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.
Pituitary adenomas are the anterior pituitary tumors. Patients with an Aryl Hydrocarbon Receptor-Interacting Protein (AIP) mutation (AIP- mut) tend to have more aggressive tumors occurring at a younger age. Single nucleotide polymorphisms (SNPs) in many studies have been related to metabolic comorbidities in the general population. Study aims investigated the role of AIP gene SNPs with susceptibility to acromegaly pituitary- adenoma, with levels of LH, FSH, TSH, Testosterone, IGF1,GH, FT4 , Prolactin hormones and blood sugar levels. The study was conducted on a group of acromegaly patients, including 50 patients) both Genders( with hyperplasia of the ends, and apparently healthy control group. Genotyping of
... Show MoreCerebellum is the most important and critical part of the central nervous system, cerebellum is very sensitive to the abnormal changes during the embryological development in its histological structure, the exposure to any infection during embryogenesis produce abnormalities in the cerebellum and behavioral of offspring. In this study we tried to study the ontogenesis of the cerebellum in the embryos of the albino rats and detection the effect of the AgNPs on the ontogenesis of the rat cerebellum after exposure of AgNPs during pregnancy. we used 60 female pregnant rats divided in to three group, each contain 20 female, (G1) treated with 2mg/kg /day suspension of silver nanoparticles (Ag NPs) (G2) treated with 20mg/kg/day AgNPs from first da
... Show MoreABSTRACT Background: Improving the properties of heat- cured and self-cured acrylic resin have been studied by many researchers. However, little studies concerned with visible light cured resin (VLCR) improved through addition of nanofiller are available. The purpose of this study was to evaluate some properties of (VLCR) after addition of SiO2 nanofiller. Materials and Methods: SiO2 nanofiller were added to (VLCR) tray material after being dissolved in tetrahydrofuran (THF) solvent. According to the pilot study 2% SiO2 nanofiller addition exhibited better properties than the other percentages (1%, 3%). The main study conducted involved (100) specimens divided into 5 groups according to the test included. (20) Specimens were selecte
... Show MoreIn this research the Empirical Bayes method is used to Estimate the affiliation parameter in the clinical trials and then we compare this with the Moment Estimates for this parameter using Monte Carlo stimulation , we assumed that the distribution of the observation is binomial distribution while the distribution with the unknown random parameters is beta distribution ,finally we conclude that the Empirical bayes method for the random affiliation parameter is efficient using Mean Squares Error (MSE) and for different Sample size .
Hate speech (henceforth HS) has recently spread and become an important issue. This type of speech in children's writings has a particular formulation and specific objectives that the authors intend to convey. Thus, the study aims at examining qualitatively and quantitatively the classism HS and its pragmatic functions via identifying the speech acts used to express classism HS, the implicature instigated as well as impoliteness. Since pragmatics is the study of language in context, which is greatly related to the situations and speaker’s intention, this study depends on pragmatic theoriespeech acts, impoliteness and conversational implicature) to analyze the data which are taken from Katherine Mansfield's short story (The D
... Show MorePurpose: The research aims to build an integrated knowledge framework for the basic research topic. The spirituality of the workplace is through access to the most important scientific proposals on these topics. In management thought framing, the knowledge within them in a serious attempt is to provide the appropriate answers about the intellectual dilemma of research by diagnosing the nature of the relationship with the influential elements and its historical development . Methodology: The study is relied on the analytical survey method. The research sample targeted (88) managers in the center of the Iraqi Ministry of Health exclusively from the researched senior leaders (general manager, assistant general manager, and head of department),
... Show MoreThe results of previous scientific studies showed that knowledge is something and application is something else, that's why teachers' preparation programs focused, in the present time, on special standards for knowledge and performance, i.e., who has knowledge is not necessary able to apply it in his life or in his field of work, which led to the existence of a gap between knowledge and application. Based on that, those interested in (teachers' preparation) reconsidered their work evaluation, thus the concept of competency appeared at the end of the sixties of the past century to address the negative in teachers' preparation.
The following contains a number of competency features in teachers' preparation programs:
Teachers' effec
Kurdish language multifunctional morphemes indicate the different functional morphological, syntactical, and semantic tasks of the morphemes. The present study discusses the multifunctional task of the Morpheme Le in Kurdish Language. The Morpheme Le has marginally been included in other studies, yet up to the present times, there has not been a research inclusively dedicated to thoroughly discuss and clarify its multifunctional aspects. The present study is divided into two chapters:
Chapter one discusses the theoretical aspect of chapter two that is entirely concerned with the practical aspect of the morpheme Le. The first part of chapte
... Show MoreThis study deals with air pollution tolerance index (APTI) and anatomical variation in leaves of two species of terrestrial plants Ficus sp. and Conocarpus sp. that have bee commonly the separated along roadsides in many stations within Babylon province. APTI values of both species were less than 10 during study period which represented sensitivity of these plants to air pollution. There are Anatomical responses to pollution in the leaves of both studied species. Main adaptations included increased thickness of parenchyma cell walls with clear dark deposits in sections of Ficus sp. from sections of stations 2 and 4 which represent polluted stations. Conocarpus sp. main adaptation included stomata increased in density and decreased in size w
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