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.
Objective: To assess the functional outcome, time to union, shoulder pain, blood loss, operative time, iatrogenic radial nerve injury, hospitalization, and infection. Methodology: It is a prospective randomized study on 30 patients with mid-shaft humerus fracture according to AO classification (1.2A1, 2, 3 and 1,2B) with functioning radial nerve. They were randomly dividing into two groups. Group A were treated by a closed antegrade interlocking nail, and group B treated by open reduction and locked compression plate fixation. The follow-up was up to 6 months, including time to union, shoulder pain, intraoperative blood loss, operative time and iatrogenic radial nerve injury. Functional outcome was assessed by quick DASH score. Resu
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Should be the goal of Government controls, including environmental controls and safety laws to protect citizens from the harmful effects of negative secreted by human's additions and changes in the environment. and perhaps the protection aspects of the protection of citizens from the adverse effects of communications towers, including those produced by towers of health effects. The people the right to choose the nature of the physical environment, which should not be imposed on them by others. Communications towers are one of the main problems that have been
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From 50 stool samples collected from children with diarrhea of both sexes who visited various hospitals in Baghdad, 26 isolates of E.coli were found to belong to the phylogenetic group E. The findings revealed that the percentage of E.coli for thephylogenetic group E is (52%) , making it the dominant group among the other phylogenetic groups. The findings demonstrated that 100% of the E.coli isolates from phylogenetic group E are resistant to penicillin, and only 15% are resistant to imipenem. Multi-drug resistance (MDR) was found to be 15%, while XDR reached 85%. The results of thephylogenetic group for the remaining species of isolates in this study were group A (2/50 and by 4%), gr
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Focused research aims to provide a framework cognitive analytical nature of real estate investments and how they evaluated in the light of the assessment tools of modern theory of real options, and the possibility to rely on that theory in the detection of the true value of projects, real estate investments that would maximize the value of the investment decision taken, and the analysis of those projects that arise in the real estate markets and environments is the organization, which she was to make sure cases and high-risk, compared with entrances techniques, discounted cash flow (net present value). Based on the assumption lies in the possibility of the application of the implic
... Show MoreThis research discusses the verbal follow phenomenon in Al-Amali Abi Al-Qali’s book (seq.356 Hijri). It aims to limit the examples of this phenomenon in the book, and examine it phonologically. Accordingly, the researcher adopted the analaytical descriptive approach, taking into account Al-Rawi’s letter when ordering the verbal follow-based examples, and the order they took in the book in question. The purposes behind this phonological study of verbal follow in Al-Amali’s book are to: reach the sounds which Arabs prefer in the process of following, confirm different beautiful and desirable senses, have easy and speedy pronunciation, maintain harmony between adjacent sounds, count the sounds that occur at the beginning of the
... Show MoreThe purpose of this work is to construct complete (k,n)-arcs in the projective 2-space PG(2,q) over Galois field GF(11) by adding some points of index zero to complete (k,n–1)arcs 3  n  11. A (k,n)-arcs is a set of k points no n + 1 of which are collinear. A (k,n)-arcs is complete if it is not contained in a (k + 1,n)-arc
Abstract:
The study focused on the application of smart tourism as one of the applications of electronic commerce in the form of (B2C) to attract tourists to Saudi Arabia, where the tourism sector is one of the important sectors on which the Kingdom depends on the diversity of its economy.
The purpose of the research: With the issuance of tourist visas for the first time the study noted a deterioration in the case of Saudi tourist sites over the Internet, which do not live up to this great interest by the Saudi government for this sector, which became vital to them. The study tried to identify the reality of the Saudi tourist sites through the Internet in order to identify the sui
... Show MoreThe aim of the research is to diagnose and analyze the gap between the actual reality and the application of the eighth requirement (operation) in the National Insurance Company in accordance with the international standard specification for the quality management system (ISO 9001:2015), which is related to the planning, implementation and control of operations, which would raise the level of performance of employees and be reflected in the provision of An appropriate service for the faithful, as the reality of the condition of the requirement was studied by identifying the strengths and weaknesses of the system to diagnose the gap and find ways to address it. A workshop was held with company officials, through which questions were raise
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Abstract
The Classical Normal Linear Regression Model Based on Several hypotheses, one of them is Heteroscedasticity as it is known that the wing of least squares method (OLS), under the existence of these two problems make the estimators, lose their desirable properties, in addition the statistical inference becomes unaccepted table. According that we put tow alternative, the first one is (Generalized Least Square) Which is denoted by (GLS), and the second alternative is to (Robust covariance matrix estimation) the estimated parameters method(OLS), and that the way (GLS) method neat and certified, if the capabilities (Efficient) and the statistical inference Thread on the basis of an acceptable
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