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.
ABSTRACT:
The study aimed to identify the impact of the role of voluntary accounting disclosure in enhancing confidence in the informational content of financial reports. Correlation - Spearman to measure the degree of correlation, as well as the method of simple linear regression analysis, and the study reached several results, including: The level of enhancing the information content in the annual financial reports of the Palestinian banks listed on the Palestine Exchange under study reached the overall average (total) (94.1%), and also Voluntary Accounting Disclosure in Enhancing Confidence in the Informational Content of the List of Change in Ownership Equity of Listed
... Show MoreThis case control study aimed to determine single nucleotide polymorphisms (SNPs) in the Kisspeptin (KISS1) gene in males with idiopathic infertility and their association with sex hormones and semen quality. The study included a total of 60 infertile and 30 healthy fertile males. Our results show that the level of the measured hormones (LH, FSH, Testosterone, Prolactin and Kisspeptin-54) were higher in the control group than in the male infertile group at p<0.05. We used polymerase chain reaction restriction fragment length polymorphism (PCR-RELP) for the genotyping of KISS1 position rs35431622 (Q36R) KISS1, which showed three different genotypes of different sizes; a wild-type homozygous AA of 233 bp and a h
... Show MoreThe pathogenicity of S. saprophyticus was studied in mice. A group of white mice were injected transurethrally using a catheter with S. saprophyticus S67 cell suspension in a concentration reached 109 CFU/ml. concomitantly, the role of its peptidoglycan in the pathogenicity was studied by injecting another group of mice with 0.3 mg/0.2 ml of partially purified S. saprophyticus S67 peptidoglycan extract. After autopsy, kidneys and urinary bladder showed several histopathological changes both in cells and peptidoglycan injected mice, included: hydropic degeneration, glomerulus shrinkage, congestion of renal vessels, infiltration of inflammatory cells, and dekeratinization in urinary bladder.
E. coli was isolated, and it was Gram-negative rod bacteria that was colony circular, regular edged, thick somewhat glitter and viscous(less). It was lactose fermenter bacteria and belongs the family of Enterobacteriaceae. E. coli showed sensitivity to all used antibiotics except Erythromycin (E), Cloxacellin (CX), Rifampin (RA), Cephalothin (KF), Ampicillin (AM), and Penicillin (P). The experimental results of antibiotic sensitivity of E. coli in media containing different concentrations of omeprazole, a proton pump inhibitor, showed an enhancement of resistance by decreasing the sensitivity of E. coli inversely with drug concentration against the antibiotics that E. coli was sensitive to. It seems that omeprazole changed cell mem
... Show MoreThis article makes it possible to verify the role of quality management in strengthening the innovation process. The first hypothesis, according to which the quality (certification ISO 9001) influences the innovation positively, is confirmed for certain innovation indicators. Another hypothesis indicates that there are the levels of quality which develop the innovation process in diverse ways. The results indicate that for some domains of innovation, the performance of innovation of enterprises that have a very increased level of quality is higher than those of enterprises with an average quality, which in return is higher than those enterprises having a low quality level. Therefore, we discovered that the difference of performance innov
... Show MoreAbstract
Tourism is one of the essential economic fields of many countries, both developed and developing. The social plays a greater role in the continuous awareness of a tourist culture based on the need to attract tourists continuously. the tourism heritage and state-owned tourism are the main factors in attracting more tourists. The interest in this strategic sector makes the country the first and most active framework in the development of appropriate mechanisms for investment in this sector, all within the framework of sustainable development of society through the rational use of resources obtained by various bodies in the implementation of seve
... Show MoreThe ability of crystals protein production was studied in local isolate Bacillus
thuringiensis by microscope examination, and the crystals protein production were seen
after 48 hour from growth starting, the study of plasmid profile of the isolate using gel
electrophoresis technique in 0.7% of agaros gel, revealed that it had one Mega plasmid
band, the plasmid role in production of crystals protein was studied by using conjugation experiments, that they applied on the local isolate B. thuringiensis which was crystals
protein producer and Rifamycin sensitive as donor cells, with Bacillus spp. which didn’t
produce crystals protein and Rifamycin resistance as recipient cells. Conjugation
experiments assured the transm
The purpose of research is highlighting the role of tax expenses in promoting direct foreign investment in Iraq, The main objective of the increase in the field of tax expenses is to manage the competition in the production of goods and services locally, in addition to the various qualities of the economical. As the search contributes to the idea of the role of the policy of the tax expenses in the promotion of foreign companies operating in Iraq. The analytical and transparent transparency used by adoption of cases of the relevant body of the tax body. For each image or form of tax expenses have been reliably related to the promotion of direct foreign investment, the taxpayers highlighted the annual controls, tax cuts as the sample was
... Show MoreThe tax policy is an important tool of fiscal policy tools which is usedasits multiple tools the State seeks to achieve objectives, such as theachievement of economic development.The importance of the research comes from the importance ofeconomic development resulting from economic policies and prudent fiscaland appropriate to the economic situation of Iraq at the moment is the mostimportant tax policy that taxes one of the most important financial instruments.The research aims to clarify the role of tax policy in developing of theIraqi economy.In an effort to achieve the goals researchers tried to prove thehypothesis ((The tax policy and through multiple tools that seeks to contributeto the achievement of economic development in Iraq)).
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