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.
This research is seeks to state the role of Green Human Resources Management Practices and their dimensions (Green Employment and Selection, Green Performance Assessment, Green Training & Development and Green Compensation and Stimulation Systems) in strengthening the Strategic Positioning in the Nongovernmental Hospitals in Erbil city, and aims to analyze the relationship between Green Human Resources Management Practices and Strategic Positioning and to show the impact of Green Human Resources Management Practices in determining the Strategic Position.
It is depended on a questionnaire as key tools for achieving data, as designed on
... Show MoreThe environmental cost management focus on continuous improvement of processes and the various activities of the organization in order to improve the environmental performance by producing an environmentally friendly products lead to a competitive advantage for the organization and supports the activities of their sustainability.
The study was carried out in Bagel cement factory, one of the pioneer projects in Yemen in manufacturing field, The study found the need to develop a separate section for environmental management in order to put plans and environmental policies and the introduction of a special division in the Department of costs cares about Management practices cost and measure environmental costs, also give solu
... Show MoreNeuro-ophthalmology, bridging neurology and ophthalmology, highlights the nervous system’s crucial role in vision, encompassing afferent and efferent pathways. The evolution of this field has emphasized the importance of neuroanatomy for precise surgical interventions, presenting educational challenges in blending complex anatomical knowledge with surgical skills. This review examines the interplay between neuroanatomy and surgical practices in neuro-ophthalmology, aiming to identify educational gaps and suggest improvements.
A literature search across databases such as PubMed, Scopus, and W
The importance of economic and technical feasibility studies include all of the investor, the society, the banks, the project and the government. As it will assist in achieving the optimal use of the available economic incomes on the national level and arranging the projects in priority which participates in achieving the government benefit without wasting the amounts .This is the research goal So, the research covered its theoretical aspect, of SAIs and the economic and technical feasibility studies then the role of the auditors in auditing those studies Then a mechanism was proposed includes a guidebook that provides guidelines for organizing the process of preparing and auditi
... Show MoreThis research aims at shedding light on the concept of insurance awareness and clarifying its role on marketing insurance services of a sample of (100) employees in the National Company for Insurance. Questionnaire is used as a main instrument for collecting data and information from the sample. Their answers were analyzed by using arithmetic means, standard deviation, centesimal weight, and the correlation coefficient ( , F, t) tests .The research reached several conclusions of which:1.The sample member's response to insurance awareness and marketing insurance services factors was in the medium level.2.There was a positive relationship of a moral sign between insurance awareness and marketing insurance services, that correlation coeffic
... Show MoreThis study included 46 patients with liver hydatid cyst diagnosed clinically and surgically. Control group consist of 22 healthy volunteers. The patients were divided according to the size of the cysts into more and less than 5 cm diameter size, 33 and 13, respectively. Also they were divided into primary and secondary hydatid cyst infection, 30 and 16, respectively. Significant increase of GOT, GPT and ALP levels were recorded due to hydatid cyst infection and had direct effect on the liver function, beside an increase in total bilirubin in patients serum compared with the control, also the same occurred in the secondary infection compared with primary infection, patients with> 5 cm showed significant increase in the above levels compared
... Show MoreThis research attempts to find the association between single nucleotide polymorphism (SNP) of IL2+166 gene (rs2069763) and type 2 diabetes mellitus (T2DM) in a sample of Iraqi patients. A total of 44 patients and 55 apparently healthy volunteers were genotyped for the SNP using polymerase chain reaction test. Three genotypes (GG, GT, and TT) corresponding to two alleles (G and T) were found to have SNP. Both study groups’ genotypes had a good agreement for the analysis of Hardy-Weinberg Equilibrium. The results revealed increased frequencies between the observed and expected GG and TT genotypes and IL2+166 SNP T allele in T2DM patients (40.9 vs. 40.0 %; OR = 1.04; 95% CI, 0.47 - 2.31), whereas the values in the control group were
... Show MoreSevere Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused enormous issues worldwide and is the most infectious pandemic. This study included 50 subjects (evenly distributed between sexes) and their range of ages starting from 2 to 67 years. According to the study's result, the ages and genders of subjects include susceptibility to COVID-19. Males were found to be more infected than females, and the ages of 36 to 67 were more common than other age ranges. Also, BMI calculations revealed that male patients with COVID-19 have the highest percentage of obesity. The clinical parameter results have been found serum C‐reactive protein (CRP) as an essential indicator that changes significantly in infection with COVID‐19 an
... Show More