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 United States government allowed Native Americans to abandon their reservations in the 1950s and 1960s. The historical, social, and cultural backgrounds shaped the forms and themes of works by American Indian writers who urged people to refuse their culture's sense of shame. Moreover, their behavior corresponded with the restoration of individuals to their rituals after disappointment, loss of sense of life, and mental illness performed from the influence of mainstream American society. Among these writers, N. Scott Momaday and Leslie Marmon Silko participate in similar interest in portraying characters caught between indigenous beliefs and white mainstream standards.
The construction of
... Show MoreNanostructured Al2O3has been applied as a protective coating against corrosion of the carbon steel (C.S) in seawater environment (3.5% NaCl) at temperatures range (298-328)K. Aluminananoparticles were deposited on carbon steel substrates by cathodic electrophoretic deposition (EPD) with ethanol as suspension medium and poly(acrylic acid) (PAA) as polymeric charging agent. Meanwhile, thesurface morphology was examined using Atomic-force microscopy (AFM). The cross-section AFM showed that the particles sizes for the Al2O3 NPs is around 60-80 nm. The anticorrosion behaviour of coated C.S was investigated in 3.5% NaCl at temperature range 298-328 K by potentiodynamic polarization measurements. Results show that using PAA in suspension coat incr
... Show MoreObjective: To determine the effectiveness of the Nursing Management Education Program upon the Nurse
Managers' Knowledge about planning in Nursing Management at Baghdad City Hospitals.
Methodology: A Quasi-experimental study in which a purposive "non-probability" sample of (50) Nurse
Managers was selected from Baghdad City Hospitals. These Managers were divided into two equal groups of
(25) Nurse Managers for each (study and control ones). A questionnaire was developed as a tool for data
collection. A pilot study was carried out to test the reliability of the questionnaire for the period from April 2nd to
June 20th 2007. The pre-post test approach was applied to the study and control groups as mean for the quasiexperime
Objectives of the study: The present study aims to evaluate nurses’ knowledge about enteral feeding in critical care units.
Methodology
A descriptive study design was carried out in the critical care units at Al-Ramadi Teaching Hospital and Al-Fallujah Teaching Hospital of Al-Anbar Governorate for the period 6th of December 2020 to 5th of January 2021. A non-probability (purposive sample) consists of 32 nurses was selected based on the study criteria. The instrument consist of, the reliability of instrument was = 0.87.
The instrument consist of 30 items of knowledge about enteral
... Show MoreThe theatrical show depends in its formation on the technical system and the elements that it has for the theatrical show, and among these techniques is the lighting, where every director looked for a style and method of implementing them and giving aesthetic functions and characteristics that give the theatrical show an aesthetic and interpretive dimension, and that is through multiple expressions and connotations of the lighting in giving the show a functional and aesthetic character. Therefore, light has been shed on the lighting and its action in the theatrical show, due to its significant role in the modern theatrical shows. The current research, thus, has been divided into four chapt
... Show MoreThe study aimed to spread the culture of efficient performance between nursing staffs, which would contribute and achieve health care quality, and to clarify the role of nursing in improving the quality of high-quality health care, as well as to clarify how to reach national standards for the quality of health care in Iraq, Therefore, the study dealt with the efficiency of nursing performance as an explanatory variable, and the quality of health care as a dependent variable. The fact that the health sector is the foundation for building a healthy society free from diseases, so hospital of IBN AL-NAFIS as an institution and it's nursing teams were taken as a community for this study. The results to be objective and reflect the rea
... Show MorePurpose: To contribute to the development of an appropriate program for the management of medical waste based on clear-cut principles in order to reach the overall goal of improving the public health and environment of the population in our country.
Design / Approach / Introduction: The research is based on the analytical descriptive approach as a method of study in the field of data collection using a check list and analysis of the data through the use of some statistical treatments.
Results: The need is to establish a medical waste management in hospitals and follow international standards in all stages of waste management from sorting, collection, transportation and treat
... Show MoreIn light of the increasing interest in Child-rearing in nurseries and kindergartens and the most important experiences gained by the child at this stage that form the basis for the subsequent stages of her/his physical mental and social growth.
The significance of the research concentrates the need to asses the affecting variables on the child growth to create opportunities for her/him to have intact rearing.
The research also aims to classify these variables at each age level and highlight its moral role.
The problem of the research is the lack of clarity of different variables impact of the child growth in different age levels in nurseries and kindergart
... Show More