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 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 MoreBackground: The problem of difficult gallbladder is not clearly defined and associated with real missing of therapeutic approaches that decreased morbidity. Moreover, the difficult gallbladder was reported as a contributing risk factor for biliary injury due to raised difficulty in surgical dissection within Calot’s triangle. The aim of this study is to determine the surgical outcomes of the open fundus-first cholecystectomy in lowering the rate of lethal intraoperative risks.
Subjects and Methods: Our prospective study conducted during the period of January 2019 to December 2022 at Ibn Sina specialized hospital, Khartoum, Sudan, for two hundred and fifty-three patients underw
... 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 MoreAn essential issue in obstetrics is the prevalence of maternal and fetal complications in pregnant women with polycystic ovary syndrome (PCOS). The purpose of the present study was to investigate the prevalence of pregnancy complications among various phenotypes of pregnant women with PCOS.
Objectives: The study aimed to determine the effect of chemotherapy on the life style of patients who
receive chemotherapy.
Methodology: A descriptive study was conducted in Specialty Surgery Teaching Hospital, Al-yamok
Teaching Hospital, and Radiation and Nuclear Medicine Hospital in Baghdad for the period from May
2007 to October 2008. A purposive "non-probability" sample of (loo) patients with bladder cancer
who receive chemotherapy where concerned in this study.
A questionnaire fom was constnicted for the purpose of the study and it was comprised of
two parts. The questiormaire consists of (125) items. They include (1) demographic information (2)
assessment of lifestyle dimension. The content validity of the q
Background: Malaria remains a leading cause of mortality in sub-Saharan Africa (including Sudan). C-reactive protein (CRP) is useful as a marker of severity in malaria. African studies have shown that serum CRP levels correlate with parasite burden and complications in malaria, especially falciparum. However, there are no data on CRP levels in Sudanese malaria patients.
This study aims to evaluate the association between CRP levels with comorbidities, species, and complications of severe malaria
Subjects and Methods: A cross-sectional study enrolled 65 severe malaria patients at Khartoum state hospitals during the period from April to June2021. Manifestations of severe
... Show MoreBackground. Colorectal cancer, ranking second place in global cancer mortality, arises from diverse causes. There is growing recognition of the substantial involvement of the epigenetic modifications of histones at the DNA level in the occurrence of CRC. Aim. To assess the expression of p53, HDAC1, and HDAC3 proteins in a cohort of CRC patients and to analyze potential relationship between their expression and the stages of CRC progression. Materials and Methods. The retrospective investigation was carried out on 95 paraffin-embedded CRC tissue samples. The expression of p53, HDAC1, and HDAC3 was assessed immunohistochemically. Results. Notably, the expression of the p53 protein in CRC tissue samples exhibited a prominent correlatio
... Show MoreThis paper presents a robust algorithm for the assessment of risk priority for medical equipment based on the calculation of static and dynamic risk factors and Kohnen Self Organization Maps (SOM). Four risk parameters have been calculated for 345 medical devices in two general hospitals in Baghdad. Static risk factor components (equipment function and physical risk) and dynamics risk components (maintenance requirements and risk points) have been calculated. These risk components are used as an input to the unsupervised Kohonen self organization maps. The accuracy of the network was found to be equal to 98% for the proposed system. We conclude that the proposed model gives fast and accurate assessment for risk priority and it works as p
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