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.
The cancer is one of the biggest health problems that facing the world . And the bladder cancer has a special place among the most spread cancers in Arab countries specially in Iraq and Egypt(2) . It is one of the diseases which can be treated and cured if it is diagnosed early . This research is aimed at studying the assistant factors that diagnose bladder cancer such as (patient's age , gender , and other major complains of hematuria , burning or pain during urination and micturition disorders) and then determine which factors are the most effective in the possibility of diagnosing this disease by using the statistical model (logistic regression model) and depending on a random sample of (128) patients . After
... Show MoreHelps to use the mechanics of organizational agility in improving product quality by reducing waste or reduce it by removing activities that do not add value, which is the main reason for inefficiency and low productivity and increase costs, so the difficulty of changing administrative decisions to cope with internal and external changes to keep up with market trends renewable are the basic issue that research seeks to be addressed through the adoption of mechanisms of organizational agility, which will be reflected in bottom line in a positive way in improving the quality of products, and thus lies Applied important to look at the light of the results achieved and in which they can know the nature of the relationship between the
... Show MoreThe subject of the listen to the voice of the customer of topics relatively new in management thought, as it won the attention of many organizations of different types, because it is important to achieve success and to continue and superiority to them, so there is a need to study this term in the Iraqi organizations and try to diagnose the implementation of the study sample to listen voice of the Customer and its
... Show MoreResearch deals the crises of the global recession of the facets of different and calls for the need to think out of the ordinary theory and find the arguments of the theory to accommodate the evolution of life, globalization and technological change and the standard of living of individuals and the size of the disparity in income distribution is not on the national level, but also at the global level as well, without paying attention to the potential resistance for thought the usual classical, Where the greater the returns of factors of production, the consumption will increase, and that the marginal propensity to consume may rise and the rise at rates greater with slices of low-income (the mouths of the poor) wi
... Show MoreThe research started from the basic objective of tracking the reality of organizational excellence in educational organizations on the basis of practical application. The research in its methodology was based on the examination of organizational excellence in the way of evaluating institutional performance. Tikrit University was selected as a case study to study the reality of application to the dimensions of organizational excellence in it, The results of the analysis for ten periods during the year and month. For the accuracy of the test and its averages, it was preferable to use the T test to determine the significance of the results compared to the basic criteria.
The research found that there is an o
... Show MoreSoftware-Defined Networking (SDN) has evolved network management by detaching the control plane from the data forwarding plane, resulting in unparalleled flexibility and efficiency in network administration. However, the heterogeneity of traffic in SDN presents issues in achieving Quality of Service (QoS) demands and efficiently managing network resources. SDN traffic flows are often divided into elephant flows (EFs) and mice flows (MFs). EFs, which are distinguished by their huge packet sizes and long durations, account for a small amount of total traffic but require disproportionate network resources, thus causing congestion and delays for smaller MFs. MFs, on the other hand, have a short lifetime and are latency-sensitive, but they accou
... Show MorePresent study was carried out to find prevalence of MRSA in healthy individual of second stage students, college of pharmacy/Baghdad University. A total of 74 student selected between age 18-23 years old were included in this study, nasal swabs collected and subjected to many diagnostic standard bacteriological identification methods. Culture, colonial morphology, Gram stain, mannitol fermentation, coagulase ,gelatinasetest, DNAase, MR/VP and antimicrobial susceptibility test was performed on tryptic soy agar by modified Kirby-Bauer muller hinton disc diffusion method and the result show that out of 74 nasal swabs,67(90.5%) were MRSA positive isolates, 21(31.4%) of them were mannitol ferment and 46(68.6%) non mannitol fermenter, am
... Show More