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.
Abstract
The research aims to identify the role played by the strategic mind of human resources managers in reducing the levels of strategic drift that can face the organization, as the problem of research to overlook the importance of this role in monitoring and follow-up all the changes that may face the organization during the implementation of its strategy, therefore highlights the importance Research in providing a set of solutions to the problems faced by the researched organization and as far as the research variables, the researchers have adopted the descriptive analytical approach in the applied side, as adopted the questionnaire as a main tool for data collection, which was prepared based on a number of ready me
... Show MoreBackgr ound: The transfer of the tibialis posterior tendon to the anterior aspect of the ankle not only replaces the function of the paralyzed muscles, but also removes the deforming force on the medial aspect of the foot. Objecti ves: In this study, we evaluated patients who underwent tibialis posterior tendon transfer for the treatment of foot drop, and comparison through interosseous membrane route versus anterior to lower tibia route of tibialis posterior tendon transfer, with evaluation of the results according to carayon criteria Methods: Nine patients with foot drop secondary to different causes treated with tibialis posterior tendon transfer from January 2011 to January 2012 were followed up for a mean of 12 months in Al Kindy Teach
... Show MoreMusic has a significant role in shaping the artistical, musical and national identity of individuals. The resources of the cultural identity can be divers according to the multiplicity of the social component. In Iraq, there is a unique ethnical and sacred diversity, which is rather than playing a positive role in shaping the cultural and national identity, on contrast, it is establishing to create many local identities in the same society. Each identity reflects the culture of individual ethnic or religious group, which makes people make their own decisions according to their background rather than according to the benefit of the country.Music as an important cultural source has a social function in forming an artistical identity with n
... Show MoreBackground: Osteoarthritis (OA) currently seems
inevitable and unavoidable for a large swath of the
population .its etiology relates to a strong ,but
complex ,non mendelian genetic basis ,combined
with mechanical and metabolic factors that cause
molecular alterations the end results of which
affect the whole joint .Glucosamine and
chondrotin sulfate alone or in combination may be
of benefit to a subgroup of individuals who have
knee pain due to OA.
Glucosamine has been shown to alter cartiage turn
over in patients with OA undergoing physical
training
Aim of the study: To find the validity of
glucosamine chondrotin sulfate in treatment of
grade 1 and 2 OA.
Methods: the sample of 280 patients
The organizational structure of relations between states is among the main features that distinguished the twentieth century as the era of international organization, especially after the increase in the number of political units after World War II in which regionalism was crystallized as a phenomenon. It is not modern, as there are many blocs such as the European Union that have developed in it, the idea of regional bloc is prominent, especially in Europe, as it emerged after a controversy revolved around what was called globalism in the face of Globalism vs. Regionalism. Regional, as the proponents of the global orientation saw the establishment of a global organization that includes all countries, as the best way to achieve inte
... Show MoreThe study aimed to identify the role of the teacher in confronting intellectual extremism in high school students, and identify the differences of statistical significance in the role of teacher in confronting intellectual extremism in secondary school students according to gender variable (males, females) and the duration of service (less than 5 years more than 5 years), the sample was consisted of (100) teachers with (50) male and (50) female in the city of Bayaa, Dora and Sadiya, the measure of intellectual extremism was applied by the researcher, and the study reached a role of the teacher in facing the intellectual extremism at Secondary school students, and the existence of differences of statistical significance in the role
... Show MoreThere are certain dates in the history of nations that have their effects on them ,and the 25th of January 2011 is considered one of them in the history of the state of Egypt .Since this date Egypt has passed through many events that led to changes in the political life and its actors . New rolls has arisen for actors that didn't take part in the political life before so clearly ,like the military establishment which started to practice more prominent political roll, till it became the most important actor in the political life of Egypt .This establishment tried to institutionalize its roll through constitutional means ,considering that controlling the authority is the only alternative to safeguard the state which we are trying to study
... Show MoreBac kground: The transfer of the tibialis posterior tendon to the anterior aspect
of the ankle not only replaces the function of the paralyzed muscles, but also
removes the deforming force on the medial aspect of the foot.
Objec t i ves : In this study, we evaluated patients who underwent tibialis
posterior tendon transfer for the treatment of foot drop, and comparison through
interosseous membrane route versus anterior to lower tibia route of tibialis
posterior tendon transfer, with evaluation of the results according to carayon
criteria
Methods: Nine patients with foot drop secondary to different causes treated with
tibialis posterior tendon transfer from January 2011 to January 2012 were
followed up for a
This research seeks to study the role of military bases in activating defense diplomacy, with a focus on studying the case of France in the African continent, which relied on its military bases as a tool to implement its foreign policy. The research explains the concept of defense diplomacy and its relationship to military bases as an effective tool to strengthening bilateral relations between the state's parties. The research focuses on studying the effectiveness of military bases as a tool for activating French defense diplomacy, and studying the goals that French foreign policy seeks to achieve through its intervention or presence in the African continent. In addition to the geopolitical reasons that prompted France to move to
... Show MoreThe process of employing modern technology in a consistent manner is what the researcher is interested in, and the psychological role of the sound effect in enhancing psychopathic representations in cinematic characters, which had a wide resonance in the field of cinematic films, and after the predominance of digital technology in the production of contemporary films, the sound effect has a higher efficiency And a good level of advanced aesthetic and dramatic expression in film employment, so many directors resorted to this type of films by using various new and advanced techniques and technological programs in their industry, since the traditional construction does not achieve the dazzling that the viewer desires.
Accordingly, th
... Show More