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.
BACKGROUND: Clavicle fractures are common injuries in young active individuals, the mid third of the clavicle is most commonly fractured part(80% of clavicle fracture) OBJECTIVE: To compare the outcomes of operative and non operative management of displaced and or comminuted closed fracture of the mid third of clavicle in young adults PATIENTS AND METHODS: This prospective observational study of 24 patients of fracture of the mid third of the clavicle was conducted in Alkindy teaching hospital from July 2015 to January 2017 and divided into two groups; one managed by operative treatment with plate and screws and the other by non operative sling immobilization after taking the consent and the patients were seen at 2, 4, 6 weeks,3, 6, and 9 m
... 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
... Show MoreThis study was conducted in Diyala province for renal failure patients during the periods August 2015 - April 2016. Hundred renal failure patients were enrolled in the study after diagnosis by the consultant physician at Ibn-Sina Center for Dialysis in Baquba Teaching Hospital according to criteria adopted by the World Health Organization for diagnosis of renal failure disease. The number of males in patient’s sample was 61 (61%) and females was 39 (39%) with an age range of 10 – 88 year (44.7 ± 22.1 year). In addition, the study included 50 apparently healthy individuals and considered as a group control, in which the number of males and females was similar (25 individual), with an age range of 18 – 88 year (51.7 ± 17.3 year). The
... Show MoreInterleukins (IL-2 and IL-4) are increased in asthmatics and were reported to induce resistance to steroid therapy in some patients who fail to get benefit from glucocorticoids when used in full dose and for long period of time. In this context, the present study was conducted on Iraqi patients to provide additional laboratory mean, beside the clinical diagnosis, for the decision whether the asthma is steroid sensitive or resistant by monitoring the level of immunoglobulins, complement proteins and interleukins among asthmatic patients (steroid sensitive or resistant) and the possible contribution of other factors like age, sex and environments in the development of steroid resistance. A total number of 55 asthmatics and 28 normal subjec
... Show MoreDiagnosing heart disease has become a very important topic for researchers specializing in artificial intelligence, because intelligence is involved in most diseases, especially after the Corona pandemic, which forced the world to turn to intelligence. Therefore, the basic idea in this research was to shed light on the diagnosis of heart diseases by relying on deep learning of a pre-trained model (Efficient b3) under the premise of using the electrical signals of the electrocardiogram and resample the signal in order to introduce it to the neural network with only trimming processing operations because it is an electrical signal whose parameters cannot be changed. The data set (China Physiological Signal Challenge -cspsc2018) was ad
... Show MoreExperience the Islamic financial industry faces many challenges, most notably the lack of proper risk management tools that meet the requirements of legality and economic efficiency advantage from another side, so it requires the search for innovative ways to manage the risk of Islamic banking, Islamic finance industry is manufacture up-to-date, if compared with the financial industry (traditional), which increases the problematic of risk management in the Islamic financial industry nature of treatment which should be compatible with Islamic law, as well as economic efficiency, thereby Progress came the importance of research to highlight the entrance to Islamic financial engineering and the goals sought to be achieved through the use of
... Show MoreMany risks have adverse consequences for construction projects’ objectives such as quality, schedule, and cost. As engineering procurement construction (EPC) contracts gradually become one of the most common types used in implementing major large-scale construction projects, identifying common risk types and analyzing their root causes is important for developing measures to decrease and eliminate future risks in these types of contracts. The information about the main causes of risks was collected
Rheumatoid arthritis (RA) is a chronic inflammatory polyarithritic disease
associated with remission and exacerbation with different immunological
features.Rheumatoid factor(RF) screening test was used quantitatively and qualitatively
using an enzyme immunoassay (EIA), RF-isotypes (RF-IgG, RF-IgM, RF-IgA) ,
Interleukin-18 (IL-18) and Interleukin – 18 binding protein (IL-18BP) were detected
quantitatively usingenzyme linked immunosorbent assay(ELISA). Results indicated a
51% positivity in RF among RA patients and a prevalence of the RF-isotype (RF-IgM)
with the highest level at (41.6±16.3 U/ml) (p < 0.05) among other RF-isotypes at a
percentage of 85.5% , results also indicatedan elevated serum level of IL-18