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: Orthodontic therapy often causes external root resorption. Serum vitamin D (VD) level is important for tooth mineralization and bone remodeling. This study aimed to test the impact of vitamin D (VD) supplements on bone and root remodelling in a vitamin D (VD) deficient rat model following orthodontic retention. Methods and Material: 30 male Wistar rats were divided into three groups: a control group of 10 rats and two experimental groups of 10 rats each with vitamin D deficiency (VDD) induced by a VD-free diet for 21 days. And a third group with VD supplementAll groups received orthodontic active treatment using a modified orthodontic appliance that applied 50 gm of force for 14 days to move the maxillary right first mol
... Show MoreThe pharmacist's role in the community is currently directed towards providing drug information and patient care rather than drug compounding and dispensing. Patient counseling is an essential skill for pharmacists. So as to improve the pharmacist role in the community and enhance the patient's education and counseling skills, many continuing education programs are established. The aim of this study is to assess the perceptions and tendency of community pharmacists in Iraq regarding patients counseling and continuing pharmacists’ educational programs.
this study deals with effect of diabetes and hypertension on quality of life
Background: The post-operative acute abdominal complication is one of the most difficult clinical problems facing the surgeon, and it represents a unique challenge for him not only because of the difficulty in making a precise diagnosis but also in the decision for further management . Objective: discuss the post-operative acute abdominal complications requiring re-interventionType of the study: Cross sectional study. Methods : Patients with early post-operative Acute Abdominal complications ( within 30 days from the initial operation ) who required re-intervention were studied prospectively Results :The study included 82 patients 47 of them were females, their age ranging 7-87,Different types of the initial operation were reported,51 %
... Show MorePrenatal markers are commonly used in practice to screen for some foetal abnormalities. They can be biochemical or ultrasonic markers in addition to the newly used cell free Deoxyribonucleic Acid (DNA) estimation. This review aimed to illustrate the applications of the prenatal screening, and the reliability of these tests in detecting the presence of abnormal chromosomes such as trisomy-21, trisomy-18, and trisomy-13 in addition to neural tube defects. Prenatal markers can also be used in the anticipation of some obstetrical complications depending on levels of these markers in the mother’s circulation. In the developed countries, prenatal screening tests are regularly used during antenatal care period. Neural tube defects, numer
... Show MoreThere is a global shortage of health care providers needed to address all levels of primary and specialty care. The recent COVID-19 pandemic also highlights the importance and added value of health professionals with specialty training in infectious diseases. In the United States, advanced practice providers (APPs) are being engaged to meet the expanding demand for generalist and specialist patient care. The history and development of advanced practice registered nurses (APRNs) and physician assistants (PAs), are discussed as collaborative healthcare providers to promote better understanding of the ways they can be incorporated into a healthcare system. An example of how APPs are utilized to provide both inpatient and outpatient
... Show MoreThe study examines the root causes of delays that the project manager is unable to resolve or how the decision-maker can identify the best opportunities to get over these obstacles by considering the project constraints defined as the project triangle (cost, time, and quality) in post-disaster reconstruction projects to review the real challenges to overcome these obstacles. The methodology relied on the exploratory description and qualitative data examined. 43 valid questionnaires were distributed to qualified experienced engineers. A list of 49 factors causes was collected from previous international and local studies. A Relative Important Index (RII) is adapted to determine the level of importance of each sub-criterion in the fou
... Show MoreThis research aims to shed light on the necessity of establishing an information security management system through which banking security risks are managed in the light of the ISO (IEC 27001) standard, through which bank departments seek to demonstrate the management of their security systems and their controls in accordance with the specifications of the standard to obtain an internationally recognized security certificate And the need for senior management in banks to an independent person with scientific and practical qualification and who has accredited certificates in the field of information technology for the purpose of helping them to verify the level of compatibility between the policies and procedures applied and the p
... Show MoreThe management of construction projects needs to complete the basics of system management and work. Starting from the idea and how to turn it into a full study and ended at the construction project completion arriving at the purpose prepared for it, so the projects need to control on its operation and integration system in order to succeed.
It is no secret for who concerned in construction projects field that the design stage is a very important stage in construction project because it determines the final features of the project through the requirements provided by the employer for the consultant to formulate it during this phase in the form of plans, drawings, and specifications, then translated on the ground as the shape of co
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