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.
Processed and red The Western diet, a modern dietary pattern, typically consists of meat, sugar-filled beverages, candies, chocolates, fried foods, prefabricated meals, refined cereals, conventionally produced animal products, high-fat dairy products, and high-fructose items. The goal of this review is to outline how the Western pattern diet affects gut microbiota and mitochondrial fitness, as well as metabolism, inflammation, and antioxidant status. Cancer, mental health, and cardiovascular health; We offer a thorough analysis of how the westernized diet and related nutrients affect immune cell responses as well as the hygienic costs of the Western diet. A consensus critical evaluation utilizing primary sources, including scientifi
... Show MoreThe instant global trend towards developing tight reservoir is great; however, development can be very challenging due to stress and geomechanical properties effect in horizontal well placement and hydraulic fracturing design. Many parameters are known to be important to determine the suitable layer for locating horizontal well such as petrophysical and geomechanical properties. In the present study, permeability sensitivity to stress is also considered in the best layer selection for well placement. The permeability sensitivity to the stress of the layers was investigated using measurements of 27 core sample at different confining stress values. 1-D mechanical earth model (MEM) was built and converted to a 3-D full-field geomechanical mode
... Show MoreThe paper aims to measure and analysis the impact Public Spending on Iraq economy (Kaldor Variables).
(variables of the magic square Kaldor) and them in after 2003.
The paper adopted econometric Methods to test the stationarity of the Variables under consideration. For the period (2005-2016) by using multiple regression and estimation the Impulse response function (IRF), by adopting Eviews 10 program.
The results of Impulse response function for the following five-years after the period under consideration reflexes that public expenditure (PEX) was fluctuating between positive and negative in all the variables of the research and this shows the fragility of the performance of fiscal policy in Iraq.
T
... Show MoreA geographic information system (GIS) is a very effective management and analysis tool. Geographic locations rely on data. The use of artificial neural networks (ANNs) for the interpretation of natural resource data has been shown to be beneficial. Back-propagation neural networks are one of the most widespread and prevalent designs. The combination of geographic information systems with artificial neural networks provides a method for decreasing the cost of landscape change studies by shortening the time required to evaluate data. Numerous designs and kinds of ANNs have been created; the majority of them are PC-based service domains. Using the ArcGIS Network Analyst add-on, you can locate service regions around any network
... Show MoreBecome organizations today can not withstand the competitive challenges and constant change in the business environment , as well as the pressures witnessed by the Iraqi environment , especially in recent years such as the opening of the market which increased ambitious organizations and desire to secure the experiences superior to the survival and expansion of the competitive environment , prompting attention to the subject of vital contemporary is emotional Marketing and measure its impact on the customer experience in the sector of the economy is important and is the financial sector , so there is a need to study this term in the Iraqi organizations and try to diagnose the extent of implementation of the study sample emo
... Show MoreThe aim of the research was to investigate the use of non-parametric tests in the analysis of the questionnaire and how to choose the appropriate test for testing the hypothesis of the study of crime motives in Khartoum State. The data were collected through the primary sources by designing a questionnaire and distributed to a sample of inmates in Khartoum state; the data were analysis by SPSS program using the analytical statistical method through using some of the suitable non-parametric tests for each case. The most important results of the research were: there was significant relationship between the type of crime and the age group therefore, we found that the age group (20-29) was the most frequent crime particularly, the fi
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