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.
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorder. To determine the metabolic disorders in women with PCOS, (25) women with PCOS ages (15 - 47) years have been investigated and compared with (20) healthy individuals. All the studied groups were carried out to measure fasting blood sugar, (anti-GAD Ab, anti β-islet cell Ab by IFAT) and measured insulin level by ELISA. There was significant elevation in the concentration of fasting blood sugar than in control groups (p ≤ 0.05) and there was negative results for anti-GAD Ab and anti β-islet cell Ab by IFAT test for serum of women with PCOS, while there was significant differences in the insulin level for women with PCOS compared with control groups (p ≤ 0.05),
... Show MoreThis research is dedicated to study Al-Ra’ee Al-Numayri, a distinctive poetic character, to find out the most important (artistic) pre-Islamic features that contributed to its formation. It is further dedicated to know the influence of these features on his literature in the literary arena. After surveying his poetic texts and reading them according to the analytical and investigative methods, the art of the researcher was limited to the field of traditionalists. He was following the footsteps of the ancients by adhering to the traditional Arabic poetry style and the traditional poetic image. Despite that, he had his own imprints and unique style of interrogating times and places with its people, animals and plants. H
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The current research aims to identify the level of organizational relaxation among the employees of educational directorates in the Sultanate of Oman. The descriptive approach was used, as well as a questionnaire of two parts to collect data. The questionnaire consists of (15) items divided into three themes about the relaxing level. It was applied on a sample of (406) male & female employees of the educational directorates who were randomly selected. The results of the study showed that the level of organizational relaxation was low. The study results also found that there were no statistically significant differences at the level of significance (α ≤ 0.05) of the study sample in the level of org
... Show MoreIt was not coincidene that much talk about intertxtuality prescription phenomenon tzms the creative process but have directed their tracks beyond the litery taxs prior or contemporaneous as the mechanics of in tertexuality able to contain all the pattems of expression in literary texts and fee structures ofher text copable of understanding and in terpretaion especially as the phenomenon of in twrtexuality actually depends on the existence of Understanding and interpretation, especially as the phenomenon of intertextuality actually depends on the existence of systems indicative independent but carries processes rebuild text templates one way or another are included in the templates and visions of other intellectual, Mstmjh languages cultu
... Show MoreDuring treatment of inflammatory diseases, many conventional therapies (non-steroidal anti-inflammatory drugs) used to relief pain and inflammation. Chronic use of the intended drugs is frequently associated with serious side effect, which may lead to discontinuation of treatment . The efficacy and dose- response effect of ammi majus extraxt (2 , 4, 8 , 16, and 32 mg/rat) were assessed using formalin to induce paw edema in rats as a model of chronic inflammation respectively. In this study, 42 rats were used and allocated into 7 groups each containing 6 rats, representing control (Distilled water) , standard (piroxicam ) and test extract ( 2 , 4 , 8 , 16 and 32 mg/rat of Ammi majus alcoholic e
... Show MoreThe general trend in Iraqi banks is focused towards the application of international financial reporting standards, especially the international financial reporting standard IFRS 9 “Financial Instruments”, in addition to the directives issued on the Central Bank of Iraq’s instructions for the year 2018 regarding the development of expected credit losses models, and not to adhere to a specific method for calculating these losses and authorizing the banks’ departments to adopt the method of calculating losses that suits the nature of the bank’s activity and to be consistent in its use from time to time. The research problem revolves around the different methodologies for calculatin
... Show MoreThis paper aims to review the intellectual to the most important thought leaders administrative and strategic They both (Henry Fayol and Michelle Porter), who forward a lot of ideas that have helped countries in the advancement and progress their economies , has been drawing literature theoretical common border in Contributions ( Fayol ) philosophical and between applications ( Porter ), which reversed strategies of the three ( the leadership of the cost, differentiation, and focus ), so browse search how to apply and use the principles of Fayol in the implementation of strategies competitiveness of Porter, and stems from a problem ( ( to what extent a reflection of the principles ( Fayol) fourteen strategies (Porter ) competitiv
... Show MoreDiscourse is a form of communication, and It carries with it an Intellectual framework, and It is a form of expression to communicate Ideas to people through an interactive process.The interest and analysis of discourse Is one of the most important fields of linguistic studies, and It has a basis In ancient studies, and It has become one of the most Important topics of the study, and (Sayyid al-Sadr) often uses guidance In his sermons.
By extrapolating and analyzing a set of examples received, from the perspective of the deliberative approach and the theory of speech acts, and the statement of the extent to whichh (Sayyid al-Sadr) relied on linguistic elements, and the use of the rank of the speaker In issuing directives, and the
... Show MoreThe current study was conducted in the environment of the Martyr Monument Lake in the city center of Baghdad during 2019 to monitor the impact of climatic conditions such as drought, water shortage, high temperatures in the environment of the city and the lack of water flow during the years 2015 to 2018 and their effects on some of the physical and chemical factors of water and the dynamics of the phytoplankton community in the lake environment. Heterogeneity of some studied environmental factors, including air and water temperature, permeability, water depth, pH, DO, BOD5, nutrients, nitrate, NO3, and phosphates were found. The results showed the effect of climate change and the pres