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.
Municipalities.
Abstract
The purpose of this research is to measure the impact of regulatory flexibility dimensions (formal and authoritarian procedures) to achieve response to the requirements of high performance dimensions (the effective recruitment, intensive training, motivate employees, participation of workers) in the general municipal Directorate as one of the directorates of the Ministry of Municipalities and Public Works. For the purpose of this measure it has been selected sample composed of 88 individuals from the research community represents the levels of assistant general manager of department heads and managers of people and some of the staff to answer the questionnaire prepared for the purpose Hama
... Show MoreThe subject of youth care of important issues in view of what constitutes the importance
to the development of societies in general and as much as enjoy young people in any society
are good psychological health and agree psychosocial be healthy to be effective to invest their
energies and their potential for the progress of that society and development of the social
aspects and economic. The universities of the most important educational institutions that
provide care for young people, they are as well as providing information and expertise
necessary to prepare young people for life and the development of mental abilities, they are
different activities that will satisfy their needs physical, psychological, social and
The research aimed to use HIIT exercises, and to know the effect of HIIT exercises on some physiological and physical indicators of the young badminton players, and to identify the degree of competition anxiety and the performance of some offense skills among the young badminton players. The research community (the young badminton players), the research sample and its selection method (the research sample was chosen by the intentional method (8) badminton player from the Athwari Club), the scientific method (the experimental method with pre and post tests), measurement tools: physiological tests (high and low blood pressure) , pulse, and physical exams (explosive force of arms and legs) and the offense skills and the scale of competit
... Show MoreThe research aimed to use HIIT exercises, and to know the effect of HIIT exercises on some physiological and physical indicators of the young badminton players, and to identify the degree of competition anxiety and the performance of some offense skills among the young badminton players. The research community (the young badminton players), the research sample and its selection method (the research sample was chosen by the intentional method (8) badminton player from the Athwari Club), the scientific method (the experimental method with pre and post tests), measurement tools: physiological tests (high and low blood pressure) , pulse, and physical exams (explosive force of arms and legs) and the offense skills and the scale of competition an
... Show MoreEnvironmental risk growing Become challenge "and a matter of controversy and concern to many of those concerned with environment, social, economic, and the same happens with the administrative rather than in isolation for this movement, as the issues of climate change Disturbed and troubled him, especially after what caused the risk of destruction, and irresponsibility , chaos, and the futility of resources, crops, fields, nature and homes and reactors, and after what happened in Japan from the scourge of "Hurricane tsunami " and earthquakes successive accompanied him and what became of him by surprise catastrophic affected the economy and the univ
... Show MoreDespite all the possibilities held by Iraq for the production of poultry , but there is low and clear in the level of production and a rise in costs and a decline in per capita consumption is due to a number of reasons, including poor investment , stop government subsides , dumping policies , market Bolmottagat imported , the contribution of the merchant squandering of national capacity , weak base material for the growth of this sector , the security situation and the crisis of energy and others .
Despite all this research has shown that there are great investment opportunities in this very sector of the market size and absorptive capacity of his and the growth of per capita income and level of cul
... Show MoreThis research focuses on the services provided by news websites (IMN, Youm7, Huffington Post Arabic) to its audience of Internet users, as well as materials posted through its pages, trying to monitor and explain them to identify their types & features, and it›s functions, whether informational or non-informational, to know the technical potential of each of the news sites, with the entry of the latest technology information. The research used the analysis method to achieve the research objectives within the period from 1/1 to 31/1/2017. The researchers used the content analysis tool as a research tool to analyze the news sites and to know the services they provide through their pages. The research was divided into three parts, the
... Show MoreMedication safety is an important part of the comprehensive patient safety term. Medication safety is gaining more attention as the World Health Organization set the goal of decreasing medication harm by (50%) for the next 5 years when launching the third global challenge. Studying medication safety in the risk groups such as young ages, children are crucial to learn more about the effect of medicines in this risk group since they are not included in the clinical trials. Adverse drug reaction is defined as any harm resulted from the drug itself during medical process journey, while medication errors are any harm resulted from the treatment process rather than the drug or it is the result of the failure in a step of the treatment process
... Show MoreEvaluating treatment effect on interferon-alpha in female patients with systemic lupus erythematosus: a case-control study
Seventy four Iraqi breast cancer paraffin blocks were collected from patients were attended to center health laboratory, histopathology department, Bagdad, Iraq. The patients information’s which included: name, age, and the pathological stage, grade, tumor size were obtained from the clinical records of the patients also relation with sex hormones was recorded. The cases which has been taken included invasive ductal and invasive lobular carcinoma type Women age were ranged from 24-80 years peak age frequency of tumor occurred in the category of more than 40 years old. Immunohistochemical expression of her-2/neu was from total 74 cases of infiltrative ductal carcinoma cases, 27(36.49%)were positive for Her-2/neu expression, 47(63.51%) were
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