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.
Purpose/ to build clear perceptions about the level of the effects of organizational failures on the competitiveness of dairy factories and the role of dynamic knowledge capabilities in minimizing these impacts
Mythology/ Design approach Use deduction approach, the research was conducted in four dairy factories in Baghdad (Abu Ghraib, Agriculture, Halal and Ayon Al-Rafidain). It was applied to a sample of (155) individuals representing a sample of the research community from factory owners, managers, Engineers, technicians and experienced workers in the dairy industry. The questionnaire was used as a main tool for collecting data, information and statistical tools in the extraction, testing and analysis o
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Abstract
Leadership has now become a process for applying methods and techniques that make the Organization at the top of its competitive pyramid a greater market share. Leadership has become a focus for all leaders and managers، and leaders and managers are increasingly seeking to develop their skills and leadership skills. The research started with a clear problem of specific questions to ensure that the general objective of the research is to describe the characteristics of the leader and to clarify the dimensions of empowering the workers and to highlight the role of the leader in empowering the workers. The study examines the relation between the role of the leader in
... Show MoreA case–control study (80 patients with chronic hepatitis B virus [HBV] infection and 96 controls) was performed to evaluate the association of an IL12A gene variant (rs582537 A/C/G) with HBV infection. Allele G showed a signifcantly lower frequency in patients compared to controls (31.2 vs. 46.9%; probability [p]=0.009; corrected p [pc]=0.027) and was associated with a lower risk of HBV infection (odds ratio [OR]=0.49; 95% confdence interval [CI]=0.29–0.83). A similar lower risk was associated with genotypes CG (17.5 vs. 29.2; OR=0.25; 95% CI=0.08–0.81; p=0.02) and GG (10.0 vs. 16.7; OR=0.25; 95% CI=0.07–0.91; p=0.036), but the pc value was not signifcant (0.12 and 0.126, respec‑ tively). Serum IL35 levels showed signifcant difere
... Show MoreObjective: To Evaluate the Roley of Cytotoxic T-Lymphocytek antigen 4 Polymorphism and soluble immune checkpoint level (PD-1,PDL-1 and CTLA-4 ) in SARS-Cov-2 patients. Methods: Fromt October 2020 to April 2021, the currentk study was conducted in Baghdad-Iraq. Ninety patients with Confirmatory SARS-Cov-2 by PCR were inclusion in the study, and they were seeking treatment at Medical City in Baghdad's Teaching Hospital (BTH). Patients with SARS-Cov-2 were divided into two groups: those with Sever SARS-Cov-2 symptom and those with mild - moderate SARS-Cov-2 symptoms (cross sectional study. Patients with another form of autoimmune illness, malignant, diabetes, under the age of 18 and pregnant women were excluded. Results: Data rega
... Show MoreThis study investigated the prevalence of quinolones resistance proteins encoding genes (qnr genes) and co-resistance for fluoroquinolones and β-lactams among clinical isolates of Klebsiella pneumoniae. Out of 150 clinical samples, 50 isolates of K. pneumoniae were identified according to morphological and biochemical properties. These isolates were collected from different clinical samples, including 15 (30%) urine, 12 (24%) blood, 9 (18%) sputum, 9 (18%) wound, and 5 (10%) burn. The minimum inhibitory concentrations (MICs) assay revealed that 15 (30%) of isolates were resistant to ciprofloxacin (≥4µg/ml), 11 (22%) of isolates were resistant to levofloxacin (≥8 µg/ml), 21 (42%) of isolates were re
... Show MoreThe Role of the Deubiquitylase MYSM1 During Alphavirus Infection Amer Nubgan The members of the genus Alphavirus are positive-sense RNA viruses and it is one of two within the family Togaviridae. Most alphaviruses are predominantly transmitted to susceptible vertebrates by a mosquito vector. Alphavirus disease in humans can be severely debilitating, and depending on the particular viral species, infection may result in encephalitis and possibly life threatening symptoms. Chikungunya virus (CHIKV) is the aetiological agent represents a substantial health burden to affected populations, with clinical symptoms that include severe joint and muscle pain, rashes, and fever, as well as prolonged periods of disability in some patients. In recent
... Show MoreThe contemporary role of administrative accounting Renewal or threat
At the last two decades , The environment has witnessed tremendous changes in many fields with the huge competition , various technological development and customer satisfaction , that are reflected in economic units a doption for lean production system.
Lean accounting that has appeared as a response for change occurred of economic units adoption for changes occurred of economic units adoption for lean production instead of wide production system , has devised new performance measures suitable for economic units adoption for lean ideas: and helping in providing suitable information about evaluating economic unit performance , these measures are divided into three levels , cell level,value flow level , a
... Show MoreOur aim in this paper is to study the relationships between min-cs modules and some other known generalizations of cs-modules such as ECS-modules, P-extending modules and n-extending modules. Also we introduce and study the relationships between direct sum of mic-cs modules and mc-injectivity.