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.
Recently, Systemic lupus erythematosus (SLE) was considered as one of the autoimmune diseases that the genetic and environmental factors contributed in the disease etiological profile. According to the environmental factors, infectious agents have been concluded to have a role in the etiology and pathogenesis of SLE. Chlamydia pneumoniae and Mycoplasma pneumoniae are among these infectious agents that have been suggested to be involved in the etiology of SLE. Accordingly, the current study was designed to assess the anti-C. pneumoniae and anti-M. pneumoniae IgG antibody status by enzyme linked immunosorbent assay (ELISA) in the sera of 64 Iraqi SLE females' patients and 32 Iraqi healthy females as controls. The patients' group were distribu
... Show MoreThe research is trying to identify the investment portfolio risks of the insurance company and their impact, on the Profitability ratios of the company, and whether the company's scientific methods followed in the measurement of these risks, and conducted research in the National Insurance Company. by relying on its annual budget as well as the annual reports, The search dealing with these data in theoretical and practical major premise to statistically significant between to investment portfolio risk and financial performance correlation and reach a set of conclusions and recommendations which are the following.
investments include many ri
... Show MoreObjectives: The purpose of the study is to ascertain the relationship between the training program and the socio-demographic features of patients with peptic ulcers in order to assess the efficiency of the program on patients' nutritional habits.
Methodology: Between January 17 and October 30 of 2022, The Center of Gastrointestinal Medicine and Surgery at Al-Diwanyiah Teaching Hospital conducted "a quasi-experimental study". A non-probability sample of 30 patients for the case group and 30 patients for the control group was selected based on the study's criteria. The study instrument was divided into 4 sections: the first portion contained 7 questions about demographic information, the second sect
... Show MoreObjective: The aim of the study to evaluate the nursing care management for diabetes mellitus patient
with total hip replacement after fractured hip.
Methodology: A field study carried out on patients with diabetes mellitus and have total hip
replacement after fractured hip in orthopedic ward at the hospital of surgical specialization (malefemale)during
January 2002 to January 2003.Physical and psychological nursing
assessment
immediately after the surgery was done for the both subjects (control and experimental) and then a
scientific management with daily nursing care were provided to the experimental subject with daily
nursing care to the patient condition by using a scientific and practical methods and leave th
This study investigates the application of hydraulic acid fracturing to enhance oil production in the Mishrif Formation of the Al-Fakkah oilfield due to declining flow rates and wellhead pressures resulting from asphaltene deposition and inadequate permeability. Implementing acid fracturing, an established technique for low-permeability carbonate reserves, was essential due to the inadequacy of prior solvent cleaning and acidizing efforts. The document outlines the protocols established prior to and following the treatment, emphasizing the importance of careful oversight to guarantee safety and efficacy. In the MiniFrac treatment, 150 barrels of #30 cross-linked gel were injected at 25 barrels per minute, followed by an overflush wi
... Show MoreThis study investigates the application of hydraulic acid fracturing to enhance oil production in the Mishrif Formation of the Al-Fakkah oilfield due to declining flow rates and wellhead pressures resulting from asphaltene deposition and inadequate permeability. Implementing acid fracturing, an established technique for low-permeability carbonate reserves, was essential due to the inadequacy of prior solvent cleaning and acidizing efforts. The document outlines the protocols established prior to and following the treatment, emphasizing the importance of careful oversight to guarantee safety and efficacy. In the MiniFrac treatment, 150 barrels of #30 cross-linked gel were injected at 25 barrels per minute, followed by an overflush wi
... Show MoreA streptococci has recognized as Streptococcus spp., associate with acute pharyngitis. S. pyogenes infection Has detected in the Hospital and Health Center in Tikrit city. Throat swabs sample has obtained and cultured on a sheep blood agar plate. Identification of S. pyogenes was performed by using the VITEK 2 automatic system. It detected of 50 samples from children included 25 were positive for S. pyogenes infection. were aged 10-35 years old and included 30 male and 20 female. . While 25 sample Negative of S. pyogenes infection (The control group included 25 clinically healthy children without S. pyogenes infection matched for age and sex with cases pateints). No significa
... Show MoreThis research discussed and analyzed the formulation of a strategy to manage tax compliance risks, as an applied research in the General commission for Taxes. The questionnaire was used as a research tool to identify the factors that stimulate or retard the research sample from being compliant. The K-means clustering method was also used to enable the classification of the research sample's views into four behaviors, some of these views pose tax-compliance risks. The research concluded that risk management is a continuous process and that all departments of the General commission for Taxes are responsible for its implementation to enable them to deal with the behavior of the taxpayer towards tax compliance. And it recommended
... Show MoreBackground: Ruptured posterior communicating artery (PCoA) aneurysms are common; they usually present with subarachnoid haemorrhage (SAH) and oculomotor nerve palsy. The aneurysmal dome projection may influence the safety access and aneurysmal neck clipping. Here, we discuss additional intraoperative steps that may be required to widen the surgical field to ensure safe surgical clipping of a rupture pure posteriorly directed PCoA aneurysm. Case description: A previously healthy 38-year-old male reported sudden severe headache and disturbed level of consciousness with a Glasgow coma scale (GCS) of 13. His initial computed tomography (CT) scan of the head showed SAH in the basal cistern. 3D-constructed CT angiography (CTA) revealed a
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