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.
Today 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
... Show MoreThe performance and durability of the asphalt pavement structure mainly depend on the strength of the bonding between the layers. Such a bond is achieved through the use of an adhesive material (tack coat) to bond the asphalt layers. The main objective of this study is to evaluate the effect of moisture in conjunction with repeated traffic loads on the strength of the bonding between asphalt layers using two types of tack coats with different application rates. Using the nominal maximum size of aggregate (NMAS), the layers were graded (25/19) and (19/9.5) mm. The slabs of multilayer asphalt concrete were prepared using a roller compactor using two types of tack coats to bond between layers, namely rapid curing cut back a
... Show MoreDocumentary Credit passes through many practical phases starting from Opening credit and matching documents and payment of the amount of credit……etc. It is worthy to mention that there are several aspects that are varied and differed from Bank to another one which can offer Competitive Advantage for the bank …This will be shown in this research.
For the purpose of achieving the objective of this research within the theoretical aspect, the researcher had seen and briefed several books and researches which are mainly related to the subject of the research.
As for the practical aspect, has included Questionnaire which included many questions that are fit and suitable to the hypotheses.
Research sample has
... 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 MoreBackground: 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 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 MoreAbstract\
Dealing economic units at the present time with an industrial environment characterized by competitiveness and the pace of change and its strength as a result of this changing environment shall be on those who made it to adopt strategies that allow them to confront these variables and work in order to meet the market requirements of quality and price appropriate products to suit and the demand for those products and conditions to maintain
its competitive position and its development.
As a result, it became the subject of competitiveness in recent years and enjoys widespread attention at the global level. And in order to keep up
... Show MoreThe 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 MoreThe study of the concepts of "democracy" and "human rights" and their impact on development, has taken a prominent place in the context of general political and cultural concerns, or in specialized studies even though researchers and scholars do not agree on defining the concepts: Democracy, Human Rights, Development or deriving a global definition hindering them, and that because of the importance of this topic, which proceeds from a number of considerations standing in the forefront, of which:
First: What the world witnesses today in the first decade of this century of consecration of the unipolar theory, trying to give its concepts and perceptions through the law ((excessive force)) to the power of international
... 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
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