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 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 MoreThe research seeks to highlight the importance of digital finance in banking by providing financial and banking services and its role in improving the access of financial services to customers at the farthest possible point by using modern technology to finance their needs by granting them cash credits through electronic payment tools to facilitate them and shorten time and effort as well as Low cost, and this cannot be achieved without concerted efforts and the provision of basic infrastructure that includes connecting the Internet to all targeted areas, whether cities or rural areas, as well as distributing the largest possible number of ATMs and sending specialized teams to those areas that develop in customers the culture of digital
... Show MoreABSTRACT: BACKGROUND: Left ventricular hypertrophy is a significant risk factor for cardiovascular complications such as ischemic heart disease, heart failure, sudden death, atrial fibrillation, and stroke. A proper non-expensive tool is required for detection of this pathology. Different electrocardiographic (ECG) criteria were investigated; however, the results were conflicting regarding the accuracy of these criteria. OBJECTIVE: To assess the accuracy of three electrocardiographic criteria in diagnosis of left ventricular hypertrophy in adult patients with hypertension using echocardiography as a reference test. PATIENTS AND METHODS: This is a hospital-based cross sectional observational study which included 340 adult patients with a his
... Show MoreThe study aimed at designing a training program by using training for the anaerobic differential threshold stand and the effects of those trainings on the variables of (Concentration of Lactic Acid and LDH Enzyme, VO2 MaX and Cortisol Hormone). The Researchers used the experimental program with one-group style. Also, they used a sample with (8) men-players in a (free 400 m men-runners) and they used many instruments and procedures, most notably the training-program prepared for 10 weeks and for 3 training units weekly, (70-90 min) for each unit. They used the training intensity from 85-100% of the player's ability. After finishing the training program and doing some pre-tests and post-tests then statistically checking the results, the resea
... Show MoreThe responsibility of the Central Bank through the implementation of its monetary policy to maintain the integrity and stability of the financial system and the economic system, because any shock, whether internal or external, may endanger the financial system and instability, so the research sheds light on the effectiveness of monetary policy in maintaining financial stability, The most important conclusion is that there is an increase in capital, which gives banks the possibility to face the risks to which they are exposed, as well as a rise in the total bad debts, which weakens its financial position, which constitutes a decline in the financial stability of these banks.
In globalization, the world became open area to competition for the attractive of investment, and the abilities of each country to win the confidence of investors depend upon the preparation to optimize circumstances. The competitiveness is an essential means of expanding the capacity of developed to coexist in an international environment characterized by globalization. While competition describes the market structure, the behavior of investors and business, competitiveness is interested in the evaluation of business performance or countries and compare them in the conditions of competition available in these markets. Regarding Malaysia, which is depend on FDI-Export- Led Growth strategy, it has taking on diffe
... Show MoreThe research addresses the role of the digital economy in the growth of the Iraqi economy during the period from 2010 to 2022. The research is based on the hypothesis that the digital economy has become one of the primary growth drivers worldwide and has a close relationship with economic development. Therefore, the digital transformation in Iraq can accelerate bridging developmental gaps with other countries.
It has become evident that the Iraqi economy suffers from structural imbalances for various reasons, hindering economic growth. These reasons include political and economic factors, as well as the absence of a well-thought-out policy to promote the agricultural sector, which is considered one of the fundamental sectors capa
... Show MoreThe responsibility of the Central Bank through the implementation of its monetary policy to maintain the integrity and stability of the financial system and the economic system, because any shock, whether internal or external, may endanger the financial system and instability, so the research sheds light on the effectiveness of monetary policy in maintaining financial stability, The most important conclusion is that there is an increase in capital, which gives banks the possibility to face the risks to which they are exposed, as well as a rise in the total bad debts, which weakens its financial position, which constitutes a decline in the financial stability of these banks.
ackground An autoimmune and inflammatory illness called rheumatoid arthritis (RA) occurs when your immune system mistakenly attacks normal cells in your body. Interleukin-35 is a brand-new cytokine that belongs to the immunosuppressive and anti-inflammatory IL-12 family. β -herpesvirus that produces inflammation and stays dormant in its host for life is the human cytomegalovirus. Human herpesvirus (HCMV) has been at the core of several RA-related theories. Objective The current study looked at the association between RA and serum IL-35 levels as well as the association between RA and CMV. Patients and methods Blood samples were taken in the Baghdad Teaching Hospital and Typical Rheumatology Unit from January 2022 to Mars 2022 for the curre
... Show MoreComparative Study Between Glimepiride and Glibenclamide in the Treatment of Type 2 Diabetic Patients in Al-Yarmouk Hospital