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 success of the company's strategy depends to a large extent on the success of its functional areas, the marketing Mix makes the company more able to monitor the external environment and the rapid changes related to competitors and customers, as well as the innovation contributes to meet the needs of customers and the requirements of competition and try to find solutions to various problems in Innovation ways, and thus integrated marketing and Innovation efforts in the company towards the design of competitive services to meet the requirements of customers and competition. The research aims to determine how marketing Mix and innovation to design unique and distinct services compared to the competitors, through exporator a sample of en
... Show MoreIntervention in International Relations from the concepts that are still highly
controversial among those he considers a breach of international law and the UN Charter and
in violation of the rule , and those who felt that the need provided, however, that this is linked
motives humanity recognized by the international community , because the international
variables proved the inadequacy of the principle of non-interference and the principle of
sovereignty as the traditional variables international , and therefore most of the international
practice came a bus with many of the behaviors that reflect a decline in its entirety to these
principles , and became adapt these principles with international reality is too compl
In this paper to isolate and study the properties of the cyclooxygenase-2 (EC: 1.14.99.1) enzyme in the blood of a patient suffering from rheumatoid arthritis and study the effect of natural products of the Soapwort on the activity of purified enzyme. The study involves taking 30 ml of blood from an adult woman 40 years old, who suffers from rheumatoid arthritis disease for 13 years. Serum is separated and subjected to a series of purification processes including: precipitation by ammonium sulfate, filtration by centrifugation radiator, dialysis in presence of ammonium bicarbonate, separation using the technology of ion exchange, lipholization and then estimating approximate molecular weight of the enzyme using gel filtration techni
... Show MoreBackground: This study is to evaluate the necessity of prescribing prophylactic antibiotics for nasal packing in spontaneous epistaxis. There are few published papers of infective complications in such patients.
Methods: This prospective study analysed 149 consecutive patients admitted to AL-Kindy teaching hospital with spontaneous, epistaxis, who underwent nasal packing over 2 years period . in the first year, 78 patients received prophylactic antibiotics , In the second year 71 patients were not given prophylatic antibiotics. Exclusion criteria included antibiotics prescribed for unrelated pathology and post-operative epistaxis. Signs and symptoms of acute otitis m
... Show MoreThe Covid-19 virus disease has been shown to affect numerous organs and systems including the liver. The study aimed to compare lipid profiles and liver enzyme levels in individuals who had recovered from Covid-19 infection. To achieve the study objectives, liver Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Alkaline phosphatase (ALP), Random Blood Sugar (RBS) and Lipid profile which include cholesterol, High-Density Lipoprotein (HDL), Triglycerides (T.G), Low-Density Lipoprotein (LDL), and Very low-density Lipoprotein (VLDL) were determined.
One hundred twenty serum samples were obtained, of which fifty samples were utilized as the control healthy persons (not affected by COVID) and seventy samples came f
... Show MoreThe aim of the currnet study to examine the effect of subclinical hypothyroidism (SCH) in diabetic patients on coagulation parameters. This retrospective case–control study involves 130 patients diagnosed with type 2 diabetes mellitus (T2DM), divided into 65 T2DM with newly diagnosed SCH and 65 euthyroid (EUT) T2DM patients without SCH. Fibrinogen (FIB) was significantly higher in SCH (508.2 ± 63.0 mg/dL) than EUT (428.1 ± 44.8 mg/dL). In the SCH patients, FIB correlated with several parameters, such as age (β = 0.396), body mass index (β = 0.578), glycated hemoglobin (β = 0.281), and activated partial thromboplastin time (β = 0.276). In conclusion SCH in DM patients appears to increase the magnitude of coagulopathy.
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