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.
Background: Obesity increases the host’s susceptibility by modulating the immune and inflammatory systems in a manner that predisposes to inflammatory tissue destruction and leaves an individual at greater risk of periodontitis. Melatonin is a pineal secretory product involved in numerous actions, such as regulation of internal biological clocks and energy metabolism, and it functions as an antioxidant and anti-inflammatory agent. There exists a substantial amount of evidence supporting the beneficial effect of melatonin supplementation on obesity and its complications. Aim of the study: To investigate the effects of systemic melatonin intake on periodontal health status and lipid profiles in obese periodontitis patients. Subjects and met
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Objectives: The study aims to know the effectiveness of the educational program in the patient’s adherence to medication and diet and to know the relationship between the effectiveness of the education program and their demographic data related to the patient’s age, gender, marital status, education level, occupation, monthly income and residence.
Methodology: A quasi -experimental design study was performed on patient who attended to Gastroenterology and Hepatology Teaching Hospital, from March 2021 to September 2021. The non-probability sampling including 50 patients for case study and 30 patients for control group. The questionnaire consists of 3 parts, part one the socio
... Show MoreThe issue of insurance against unlawful risks raises a jurisprudential and judicial debate between two opposing trends: the first considers coverage of these risks invalid due to their impact on public order or morals, while the second—which this research analyses—calls for the possibility of covering these risks in specific circumstances, based on contractual considerations in accordance with the principle that the contract is the law of the contracting parties, and based on the obligation to compensate the harmed third party—the victim—who has no connection to the unlawful act. In this context, our research highlights that contractual considerations can justify coverage of some unlawful risks, provided that the goal is to achieve
... Show MoreThe international business environment faces many challenges, including the intensity of competition, the speed of expansion, and control of the market. This leads to its shadow on the local business environment, which prompted many economic units to adopt modern strategies, including mergers and acquisitions, for expansion and prosperity. The research was conducted to verify the role of internal audit in the governance of strategy operations (Mergers and acquisitions) and its reflection on management decisions and making them efficient and effective. Internal auditing is the independent variable related to the other variable, the governance of strategic operations and its impact on management decisions for strategic operations as a depende
... Show MoreThe technique of plant tissue culture has been used to In vitro micropropagation of Spilanthes acmella (L.) Murr. It is an ornamental and medicinal plant not cultivated in Iraq. Seeds were sterilized and cultuared on full strength Murashige and Skoog medium(1962)(MS). Naphthalene acetic acid (NAA), 6- furfuryl aminopurine (Kin.) growth regulators were used at the Initiation stage.The combination between IAA and Kin. was used in multiplication stage. IAA was used for rooting the shoots. Results showed that 1.5% sodium hypochlorite for 15 min was very effective for disinfecting and survival. Nodes exhibited relatively highest response as compared with apical meristems and leaflets culture. Supplying the culture medium with 1 mg/L.
... Show MoreThe research has tackled about an important transformation within the whole region of middle east, especially there were more challenges which revealed under the huge pivotal interests of global powers that ruled the new world order by United states of America ; being very affected over the international and regional relations than any situations appeared previously within political realities. So that, many of variables inside the international scene which happened during of this period of contradicting strategic policies by the process of reforming and restructuring of difficult equations that imposed by international and regional allies and blocs . This article had concentrated over various strategic and political studies which reflect
... Show MoreThe issue of the research lies in the non-representation of the models developed for the communication process in the interaction and networking processes through social media, as the research sought to build a network model of communication according to the specific data and features of social media platforms in order to reach a special generalization to understand how the process of networking operates in cyberspace.
The researcher followed the analytical survey approach as she described the communication models outwardly in order to be able to build a networked communication model that represents the flow of post-reactive communication. Therefore, it has been named "Nebula - Sadeem" after the concept of post-space and cosmic g
... Show MoreToday many people suffering from health problems like dysfunction in lungs and cardiac. These problems often require surveillance and follow up to save a patient's health, besides control diseases before progression. For that, this work has been proposed to design and developed a remote patient surveillance system, which deals with 4 medical signs (temperature, SPO2, heart rate, and Electrocardiogram ECG. An adaptive filter has been used to remove any noise from the signal, also, a simple and fast search algorithm has been designed to find the features of ECG signal such as Q,R,S, and T waves. The system performs analysis for medical signs that are used to detected abnormal values. Besides, it sends data to the Base-Stati
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