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.
The decorative supplements added are important factors in determining many decorative effects and how to implement them, whether in fabrics or fashion, and also work to determine the nature of perception for both the designer and the recipient and have a key role in shaping the human personality and determining his motives and emotional tendencies in the acquisition of fabrics and fashion and the vocabulary they carry A design that has certain connotations and symbols that gain its value from the effects it leaves on the physical formations of women. The problem of the research came with the following question (What are the decorative supplements and their role in the designs of fabrics and women’s fashion?) The research also dealt wit
... Show MoreGender mainstreaming is a goal for building a society characterized by justice and equality. Gender mainstreaming requires a clear understanding of the concept. Therefore, the research focuses on the concept of gender and how it was addressed in the literature through which the concepts related to gender were extracted which is represented by the role and social status through which the relationship of gender can be measured. In order to find out the basis for the different status and roles of both sexes in societies, the interpreted theories of gender were addressed, through which the most important factors affecting gender relations, such as biological, social and economic factors, as well as political systems, were discussed. Due to t
... Show MoreBackground :Alkaline phosphatase (ALP) was a widely used marker for skeletal and hepatobiliary disorders, but its activity was also increased in atherosclerosis and peripheral vascular disease. Several study has showed that ALP activity was increased in the sera of diabetic patients. The current study was conducted to evaluate ALP activity in type 2 diabetic patients and optimum conditions for enzyme activity in their sera.Methods: This study was carried out at in AL-Yarmok hospital(diabetic center) between February /2009 and April /2009. Fifty two patients with type 2 diabetes have been enrolled. Besides BMI, WHR, serum fasting blood glucose, ALP, HbA1C,uric acid and lipid profile levels have been performed .The relationship bet
... Show MoreThis research aims to numerous risks to the portfolio of the insurance company that arise from practicing the activity in general, and the risks arising from insurance contracts in particular, and what is the role of the company in the disclosure to help users (such as owners) to understand and concentration of risks in the financial reporting and identifying movable risks size to reinsurers that may affect the solvency of the portfolio and makes them at a given moment required to fulfill the obligations towards policyholders outweigh the financial capacity, which leads to stumble or bankruptcy.
So I sought this research is to identify the extent of the obligation to disclose the accounting for this risk and the extent of their i
... Show MoreWe have focused the research problem through an assessment of the applicability of the third pillar of the decisions of the Basel Committee 11 (market discipline) or not and its impact on both the adequacy of bank capital, supervisory oversight and banking risks and the statement weaknesses commitment banking institutions and which in turn lead to the stability of the financial system as a whole. .
The research is important statement on the importance of big capital in the banking business and the attributes of a role in the absorption of losses suffered by the bank, which reflects the willin
Background: The menopause is physiological changes in women that give rise to adaptive changes at both systemic and oral level. During menopause, ovarian function declines and the production of sex steroid hormones reduces significantly affecting the oral tissues and periodontal structures leading to chronic inflammation of the gingiva, increased risk of tooth loss. Aim of study: The present study was designed to estimate the oral hygiene status in relation to salivary estradiol level among pre and post-menopausal women. Materials and Methods: Ninety women aged 48-52 years old, the control group consisted of 45 pre-menopausal women and the study group consisted of 45 post-menopause were examined for gingival index, plaque index and calcu
... Show MoreBackground: human paillomavirus infections (genital warts) are the most frequent sexually transmitted viral infections. a wide range of treatment options is available with different efficacy.
Objective: To evaluate the efficacy of podophyllin, trichloracetic acid (TCA) in the treatment of genital warts and side effects of them.
Subjects and methods: a total of sixty patients with genital warts were randomly selected, 30 in each group, in the Department of Dermatology, medical city for a Duration of 11 months from January 2009 to December 2009 treated with 35 % podophyllin in the tincture of benzoin or 50% TCA) .Forty-eight patients were followed up for three months.
Results: wart
... Show MoreBackground: Mitral regurgitation (MR) is the most commonly encountered valve lesion in modern clinical practice. Severe mitral regurgitation may cause systolic dysfunction. Left ventricular ejection fraction may not be an accurate measurement of LV function in patients with mitral insufficiency. Myocardial performance index (MPI) is a simple non invasive measure of myocardial function. Methods: The study involved 50 patients with valvular mitral regurgitation and 50 healthy subjects as a control group. Transthoracic echocardiography was carried out for all patients and control group. The echocardiographic measurements included left ventricular end diastolic and end systolic dimensions, left atrial diameter, ejection fraction (EF), and myoca
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