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 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 MoreThis study examined the relationship between the reporting lag (the timeliness of corporate financial reporting) and several independent variables: (1) Audit reporting lag,(2)Company Size,(3) Profitability of the company,(4)Company Age,(5) Sector Type.(6)Audit’s Opinion,(7) Market Type,(8) Gearing,(9) Concentration of ownership,(10) Audit Firm Size(11)Profit or Loss Company(12) Companies Listed lag on the PEX. In order to achieve the objectives of the study and testing its hypotheses, the data Obtained through actual data of a financial reports, and based on me
... Show MoreEnglish has for long been one of the most widely used media of communication globally, especially in the Malaysian universities. It has been termed as a Lingua Franca because it is shared with other languages which are considered first languages by different speakers. For this reason, English as a Lingua Franca (ELF) has attracted a number of researchers to investigate its variety via other languages in various communities. The objective of this paper is therefore to establish the strategies which are employing by the international students at the National University of Malaysia/ UniversitiKebangsaan Malaysia (UKM) as an example of one of the Malaysian universities; when they e
... Show MoreBackground: Several risk managem-ent standards had been developed including the Project Management Institute, the National Institute of Standards and Technology, actuarial societies, and ISO standards.
Objective: The study aimed at evaluating risk management among managers of model and ordinary primary health care centers in Baghdad City and comparing the risk management among these centers.
Methods: A descriptive comparative des
... Show MoreCu (In, Ga) Se2 (CIGS) nano ink were synthesized from molecular precursors of CuCl, In Cl3, GaCl3 and Se metal heated to 240 °C for 1 hour in N2-atmosphere to form CIGS nanocrystal ink, Thin films were deposited onto Au/soda-lime glass (SLG) substrates. This work focused on CIGS nanocrystals, including their synthesis and application as the active light absorber layer in photovoltaic devices (PVs). This approach, using spin-coating deposition of the CIGS light absorber layers (75 mg/ml and 150 nm thickness), without high temperature selenization, has enabled up to 1.398 % power conversion efficiency under AM 1.5 solar illumination. X-ray diffraction (XRD) studies show that the structural formation of CIGS chalcopyrite structure. The mo
... Show MoreBackground: Molars and premolars are considered as the most vulnerable teeth of caries attack, which is related to the morphology of their occlusal surfaces along with the difficulty of plaque removal. different methods were used for early caries detection that provide sensitive, accurate preoperative diagnosis of caries depths to establish adequate preventive measures and avoid premature tooth treatment by restoration. The aim of the present study was to evaluate the clinical sensitivity and specificity rates of DIAGNOdent and visual inspection as opposed to the ICDAS for the detection of initial occlusal caries in noncavitated first permanent molars. Materials and Methods: This study examined 139 occlusal surface of the first permanent
... Show MoreBackground: Optimal root canal retreatment was required safe and efficient removal of filling material from root canal. The aim of this in vitro study was to compare the efficacy of reciprocating and continuous motion of four retreatment systems in removal of root canal filling material. Materials and Methods: Forty distal roots of the mandibular first molars teeth were used in this study, these roots were embedded in cold clear acrylic,roots were instrumented using crown down technique and rotary ProTaper systemize Sx to size F2 ,instrumentation were done with copiousirrigation of 2.5% sodium hypochlorite and 17% buffered solution of EDTA was used as final irrigant followed by distilledwater, roots were obturated with AH26 sealer and Prota
... Show MoreThe increasing level of residents’ requirements of the local community led to the necessity for sufficient local funding to satisfy the residents’ requirements and services of the local units affiliated with the decentralized administrative systems on the one hand, and to the role of local financing in the financial independence of local units on the other hand.With the presence of local financing, the financial independence of local units is achieved and is considered one of the conditions for financial independence, which is the provision of local financing to the units away from central support. The study focused in this research to clarify the concept of local financing for local units with a statement of its conditions and importan
... Show MoreThe proposal of nonlinear models is one of the most important methods in time series analysis, which has a wide potential for predicting various phenomena, including physical, engineering and economic, by studying the characteristics of random disturbances in order to arrive at accurate predictions.
In this, the autoregressive model with exogenous variable was built using a threshold as the first method, using two proposed approaches that were used to determine the best cutting point of [the predictability forward (forecasting) and the predictability in the time series (prediction), through the threshold point indicator]. B-J seasonal models are used as a second method based on the principle of the two proposed approaches in dete
... Show MoreDiabetes mellitus type II is a disorder of metabolism and complex diseases affected by genetic environmental factors and associated with inflammation. The symptoms of type II diabetes develop gradually, which are associated with increased blood concentration of marker of the endothelial inflammatory factors. The expression of adhesion molecules, including E-selectin, intracellular adhesion molecule-1(ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) on the surface of vascular endothelial cells to help leukocyte stick to other surrounding tissues. Many researchers have made attempts to determine the significance of particular ABO phenotype for the susceptibility to diseases. Many reports show a strong association with the ABO blood grou
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