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.
Our study comes up to clarify the role of television in spreading the culture of violence with a child. This study represents one of the important studies that have tried to highlight the impact of these programmes, particularly cartoons, on the child's behaviors, actions and acquired habits.Violence considers a common phenomenon among the people, as the role of the media, particularly TV has a vital role due to its properties, characteristics and its significant impact on different segments and groups in society and in children particularly through exposure to programmes of films.The results of the study have been affected by the rising proportion of females to males, and that the contribution of real life has a big role in the child ac
... Show MoreThe current study aims to overcome the conflicts facing the company in its way of staying and continuing to maintain its performance excellent in light of the intense competition, which made it seek to find strong ways and links with its customers through electronic communication using electronic platforms, and this put confidence and safety in The place of suspicion and fear of not fulfilling credibility or violating the privacy, so this research comes to answer about the question: “Can the company achieve an excellent performance by relying on the customer's electronic confidence?”.
The study followed the descriptive and analytical approaches by providing a virtual model and testing the zero hypotheses, which stipulat
... Show MoreElectrochemical Grinding (ECG) process is a mechanically assisted electrochemical process for material processing. The process is able to successfully machine electrically conducting harder materials at faster rate with improved surface finish and dimensional control. This research studies the effect of applied current, electrolyte concentration, spindle speed and the gap between workpiece and tool on hardness and material removal rate during electrochemical grinding for stainless steel 316. The characteristic features of the electrochemical grinding process are explored through Taguchi-design-based experimental studies. The better hardness can be obtained at 10 A of the current, 150 g/l of the electrolyte concentration, 0.3 mm of gap an
... Show MoreThe modern business environment has witnesses tremendous developments as a result of the globalization of markets and economic openness and technological as well as the acquisition of the issue of corporate governance of great importance regarding it as one of the global innovations trends of control provisions on the management of companies as result of these developments ,increasing on competition between economic unit ,thus a decrease in market share because they do not take into account the response to the requirements of customers ,which kept her to search a modern management accounting methods to help them keep up with the changes and the availability of information for the various adminis
... Show MoreThe Quality function deployment (QFD) tool is an important tool of total quality management because its a link between two important parts customer and production process of the product, using advanced House of quality, which contributed to provide more details about improving the product before it had a vision for the future of the product be improved. Also the identification of the two competitors (Alwazeer , Altouri) bases on the survey of retailers which they identified five competitors products (Alwazeer , Altouri , Ferry , Jif , Dina)for the product (Zahi). Then House of quality to product (Zahi) has been developed By using a Kano Model to classify of customer's requirements for the
... Show MoreIn this study, 20 patients were selected having renal failure .10 patients were hemo& 10 peritoneal dialysis procedure. Patients had been given r HuEPO subcutaneous with supplement of Iron dextran after di alysis . Hemoglobin Hb concentration Hematocrit(Hct),serum I ron ,total Iron binding capacity, transferrin saturation percent Ts%
& Serum ferritin were measured. Non significant chan
... Show MoreHepatocellular carcinoma (HCC) is the third most common cause of cancer-related death. Therefore, it is critical for researchers to understand molecular biology in greater depth. In several diseases including cancer, abnormal miRNA expression has been linked to apoptosis, proliferation, differentiation, and metastasis. Many miRNAs have been studied in relation to cancer, including miR-122, miR-223, and others. Hepatitis B and C viruses are the most important global risk factors for HCC. This study is intended to test whether serum miRNAs serve as a potential biomarker for both HCC and viral infections HBV and C. The expression of miRNA in 64 serum samples was analyzed by RT-qPCR. Compared to healthy volunteers, HCC patients' sera expre
... Show MoreObjective: Rheumatoid arthritis (RA) patients have increased morbidity and mortality from premature cardiovascular (CV) disease (CVD). Framingham risk score (FRS) is a simplified coronary prediction tool developed to enable clinicians to assess the risk of a cardiovascular event and to identify candidate patients for risk factors modifications worldwide. The predictive ability of the FRS varies between populations, ethnic groups, and socio-economic status. The aim of this study is to find if there is any correlation between the Framingham risk score and the inflammatory and biochemical parameters used to measure disease activity and functional ability in Iraqi patients with active RA.
Methicillin resistant Staphylococcus aureus (MRSA) is the most common pathogenic bacteria in the hospitals and communities, the ability to form biofilm is considered the main cause of Staphylococcus pathogenicity since it provides resistance to both antibiotics and host immune response, so this study was aimed to evaluate the biofilms formation and its association with antibiotic resistance in clinical isolates of MRSA, in order to achieve this aim, 237 samples were collected from different patients with wounds infections after surgeries and samples from operations galleries from varies hospitals in Baghdad ,68 isolates out of 237 were subjected to Staphylococcus aureus according to conventional meth
... Show More