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.
This study aims to explore the potential mediation role of person-centeredness between the effects of the work environment and nurse reported quality and patient safety. A quantitative cross-sectional survey collected data from 1055 nurses, working in medical and surgical units, in twelve Malaysian private hospitals. The data collection used structured questionnaires. The Hayes macro explored the mediation effect of person-centeredness between the associations of work environment dimensions and care outcomes, controlling nurses’ demographics and practice characteristics. A total of 652 nurses responded completely to the survey (61.8% response rate). About 47.7% of nurses worked 7-h shifts, and 37.0% were assigned more than 15 pati
... Show MoreThis study aimed to evaluate the preparedness and adherence of community pharmacists to the International Pharmaceutical Federation (FIP) Health Advisory COVID-19 guidelines for pharmacists (July 2020) during COVID-19 pandemic. This was a cross-sectional study based on electronic survey using google form, which was distributed from November 19, 2020 to January 1, 2021 using social media platforms. The survey measured 21 pharmacy preventive measures (PM). A multivariate regression analysis was used to identify factors influencing pharmacy implementing of PM. Hand disinfection after serving patients represented the main adopted measure (89.3%). Surprisingly, only 35.4% of participants implemented the proper ways of hand disinfection during fa
... Show MoreThis purpose of the research is to test liquidity ratios to assess bank liquidity risks represented by liquidity ratios (current assets / current liabilities, current assets / total deposits, current assets / total assets, cash credit / total deposits, liquidity coverage ratio LCR, net stable financing ratio NSFR). This research involves evaluating these risks in banks via these ratios, and reveal the most important means used to solve these risks, including the capital adequacy ratio under the Basel II decisions and for selected period (2017-2019).The research reached the most important conclusion, which is the bank sample did not fall into bank liquidity risks throughout the years of research. Tracking specific ratio with adequ
... Show MoreBackground: Shunt operations are performed for different reasons mainly hydrocephalus congenital or acquired. It’s associated with certain morbidity and mortality.
Patients and method: A prospective study from Jan 2004 to Jan 2006, 226 patients under went shunt operation in the specialized surgical hospital in Baghdad. The patients were divided into two groups according to the way of applying the upper end catheter. In group A49 patients where posterior parietal approach was used, and group (B) 174 where parietal or temproprietal approach was used.
Results and discussions: different complications were recorded, but the most frequent was upper end obstruction by choroids plexus or by debris. In group
Background: Major life changes are among many factors that cause emotional arousal and anxiety ,and one of these changes is surgery. emotional reactions to surgery have specific
effects on the intensity and velocity as well as the process of physical disease and on the general state of wellbeing of the patient.
Aims: This study is aimed at determining the relationship between the nature, extent and severity of preoperative anxiety and different types of surgery.
Methods: 150 patients 84 males 68 females awaiting different types of surgery at Al-Kindy teaching hospital at the period from 1st January to 1stJuly 2008 were assessed for a clinically
detected preoperative anxiety in relation to different variab
Stuck pipe is a prevalent and costly issue in drilling operations, with the potential to cost the petroleum industry billions of dollars annually. To reduce the likelihood of this issue, efforts have been made to identify the causes of stuck pipes. The main mechanisms that cause stuck pipes include drill cutting of the formation, inappropriate hole-cleaning, wellbore instability, and differential sticking forces, particularly in highly deviated wellbores. The significant consequences of a stuck pipe include an increase in well costs and Non-Productive Time (NPT), and in the worst-case scenario, the loss of a wellbore section and down-hole equipment, or the need to sidetrack, plug, or abandon the well. This paper provides a comprehensive
... Show MoreObjective: to evaluate the benefit of coverage of
the urethral repair by dorsal dartos flap as a second
layer for preventing fistula and V like incision on
the tip of the glans for preventing meatal stenosis.
Patients and Methods:
Forty five children included in this study age
ranged ( 11 months – 7 years), they underwent
hypospadias repair between December 2008 to
March 2012, all cases with distal hypospadias,
same technique used for all patients, a combination
of techniques used for reconstruction starting
withtubularized incised plate urethroplasty with deepithelialized
or stripping of the skin from both
sides of U shaped incision surrounding the urethral
plate, adding a V like incision on t
Pain is a sensory and emotional experience that is influenced by physiologic, sensory, affective, cognitive, socio-cultural and behavioral factors. Postoperative pain is the commonest reason for delayed discharge and unanticipated hospital admission after ambulatory surgery. Our Objective is to test the hypothesis that administration of 2 ml/kg/hr preoperative IV fluids may attenuates postoperative pain.The study was carried out in the Baghdad Teaching Hospital, Al-Yarmok Teaching Hospital and Al-Karama Teaching Hospital from 12 May till 17 June 2009. The total number of patients was 120 (35 males and 85 females) with their age ranged between 10-90 years. The patients were divided into two groups according to administration of preoperati
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