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.
رافقت القسوة الانسان منذ القدم وكثيرا ما تم الخلط بينها وبين العنف لشدة التقارب بينهما , وهنا يحاول البحث ان يفصل بين كلا المفهومين ويتفرد بمفهوم القسوة, الذي سلط عليه الضوء في المسرح لأول مرة على يد الفرنسي(انطوان ارتو) في محاولة للكشف عن المعالجة الاخراجية التي قدمها المخرج العراقي(صميم حسب الله) لمفهوم القسوة في مسرحيته الموسومة (خريف) ويتضمن البحث نبذه (مفهوم القسوة في الفكر الانساني) وكذلك (الق
... Show MoreDeception is an inseparable facet of political discourse in attaining strategic political gains though compromising public opinion. However, the employment of discursive deception strategies by the policy-making institutions of think tanks has not received due attention in the literature. The current study aims at exploring how the ideologizing deception strategies are utilized by the conservative American think tank of the Washington Institute to reproduce socio-political realities and re-shape public opinion. To fulfill this task, van Dijk’s (2000) notion of ideological polarization which shows positive self-representation and negative other representation is adopted to conduct a critical discourse analysis of four Arabic texts relea
... Show MoreThe importance of this study lies in shedding the light on the impact of Islam and Prophet Mohammed (peace be upon him) on the western culture and English literature in particular. While some writers were looking at Islam as a dangerous element, others were completely taken by the oriental spirit of Arabic and Islamic culture and glorifying it. Writers from Chaucer to later ones mostly make references to this impact showing how vast was the gap of misunderstanding between the east and the West. Thus, this study aims at breaking the barrier between East and West in its three sections as it introduces the meaning of Islam and its common features with other religions in the first section. The second section briefly presents writers’ reflecti
... Show MoreStatistical methods of forecasting have applied with the intention of constructing a model to predict the number of the old aged people in retirement homes in Iraq. They were based on the monthly data of old aged people in Baghdad and the governorates except for the Kurdistan region from 2016 to 2019. Using BoxJenkins methodology, the stationarity of the series was examined. The appropriate model order was determined, the parameters were estimated, the significance was tested, adequacy of the model was checked, and then the best model of prediction was used. The best model for forecasting according to criteria of (Normalized BIC, MAPE, RMSE) is ARIMA (0, 1, 2)
The paper deals with the study of the sciences of the Qur’an according to the interpreter, Ayatollah Sayyid Mahmoud al-Talaqani, a religious jihadist figure from Iran. He is the author of the exegesis (Ishraq from Al-Quran), which consists of six parts, which he wrote inside the prisons of the Shah and in exile. Mr. Al-Talaqani agreed with some of the commentators in his positions on the sciences of the Qur’an, and some of them disagreed with others.
Death is undoubtedly the theme of Don DeLillo’s White Noise. Murray Siskind, a College-on-the-Hill professor who is obsessed with the exploration and reinterpretation of American popular culture, talks about the Tibetan Book of the Dead, and the German mentor of Jack Gladney has been using the Egyptian Book of the Dead, translated into German. The core episode of the story is the Airborne Toxic Event, the associate of Heinrich (Jack’s teenage son), Orestes Mercator, dreams of becoming one of the great figures in the Guinness Book by challenging and confronting death by enclosing himself in a glass pen jam-packed with poisonous snakes, and Heinrich challenges an imprisoned mass murderer in a chess game. The scholarly expertise of Jack c
... Show MoreThis research aims to study the performance of operations to provide nursing services, which included dimensions (quality, timeliness, leadership skills, behavioral manifestations, relationships with others, problem-solving and decision-making, job performance) and its effects in nursing performance. The research to prove the value of the performance of service delivery processes dimensions by nursing staffs working in Iraqi hospitals, nursing and measuring performance. To find out the nature of nursing services, and a comparison between hospitals to measure the extent of the application dimensional among themselves, and that by relying on the dimensions of a global study, which was measu
... Show MoreBackground: Gray-scale sonography is generally
considered as a first-line diagnostic tool for patient with
suspected acute cholecystitis. It is suggested by gallstones,
Murphy's sign, thickening of the gallbladder wall and bile
sludging, but the specificity of these sonographic findings
are not as high as their sensitivity. Blood flow of the
gallbladder wall is increased in acute inflammation.
Objective: To evaluate the sensitivity and specificity of
power Doppler sonography and compared with conventional
color Doppler and gray-scale sonography in diagnosing
patients with acute cholecystitis.
Type of the study: This was a cross sectional study.
Patients and methods: The study was conducted t
This prospective study investigates the prevalence of methicillin-resistant S.aureus (MRSA)
in burn unit of Al-Kindy Iraqi hospital, their susceptibility to antibiotics and bactericidal effect of near
infrared light from high powered 1064nm Nd: YAG laser and green light 532nm from SHG Nd: YAG laser
using various energy densities on these bacteria. Twenty four clinical isolates of S.aureus out of sixty
four examined patients with sever burn ulcers.MRSA was associated with 50% of S.aureus infections
.Results of antimicrobial susceptibility revealed that MRSA were multidrug resistant. After laser treatment
of non MRSA with Nd:YAG with wavelength of 1.064nm, 4mm beam diameter, energy density of
0.636 kh/cm2 and 180sec ex
Background: Hip fractures are common, morbid, and costly health events that threaten independence and function of older patients . Early functional recovery is extremely important for elderly patients with femoral intertrochanteric fractures to shorten their hospital stay, omit the necessity of the further nursing and care services, and reduce associated medical expenditures . Assessment of (ADL) is an important predictor of outcomes Of orthopedic surgery in very early postoperative period at two weeks and a month postoperatively using Japanese orthopedic score get a quick recovery of ADL & return the patient to his or her premorbid level function reducing the morbidity and mortality.
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