of factors, like: obesity, previous biliary admission, gall bladder wall thickness, ultrasoundfindings (stone size and pericholecystic fluid) and aging process, evaluating of such factors minimize thecomplications of laparoscopic cholecystectomy and conversion to the open procedure.
Air pollution is considered one of the major environmental problems that contain many challenges and difficulties facing most countries of the world, including Iraq. The problem has emerged widely with the emergence of the industrial revolution in the world and the tremendous increase in the population and the increase in the number of transportation and its development in addition to excavation, maintenance and work Construction and weather fluctuations, such as dust and sandstorms, pollution resulting from oil refining, extraction, diversion and other processes that cause pollution, and the start of the world using methods that limit the volume of environmental pollution. The most prominent of these methods is the imposition of
... Show MoreThe liability limit liability limit and reinsurance re factors insurance are important in influencing the achievement of company's competitive goals and achieve success and excellence in the market and because the limit of liability and reinsurance aimed to increase output with the stability of inputs leading to increased insurance business and increase profits. The study was based on two variables presidents interact with each other to form the intellectual and philosophical framework has two ( the limit of liability and reinsurance ) . The study was launched from a problem expressed by a number of targeted questions answered from the elucidation of theoretical philosophy and intellectual goals of these variables and highlight the impor
... Show MoreAntibiotic resistance is the capability of the strains to resist or protect themselves from the effects of an antibiotic. Such a resistance towards the current antimicrobials leads to the search of novel antimicrobials. Nanotechnology has been promising in different field of science and among it is the use of nanoparticles as antibacterial agents. The gastrointestinal tract seems to be the primary reservoir of uropathogenic E.coli (UPEC) in humans. UPEC strains harbour the urinary tract and cause urinary tract infection. They cause serious ailments in terms of humans. They develop resistance and increase their virulence by forming biofilms. They also show a remarkable locomotory movement with the aid of autoinducer controlled ge
... Show MoreBACKGROUND Multiple myeloma (MM) is a plasma cell disorder characterized by the infiltration of clonal plasma cells in the bone marrow and the detection of a monoclonal immunoglobulin in serum and/or urine. Renal failure, anemia, hypercalcemia, and the presence of bone lesions are the hallmarks of the disease. The study aimed to evaluate the clinical, hematological, radiological, and immunophenotypic features of MM patients and to identify prognostic factors influencing survival outcomes. This cohort study included 77 newly diagnosed, untreated MM patients. Their clinical presentation, laboratory data, imaging results, and the expression of flow cytometry markers were analyzed in correlation with the 1-year overall survival (OS). The mean a
... Show MoreBreast cancer (BC) is one of the most frequently observed malignancy in females worldwide. Today, tamoxifen (TAM) is considered as the highly effective therapy for treatment of breast tumors. Oxidative stress has implicated strongly in the pathophysiology of malignancies. This study aimed to investigate the changes in the levels of oxidants and antioxidants in patients with newly diagnosed and TAM-treated BC. Sixty newly diagnosed and 60 TAM-treated women with BC and 50 healthy volunteers were included in this study. Parameters including total oxidant capacity (TOC), total antioxidant capacity (TAC), and catalase (CAT) activity were determined before and after treatment with TAM. The serum levels of TOC and oxidative stress index (OSI) were
... Show MoreWe studied the relationship between DNA sequencing of interleukin-10 (IL-10) gene promoter for -1082 (A/G) and -592 (A/C) positions with the concentration of IL-10 in blood serum of Iraqi children with type 1 diabetes mellitus (T1D). Fifty blood serum samples collected from children with age ranged between 7-12 years. Thirty-five blood samples collected from patient children with T1D, and compared with 15 healthy children age matched as control sample. The results revealed decreasing in anti-inflammatory IL-10 concentration in T1D patient’s blood serum (0.068 Pg/ml) as compared with the control sample (0.111 Pg/ml). No significant differences were found in interleukin concentration between the studied samples when they analyzed with the M
... Show MoreThis research aims to clarify the concept of doctrinal rules and adjust its basic terminologies. It further aims to lay down a map for the method of rooting this science by mentioning its rooted sources, in addition to drawing a miniature picture of its history, origin, formation and development. The paper ends with practical models to highlight its importance in rooting the science of nodal rules and facilitating the mentioning of its scattered discussions in a short and comprehensive phrase. The study further illustrates the pioneering role of doctrinal rules science in managing the doctrinal disputes, combining multiple sayings, and in bringing together opposing opinions. The study follows the inductive, descriptive and analytical app
... Show MoreThe insurance companies are one of the organizations that rely mainly on human capital to underwriting to insurable risks because most of risks have many variables, so the aim of the research is to show the level of interest of the researched company in human capital, the reality of the underwriting policy in it, and the relationships of correlation and effect between them, and the approach has been used Analytical descriptive, as books, research and other related sources were used for the purpose of completing the theoretical side, on the practical side, a questionnaire was prepared, which represents the main tool for collecting data and distributed to a random sample of 64 people from underwriting managers and employees in spec
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