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: laparoscopic cholecystectomy (LC) is getting popularity for the treating of symptomatic gall bladder disease; conversion from laparoscopic to open cholecystectomy (OC) is also common.
Objective : To find out the prevalence of causes, risk factors of conversion from LC to OC among patient suffering from gall bladder disease, and to explore the most common causes of conversion from laparoscopic to open cholecystectomy.
Methods: This prospective study was conducted in the department of general surgery at Alkindy teaching hospital from first of January 2016 to the end of December 2017 .Nine hundred twenty patient were included. Patient age, gender, his
... Show MoreThe research dealt with the risks of reinsurance and its impact on the financial performance of the National Insurance Company by focusing on reinsurance in the marine insurance branch. Negative impact on the financial performance of the NICs and the Marine Insurance Branch. The research sample resulted in a main hypothesis that reflects this relationship. Lee in the analysis of financial information reports National Insurance Company of the branch of marine insurance for the period of 2010 until 2017, and the use of (retention) for measuring the re-insurance operations index, and (insurance financial surplus rate) to measure financial performance. For the purpose of obtaining the results, a number of statistical methods were used accord
... Show MorePurpose The purpose of this study was to evaluate the complications associated with the use of reconstruction plates with or without non-vascularized bone graft in reconstruction of mandibular segmental defects caused by trauma and tumor resection and to analyze various factors that are associated with the development of complications. Methods A retrospective observational study was conducted, and the investigated variables included the age and gender of the patients, etiology of the defect, the site of the defect, the size of the defect, whether bone graft was used or not, type of plate used, and whether the reconstruction was immediate or delayed. The outcome variables were the postoperative complications and the success rate. Results Fif
... 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 Audit evedances represent the reconciliation tools between the Financial data shown on financial statements, and the level of satisfaction level of the Auditor about these statements. According that, the Auditor try to achieve the highest quantity of These evidances, and the most satisfactive of it…, but that will be so hard sometimes, when the internal controlling system is not good, and when the Auditor had some satisfied evidences, but not sharp… So, this research comes to inspect the relation between the quantity, and the level of satisfaction, and argument to prove that evidences gives. This research assumes that getting enough evidences leads to reduce faults, improves the auditing operation, and avoids risks. The research
... Show MoreStudy the role of CoQ10 and IGFBP-1 in obese male patients with diabetic mellitus type 2. ELISA method was used to assay Serum CoQ10 and IGFBP-1. Blood was taken with drawn sample from 30 obese normal patients with age range (40-60) years, 30 diabetic patients with age range (40-60) years at duration of disease (1-5) years and 30 normal healthy patients. The mean difference between T2DM according to CoQ10 (12.5±1.1) was decreased than the mean of IFG (21.8±3.2) (P 0.002) and the mean difference between T2DM according to IGFBPs (0.65±0.06) was decreased than the mean of IFG (3.2±0.3) (P 0.000). While no significant difference between mean age of DM2 patients (55.5±1.06), and IFG (55.6±0.9) (p 0.90), no significant difference bet
... Show MoreSocial risks posed a great challenge to the development path in Iraq, which resulted in widening the development gaps, whether these gaps were between rural and embargoed areas, or between Iraqi governorates, and the gender gap. Besides, the nature of the reciprocal relationship between the social risks and the development process requires the adoption of development trends that are sensitive to the risks that take upon themselves the prompt and correct response to these risks, away from randomness and confusion that Iraq suffered from for decades. However, currently, the situation has differed a great deal. This is because the size and types of such gaps have widened and become more complicated than before; a matter which has led to hav
... Show MoreThe acute phase response is a major pathophysiologic phenomenon that accompanies inflammation whether acute or chronic. Complement (C3 and C4) and C - reactive protein (CRP) are positive acute phase proteins (+ ve APPs ). Their production takes place in hepatocyte and the blood concentration of these parameters are increased in osteoarthritis (OA). Chloroquine (CQ) is a diprotic weak base traditionally used to treat malaria. Recently the phosphate salt of CQ is used to decrease this type of (+ve APPs) . In this study, patients who suffered from knee osteoarthritis (KOA) are treated with oral dosage form of chloroquine phosphate (CQP) for one month, twice daily. Our results demonstrate that CQP improves the patient status by decreas
... 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
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