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.
Construction is the opening of the important pillars of the construction of the film as a whole for this, we find that the first of any narrative of my film begin at the borders of this construction is the window that we look through the contents tale and puzzle narrative is of significance that degrade traveler when reservoirs expression later in reasoning and find justifications ills that came by those initiation, this initiation may be the window that lead us to the core, understanding the story through signals received to the recipient to sail because of the paths of pickling what is which is encoded, but this initiation may serve as keys that understanding the be puppies and signals that beset and surrounded to what He holds inevita
... Show MoreThe first chapter includes introduce the research and the problem of the research that there are negligence of some educational institutions and schools management , some parents and supervisors .Also there are some educators who believes that school activities are obstacles means to learning and prevent pupils from studying and understanding the subjects. That may due to social , psychological and educational reasons
The purposes of the researches come from the reports of supervision visits which indicate a lot of difficulties faced by pupils and teachers related to education activities and its influence on in education and the necessity of indentify these difficulties and remedy them
... Show MoreIt is necessary to examine the nature of the Turkish position and what Turkey seeks to achieve at the international, regional and Iraqi levels. Or is this external role an expression of foreign policy and has not yet reached the level of maturity that reaches the stage of strategy? The answer to this question is the essence of research in the Turkish role. The answer to this question requires the realization of the elements and pillars that guarantee Turkey's continuity and survival. Continuity is a cornerstone of the strategy. The continuity of the role and its interaction with the event and the ability to employ multiple alternatives are what qualify the state to describe its politics. The external strategy has evolved into. In order t
... Show MoreFacing the receiver (critic) problematic understanding of modern art done, which turned positive professional image to symbolic language, which gave it authenticity previous Arts advantage, and this latest progress in critical reading contemporary and several mechanisms for analyzing literary texts and plastic, including textural fabric. And we suffer from the absence of cash the recipient culture (learner), so the current search goal focused on detecting structural mechanisms formative (Goldman) reading done modern art and its role in raising criticism knowledge (learner). Defining the theoretical framework of chapter II by discussing it; the first episode dealt with the textural fabric, while the latter was accomplished Studio talk, an
... Show MoreThe purpose of this paper is to identifying some of the physical, kinetic and electrical capabilities of the working muscles of patients with simple hemiplegic cerebral palsy, preparation of special exercises (rehabilitation and water) accompanied by symmetrical electrical stimulation in the rehabilitation of working muscles for patients with simple hemiplegic cerebral palsy, and identifying the effect of exercises, especially (rehabilitation and water), accompanied by symmetrical electrical stimulation, on some physical, kinetic and electrical capabilities in rehabilitating working muscles for patients with simple hemiplegic cerebral palsy. The researcher used the experimental approach with a one-group design with two pre and post-tests du
... Show MoreBackground: Dental caries is a localized, progressive destructive, largely irreversible microbial based disease of multifactorial nature; these factors include (host, microbes and food) they influence differently on the initiation and progression of dental caries. The aims of the study: was to evaluate the effect of smoking on salivary flow rate, secretory immunoglobulin (SIgA) level and viable count of mutans streptococci (M.S) bacteria in oral cavity and their relation to dental caries experience. Material and method: The samples were collected from 80 male students ranging in ages from 18-22 years old. Where they divided in to two groups, 40 non-smokers (control group) and 40 smokers (study group). Unstimulated salivary samples were c
... Show MoreAtrial fibrillation is associates with elevated risk of stroke. The simplest stroke risk assessment schemes are CHADS2 and CHA2DS2-VASc score. Aspirin and oral anticoagulants are recommended for stroke prevention in such patients.
The aim of this study was to assess status of CHADS2 and CHA2DS2-VASc scores in Iraqi atrial fibrillation patients and to report current status of stroke prevention in these patients with either warfarin or aspirin in relation to these scores.
This prospective cross-sectional study was carried out at Tikrit, Samarra, Sharqat, Baquba, and AL-Numaan hospitals from July 2017 to October 2017. CHADS2
... Show MoreAbstract:
This study aims to identify the level of patients’ satisfaction among a sample of hospitalized patients in the targeted hospital (Al-Kindy Teaching Hospital, and Al-Yarmook Teaching Hospital). Moreover, this study highlights the reality of services for patients, especially in the targeted governmental teaching hospitals. The Patient Satisfaction with Nursing Care (PSNCS) has been measured in these hospitals through the revised scale by Tang et al, (2013).This scale includes four major domains; Health Information (5 items), Influencing Support (4 items), Decision Control (4 items), Specialized Technical Competence (7 items). The method of surveying patients’ opinions about the degree
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