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
Due to the momentum of winning in the streets of the city of Baghdad as a result of the large number of checkpoints so felt researcher to conduct a field visit to find out the main reasons that led to this congestion and to find practical solutions to mitigate wastage winning the arrival time citizen to where you want the least possible time.
This research aims to overcome the difficulties experienced by citizens to reach their places of work and reduce waste at the time of service and waiting time as well as reduce the cost of waiting.
Has emerged study a set of conclusions, including the use of model queue (G / G / C) and the mome
... Show MoreIn this work, the dyes Rhodamine B and Coumarin 102 containing titanium dioxide nanoparticles were used as scattering centers to fabricate a random gain medium. The laser dye was dissolved in hexanol and methanol solvent respectively. The titanium dioxide nanoparticles were synthesized by DC reaction magnetron spraying technique. The random-gain medium was made by adding 2.5 mg of titanium dioxide nanoparticles to Rhodamine and coumarin 102 dyes by coating the glass cell with two-sided titanium dioxide with high spectral efficiency and low production cost. A narrow line optical emission was detected at 565 nm for Rhodamine B and 534 nm for coumarin 102, where it was found that rhodamine B dye has FWHM 8 nm and coumarin dye 102 has FWHM 9 nm
... Show MoreA total of 258 voluntary blood donors (males 101; females 157) in the age range of 18-52 yr among males and 18-55 yr among females were examined for Toxoplasma gondii antibodies (IgG), and (IgM) by immunological technique (Enzyme linked Immunosorbant Assay) during the period from March 2009 to April 2010. This study covered a wide range of factors including immunological, age ,sex , place of residence and symptoms that may have a possible relationship with toxoplasmosis. Results presented in this study showed clearly that 38 (14.7%) of individuals participated in this study having IgG Toxoplasma Ab, among those 10 samples (9.9%) were males and 28 samples (17.8%) were females. Moreover, we found the prevalence of IgM seropositivity in th
... Show MoreThis research evaluated the effect of (UV)(400-320A)Hz(320-220B)Hz on the patient with vitiligo , using it with our new combing therapy that include the oral (Psorlene ) topical , meladinine solution applied on the Vitiligiousns Lesions , In edition to the instralesnional injection in the Vitiligiousns Lesions by long acting steroid (kenacort-A ) by aprecentage of (5%) , after that we expose the patient to UV . The ruslets of this way of treatment more effective by using of the UV rays in the treatment of vitiligo , while the previous treatment that used the UV ray with or with out the psorlene , the results were not effective on controlling of the Vitiligio diseases comparing by the treatment used in this research as it stop’s the sp
... Show MoreThe tax is a financial amount collected from the taxpayer for the account of the public treasury.. and is the cornerstone of the close bond between members of the community and the country in which they live , as income tax is imposed on the profits and revenues achieved by people and often the constitution of most contemporary countries stipulate that the legislator is obligated to determine the sources of revenues and profits subjected to tax. Because the tax has a serious impact on people’s money because it is exposed to that money through direct deduction . Therefore, we note that the applicable income Tax Law stipulated that in order income to be subject to tax , it must be derived from one or more of the income sources st
... Show MoreThe most common nosocomial fungal infection in hospitals is urinary tract candidiasis. Candida albicans is the most prevalent cause of nosocomial fungal urinary tract infections, however Candida species distribution is changing rapidly. At the same time, the rise in urinary tract candidiasis has resulted in the emergence of antifungal-resistant Candida species. This study aimed to diagnose Candida Spp. In women with UTI and reveal the nucleotides sequences of CA-INT-L Gene to look for mutation within the gene. This study included 100 women patients suffering from urinary tract infections and vaginal swabs samples from those individuals were taken to identify the presence of Candida. They were between the ages of 22 and 67. Candida i
... Show MoreThe moral aspect is an important one in the structure of personality , and the lack of moral aspect is responsible for what we suffering today from problems . there is no exaggeration to say that many of our current problems are moral problems , and reflects the lack of moral growth.
The goal of research is to build scale in order to detect the level of moral reasoning among junior high school students in Baghdad , The researcher followed the procedures in the construction of scientific standards in order to measur
... Show MoreThe use analysis value chain such information in the provision as financial so information quality meet and satisfy the needs of users such information , particularly investors and lenders as the identification needs financial information and the knowledge as their behavior influenced by that information can be based on the accounting profession to focus on improving their function in order to achieve its goal that satisfying their needs and rationalize their decisions . In accounting thought discovered fertile ground for users preferences as one of the entrances theorising positive which is based on the need to include knowledge on accounting hypothesis that explain the
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