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.
This research seeks to identify the dimensions of the development of staff performance (training ', incentives, management skills) and its impact on the settlement of compensatory claims adopted in the current research in the Iraqi insurance company،This research aims to highlight the role of developing insurance company’s workers’ performance in settling insurance compensation, and to check this process, the research was applied in the general Iraqi insurance company as it considered as the research community, and a sample was taken from this community that represented by company’s insurance department workers or by collecting actual data that is related to the research’s sample, in addition to the financial compensation data.<
... Show MoreThe study aimed to find out the relationship between the dimensions of internal control systems and the availability of an effective governance framework in the Sudanese banks. The study used descriptive and analytical method for collecting and analyzing the study data using SPSS program. The questionnaire was used as an analysis tool. The target sample of Sudanese bank employees, the study found several results, including that the bank avoids methods that lead to the rational use of available resources, and identifies and separation of tasks among employees, in addition to rapid response to reports The study found several recommendations, including the need for a list of banks that are sufficiently flexible and comp
... Show MoreThe internal observing system is considered a cornerstone for the high management in all the systems. It aims at defending the things for waste and increasing efficient and application the rules and regulations and constrictions. To easier for the high management activity in the internal observing system which in presented and practiced and to what extent can depend on it. Thus it goes to evaluate the internal observing system periodically to check the weak points in that system so as the find out the mistake, in the construction of the system or mistake, by indication of the workers. The importance of this study is represented in the need of increasing the coactivity in the internal observing system so as to be in touch with the new tre
... Show MoreThis study tries to examine a model involving human resources management practices, employees’ outcomes, governmental support, and organizational performance of small businesses in Malaysia. It was hypothesized that HRM practices will be positively related to the organizational performance (financial and operational), and that employees’ outcomes would serve as a mediator in the relationship between HRM practices and performance. Also it was hypothesized that the governmental support will be positively related to organizational performance. The statistical results on data gathered from a sample of 265 small manufacturing businesses will demonstrate the nature of relationships among the study variables. Theoretical and practical
... Show MoreAbstract Objectives: to determine efficiency and safety of three misoprostol regimens for 2nd trimester pregnancy termination in individuals with two or more cesarean section scars. Methods: a cross-sectional study included 100 pregnant ladies at 13th-26th weeks gestation with previous two cesarean sections (CSs) who were scheduled for pregnancy termination using misoprostol. Patients were conveniently assigned to 100µg/3h, 200µg/3h or 400 µg/3h regimens. Primary outcome was time to abortion, secondary outcomes were side effect and complications. Results: a significant association was found between number previous CSs and longer time to abortion (p=0.01). A highly significant association was identified between earlier gestatio
... Show Morehe study aimed to purify of Leucine aminopeptidase (LAP) from sera of hyperthyroidism patients and its relation to some thyroid hormones (TSH, T 3 , T 4 ) of subclinical hyperthyroidism and hyperthyroidism patients with lipid peroxidation levels that may be play a role in this diseases. Specimens were collected during the time from Nov 2017 until Jan 2018 from Endocrine and Diabetes Center, blood samples were collected from fifty healthy control and one hundred patients, patients were divided into two groups consisted of (50) with hyperthyroidism and (50) with subclinical hyperthyroidism. The aged for all subjects ranged (15-60) years with body mass ranged ((25- 29) kg/m 2 . The purification is done by addition of ammonium sulfate, dial
... Show MoreHypothyroidism is the decrease in thyroid hormones production and thyroid gland function. Hashimoto’s thyroiditis is the most common cause of hypothyroidism with production of autoantibodies directed toward autoantigens thyroglobulin (Tg) and thyroid peroxidase (TPO). This study was carried out to determine and compare serum and salivary levels of thyroid antibodies (TPO-Ab and Tg- Ab) in hypothyroid patients (with and without periodontitis) and healthy control; as well as to estimate the possibility to evaluate and measured these antibodies in the saliva as measured in the serum. Serum and saliva samples were collected from sixty hypothyroid patients with age ranged (20-64) years (30 of patients were with periodontitis and 30 without per
... Show MoreBackground: Recent studies suggest that chronic periodontitis (CP) and type2 diabetes mellitus (T2DM) are bidirectionally associated. Analysis of saliva as a mirror of oral and systemic health could allow identification of α amylase (α-Am) and albumin (A1) antioxidant system markers to assist in the diagnosis and monitoring of both diseases. The present study aims at comparing the clinical periodontal parameters in chronic periodontitis patients with poorly or well controlled Type 2Diabetes Mellitus, salivary α-Am, A1, flow rate (FR) and pH then correlate between biochemical, physical and clinical periodontal parameters of each study and control groups. Materials and Methods: 80 males, with an age range of (35-50) years were divide
... Show MoreBackground: Diabetic mellitus type ? is a metabolic disorder of diverse etiological factors, characterized by hyperglycemia resulting from an absolute deficiency of insulin affected childhood and adolescent. Some of these patients seek an orthodontic care .The orthodontist who is treating these medically compromised patients should have a working knowledge of the multitude of medically complex problems. This information will support and enable for delivery of high standards of dental care in general and orthodontic care in particular. The aim of this study was to analyze serum IgG levels and salivary secretory IgA (sIgA) levels in human dentine extract (HDE) before (T0) and 6 months after (T6) orthodontic treatment and to correlate anti-HDE
... Show MoreObjectives The gold standard in the field of periodontal research currently is to find a valid biomarker that can reliably be used for diagnosing periodontal diseases. Given the limitations of the current diagnostic tools that stall to predict susceptible individuals and determine whether active tissue destruction is occurring, there is an increased urge to develop alternative diagnostic techniques that would compensate for the problems inherited in these available methods, such as measuring levels of biomarkers present in oral fluids such as saliva; so the aim of this study was to determine the diagnostic potential of interleukin-17 (IL-17) and IL-10 to differentiate periodontal health