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 purpose of this paper is to examine absorbance for the removal of the Red Congo using wheat husk as a biological pesticide. Several experiments have been conducted with the aim of configuring breakthrough data in a fluidized bed reactor. The minimum fluidized velocities of the bed were found to be 0.031 mm/s for mish sizes of (250) µm diameter with study the mass transfer be calculated KL values. The results showed a well-fitting with the experimental data. Different operating conditions were selected: bed height (2, 5 and 10) cm, flow rate (90, 100and 120) ml/sec and particle diameter (250, 600, 1000) µm. The breakthrough curves were plotted for Congo Red, Values showed that the lower the bed, the lower the number of ad
... Show MoreA simplified parallel key was presented in this work for the Taxa of Stackys L. wildly grown in Iraq. Three records within this genus were newly recorded to our country in the present work and they are S. kermanshahansis Rech S. setifera C.A. Mey. subsp setifera, S. setifera ssp iranica (Reck.) The characteristics of these new records were also given with some representative specimens.
Arabian killifish,
In this study, the staging of normal embryonic development of
This study unveils the ideologies of women empowerment encoded in the Mona Lisa Smile movie (2003). It reveals how the stereotypical image of women born only to be wives and do the duties of upbringing and housework is challenged. Katherine Ann Watson (Julia Roberts), the main character in the movie, wants to make a difference in the next generation of women. She rejects the imposed traditional ideologies. Linguistically, she opposes conventional thinking and seeks to persuade her students that life is about more than getting married. The primary focus of this study is to examine and clarify how the characters’ linguistic choices convey their ideologies concerning the notion of women empowerment. To do this, the researchers apply
... Show MoreThe construction sector in Iraq has faced many challenges. One of the major challenges is the lack of productivity of laborers who are working construction sites. Although research studies have been conducted to investigate, explore, and identify factors influencing labor productivity in the Middle-east region, the lack of such research studies to address these challenges in Iraq. This motivates the researcher to explore and identify the key factors affecting labor productivity in construction sites across different organizational structures (Matrix, Projectized, and functional). A survey questionnaire has been conducted using Delphi technique in order to achieve a concrete and reliab
Cyclophosphamide which acts as cytotoxic alkylating agent can induce a renal damage through the toxic metabolites which result from metabolic activation of Cyclophosphamide by cytochrome P-450 inside hepatocyte and develop renal toxicity by direct binding with cellular organelles in the urinary tract cells. Guggulsterone is a sterol derived from plant has ability to bind to farsenoid X receptor, mineral corticosteroid receptor, androgen receptor, glucocorticoid receptor and estrogen receptor.