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.
Abstract
The current study was conducted to assess the effect of advancing age on total serum IgE level in asthmatic patients. To this purpose, 90 asthmatic patients and 30 healthy individuals ( control group ) were enrolled. Asthmatic patients were categorized into four groups. Group A consisted of asthmatic patients (9) whose age was more than 20 and up to 30 y. Group B contained asthmatics (13) of age more than 30 and up to 40 y. Group C comprised those (23) of more than 40 and up to 50 y. Group D consisted asthmatic patients (45) of age more than 50 y. Total serum IgE level significantly changed in group D patients when compared with those of
Objectives: ٨ descriptive study has been conducted in the premature baby unit in Al-Khansaa' and Al-Batool
hospitals for maternity and children in Mosul city to assess knowledge and practice of the nursing staff in the
caring of premature infants. A descriptive study has been conducted in the premature baby unit in Al-Khansaa'
and Al-Batool hospitals for maternity and children in Mosul city to assess knowledge and practice of the nursing
staff in the caring of premature infants.
Methodology: the data were collected by using knowledge assessment and practice measurement tool.
Results: the results of the study show that high percentages (about 40%) of the staff who work in the premature
baby units are of the young age
This study deals with the orthographic processing ability of homophones
which can account for variance in word recognition and production skills due to
phonological processing. The study aims at: A)Investigating whether the students
can recognize correct usage and spelling comprehension of different homophones
by using appropriate word that overlapped in both phonology and orthography.
B)Assessing spelling production word association to the written form of the
homophone in the sentence comprehension task. To achieve these aims, two tests
have been conducted and distributed on 50 students at first stage at the College of
Education(Ibn-Rushd) for the academic year 2010-2011. The two tests are exposed
to a jury of
The reconciliation of tax reconciliation is one of the legal methods used by the financial authority in Iraq, which is done with the taxpayer
The research dealt with the weakness of tax revenues for many reasons, including tax evasion, which led to the search for ways to reduce evasion to increase the tax revenue, and settlement reconciliation one of these means .
The research proceeded from the premise that the use of a more broadly settled settlement would govern the tax evasion of taxpayers.
The researchers used a series of studies and previous research, books and other sources related to the subject of research, and this was done through the theoretical framework, and the practical aspect that included the fin
... Show MoreAssessment of the in service behavior of asphalt stabilized subgrade soil under environmental impact has got little attention by the research workers. However, the sustainability of the roadway depends mainly on the welfare of its subgrade soil condition. In this work, Gypseous soil was stabilized with asphalt emulsion for subgrade usage, the durability of the mixture has been assessed in term of its ability to maintain the compressive strength when practicing the environmental impacts. Specimens of 38 mm in diameter , and 76 mm in height have been prepared with various water-asphalt percentages, and subjected to 30 cycles of (freezing-thawing), (heating-cooling) and (wetting-drying) processes. Specimens have been tested for unconfined comp
... Show MoreTwo groups of chronic hepatitis B and C virus patients were divided into Pre-treated patients (25 CHB patients with positive HBs Ag for more than 6 months and 40 CHC patients), and post-treated patients [12 CHB patients (4, 6, and 2 were treated with lamivudine, IFN-? and combination of LMV + IFN-? respectively), and 27 patients for CHC (3, 13 and 11 patients were treated with Ribavirin, IFN-? and combination therapy (RBV+ IFN-?) respectively].These patients were followed up for 6 months. By using ELISA technique, levels of IL-6, IL-10, IFN-? and TNF-? were measured in vivo and in vitro (supernatant of PBMCs stimulated with PHA) and compared with healthy control. The mean level of IL-6, IL-10 and TNF-? in CHB patients showed significant dif
... Show MoreAsthma is a chronic inflammatory disease of respiratory airways characterized by distinctive history of respiratory symptoms due to variable airflow obstruction which reverses either spontaneously or in response to certain medications. Acetylcholine is a parasympathetic neurotransmitter which plays fundamental roles in the development of persistent asthma. Treatment guidelines recommend using medium doses of inhaled corticosteroids in addition to another controller bronchodilator instead of using high doses inhaled steroid alone for treatment of moderate to severe persistent asthma. The inhaled long acting muscarinic antagonist, tiotropium, was approved recently to control unresponsive asthma to inhaled corticosteroid with or without a long
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