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.
The Research dealt with the role of the target costs in reducing the cost of products in the General Company for soft drinks. One the modern approaches reduce costs and thus increase the ability and continuity to compete in the market. Where the problem of research in identifying the shortcomings in the traditional method used in the company sample research. Which led to a weak control of the cost and the researcher relied on data and costs of the company. The research recommended that the target cost of the company should be applied to the research sample. Training the employees. In addition, preparing training courses for them. He stressed the need to address obstacles that prevent the existence of an effective cost system. Including t
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The current research aims at highlighting the role of engagement of a sample of employees who works in some of the Iraqi private banks in terms of their interaction , commitment and enthusiasm and the positive impact they own regarding their job and devote their efforts to achieve the core purpose which is customer loyalty. The problem was expressed through a number of intellectual and practical questions.
In order to achieve the aim of the research the quantitative analytical method was used depending on a questionnaire as a basic tool to collect research data and the qualitative survey method depending on semi-structured interviews which were distrib
... Show MoreVitamins play an important role in the human health, and thus they are the kind of major nutrients in the body. Chemical products perform numerous physiological functions and can jeopardize health jointly in their absence and surplus. Therefore, it is necessary to establish methods for observation vitamin levels in various molds. In this review paper, the most methods of determination used are high performance liquid chromatography (HPLC), spectrophotometric and potentiometric techniques by listed the value of : slope, linear range, correlation coefficient, detection limit, the max of wavelength and PH and compared with these methods.
This study was carried out to describe the gene expression of the micro RNA 122a gene with the development of diabetes in Iraq. The difference in gene expression between patients and healthy controls was properly considered. In this study, blood was isolated from 121 individuals divided into two groups as follows: 80 samples of diabetic patients and 41 samples from a healthy control. miRNA was isolated and transformed into cDNA, and the expression of mi122a was measured by qRT-PCR. The researchers looked at the relationship between age and gender and the occurrence of diabetes, as well as how they compared to controls. When comparing the mean gene expression level (Ct) of patient groups to the corresponding Ct means in the control group, th
... Show MoreAbstract Kidney stones are one of the most common and most painful medical problems known (1). Nurses assess and monitor patients through diagnosis and treatment and teach patients how to avoid recurrence of stones (2). A descriptive study was conducted on 150 patients diagnosed with recurrent kidney stones, who were attending the out patients consultation urology disease clinics at surgical specialties, Al-Kadhimia, Al-Yarmook, and Al-Karama Teaching Hospital and Extracorporeal shock wave lithotripsy (ESWL) departments for the period from the 1st of Feb. 2002 through to the end of May 2004. The aim of
Objective(s): To determine the quality of life for adults with a chronic obstructive pulmonary disease.
Methodology: A descriptive study was carried out on (80) patients with a chronic obstructive pulmonary disease from
December 2008 through October 2009 with special inclusion criteria (adult paƟents from 18 years and above exclude
the patients who suffer complication related of disease and from psychological problems and other chronic illnesses.
The data were analyzed through the application of descriptive data analysis approach and inferential data approach.
Result: The study indicated that the determination of QoL for COPD depended on the level of effect .The grades
according to R.S are: "high" effect of disease in
Checkpoint inhibitors are a type of immune therapy used to treat different types of cancers. These drugs block different checkpoint proteins, for example, CTLA-4, PD-1, and PD-L1 inhibitors.
They block proteins that stop the immune system from attacking the cancer cells. Checkpoints are also described as a type of monoclonal antibody that antagonizes binding between B7 to CTLA-4 and PD-L1 to PD-1.
Immune checkpoint inhibitors are used to treat BARCA mutated triple-negative breast cancer (TNBCS) in patients who do not respond to chemotherapy, and also in the treatment of highly mutated and solid tumors such as brain tumors, liver, and pancreatic cancers.
Immune checkpoint inhibitors exhibit an effect on solid tumo
... Show MoreThe development of information systems in recent years has contributed to various methods of gathering information to evaluate IS performance. The most common approach used to collect information is called the survey system. This method, however, suffers one major drawback. The decision makers consume considerable time to transform data from survey sheets to analytical programs. As such, this paper proposes a method called ‘survey algorithm based on R programming language’ or SABR, for data transformation from the survey sheets inside R environments by treating the arrangement of data as a relational format. R and Relational data format provide excellent opportunity to manage and analyse the accumulated data. Moreover, a survey syste
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