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.
Background: Brush cytology is an accepted technique that gets renewed interest. It is now used as an aid for the diagnosis and observation of possible epithelial changes that could be associated with oral mucosal diseases. This study aimed to evaluate the cytomorphometric changes in gingiva and buccal mucosa of type II diabetics and to assess their relation to oral symptoms and glycemic status. Materials and methods: Cytological Papanicolaou stained smear were prepared from cheek and gingiva of 20 non treated cases, 20 treated diabetics and 20 healthy persons of both sex after measuring their HbA1c and recording their oral symptoms. Hundred unfolded epithelial cells were evaluated qualitatively using MCID software to measure nuclear and cy
... Show MoreIs hardly day expire without hearing the news either Abuse Managementthe accounting standards or the existence of serious misstatements by someauditors.Which caused the demanding of many companies in the recent republication of the financial statements and the re-announcement of its financialresults. Such acts raise questioning about the role that should be played by theauditors, prompting agencies responsible for setting auditing standards to takeTo throw increasingly responsibility on the auditors in order to interest risksfraud The Risks of Fraud in their review of the financial statements.also The Public Company Accounting Oversight Board in the U.S.called about the need of owning the Certified Public Accountants those whoaudits for
... Show MoreThe people lived under Mamluk rule, distress, poverty, famines, oppression of princes, rulers, And their domination and he always wished for a just ruler to relieve his misery, and remove the injustice
from him, so they found in Al-Nasser Mohammed tend to establish justice.
When Al-Nasser ascended the throne of the Sultanate, there was a rise or fall in prices, so he pursued Prices will end and punish those
who come out for it. And you talk about this search for a relationship
Sultan Al-Nasser with the poor classes in society and his keenness to pursue their affairs was compassionate On them, mer
... Show MoreRheumatoid arthritis (RA) is a common inflammatory disease that associated with increased morbidity and mortality due to accelerated atherosclerosis. Rosuvastatin is a unique hydroxy methyl glutaryl Co A (HMGCoA) reductase inhibitor that has anti inflammatory effects.
The aim of this study was to evaluate the effect of rosuvastatin as adjuvant therapy to methotrexate (MTX) on lipid profile and its possible cardioprotective effect in RA patients. A double blinded placebo controlled clinical trial with 8 weeks follow up periods at which 40 patients with active RA using MTX were randomized into 2 groups to receive either rosuvastatin 10mg or placebo as adjuvant therapy to MTX. In addition to twenty healthy subjects as control group.
... Show MoreThis research set to indicate the role of the opportunity cost in the overall economic development (human and social development) by selecting the most appropriate alternative for the growth of the country in exchange for sacrificing profit limits to achieve this growth and development of the country, especially in the present circumstances of the country and after studying the reality of the economic case for him, as the problem lies with don't selecting the best alternative that enhances the gross domestic product, which extends to promote overall economic development and revive the industrial and agricultural sectors, productivity is more like Impotent, versus sacrifice alternative consumption may bring more financially lucrative than
... Show MoreThroughput accounting is concerned with a throughput measurement process to determine the efficiency of the company, to know the problems and obstacles it suffers from, to determine their causes and ways to address them.The research problem is represented by the following question: does the application of a throughput accounting lead to maximizing the company's profits? The aim of the research is to demonstrate the importance of throughput accounting, which is one of the tools of management accounting in providing an efficient information system that provides the company’s management with the information it needs to improve its production processes, increase a throughput, and thus maxi
... Show MoreBackground: Periodontitis and type 2 diabetes mellitus are both considered as a chronic disease that affect many people and have an interrelationship in their pathogenesis. Objective: The aim is to evaluate the salivary levels of interleukin-17 (IL-17) and galectin-3 in patients with periodontitis and type-2 diabetes mellitus. Materials and Methods: The samples were gathered from 13 healthy (control group) and 75 patients split into 3 groups, 25 patients with type 2 diabetes mellitus and healthy periodontium (T2DM group), 25 patients with generalized periodontitis (P group), and 25 patients with generalized periodontitis and type 2 diabetes mellitus (P-T2DM group). Clinical periodontal parameters were documented. The concentration of IL-17
... Show MoreBackground: Coronary artery disease (CAD) is a major contributor to morbidity and mortality worldwide. Early-onset CAD, also known as PCAD, is a severe form of CAD associated with high mortality and a poor prognosis. Early diagnosis is crucial to reducing complications. While hsCRP is an established biomarker for CAD, kalirin is a potential novel biomarker due to its role in promoting smooth muscle proliferation and endothelial dysfunction. Objective: To evaluate the relationship between serum kalirin and hsCRP levels with the presence and severity of PCAD and to compare the diagnostic value of both biomarkers. Method: The study recruited 92 participants into two groups: the PCAD group (46) included patients with confirmed CAD by an
... 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