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.
In Production and Operations Management the specialists have tried to develop a strategy to counter the risks arising from the activities of the organization and of waste of various types and therefore the risk management in the contemporary framework represents a phenomenon of new quality, and can not be this phenomenon to take practical dimensions, but the development of culture of the organization towards the risks and deal with all aspects and paint ways to address them within an integrated program, and requires new skills and systems provide accurate information capable of coordination between the various parties within the organization.
The research aims to develop a blu
... Show More
Patient aggression is a global health care problem. This study examined the impact of patient aggression on the quality of care that patients receive as perceived by their family members and the ethical challenges involved from the nurse’s perspective. A descriptive–analytical method was used. The participants of this study were nurses working on psychiatric units and family members of patients in Iraq. Two questionnaires were used: one on nursing care quality and one on ethical challenges in clinical situations. The results showed that the quality of care for these patients was reduced, with a
Background: 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
... Show MoreIt must be emphasized that media is amongst human studies fusing older and more recent sciences together, and that its disclosures are the physics of the new communication. Michio Kaku, a theoretical physicist, in his book “ Visions”, confirms this fact when he says :” As a research physicist, I believe that physicists have been particularly successful at predicting the broad outlines of the future .Professionally, I work in one of the most fundamental areas of physics, the quest to complete Einstein's dream of a "theory of everything." As a result, I am constantly reminded of the ways in which quantum physics touches many of the key discoveries that shaped the twentieth century. “ He then got to the fact that the physical disclo
... Show MoreHR Al-Hamami, AA Noaimi, MM Al-Waiz, AS Al-Kabraty, Iraqi Postgraduate Medical Journal, 2010 - Cited by 4
Background: It is well-known that silicon oil (SO) injection into the vitreous cavity after pars plana vitrectomy is usually associated with high intraocular pressure.
Objectives: To determine the influence of silicon oil (SO) removal on IOP level after pars plana vitrectomy for spontaneous rhegmatogenous retinal detachment (RRD)
Subjects and Methods: A prospective study was conducted at Ibn Al-Haitham eye teaching hospital, Baghdad- Iraq. Intraocular pressure (IOP) was measured pre and post SO removal in patients who have underwent retinal detachment surgery with SO injection of 1000 centistokes (cSt) viscosity. Baseline IOP was measured for all the patient before the SO
... Show MoreDiabetic retinopathy is one of most important complications of diabetes mellitus that can be treated by Nd:YAG laser. Laser is used in ophthalmic practice for photocoagulation and photodisruption. The purpose of this study is to evaluate changes in immunological ,hematological and biochemical values after treatment of diabetic retinopathy by laser. Blood samples from 10 patients suffering from diabetic retinopathy were taken before and after laser treatment to coagulate retina to prevent leakage and hemorraghe to avoid deterioration of vision.In group one (4 patients = 40%), blood tests were done one day after treatment. In group two (6 patients =60%) tests were done 7 days after treatment with laser. The study showed no clear changes in
... Show More