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.
Long-term use of sulfonylureas including chlorpropamide, is known to potentiate the antidiuretic action of arginine vasopressin (AVP), predisposing to hyponatremia.The present study was designed to evaluate the effect of long term use of glibenclamide on serum and urinary levels of sodium and potassium in Type 2 DM patients in Iraqi DM centers. Ninety eight patients with Type 2 DM who were maintained on different doses of glibenclamide for at least 1 year, attending the centre for Diabetes and Endocrinology in Al-Rusafa, Baghdad, were enrolled in the study, in addition to 15 normal healthy subjects. Patients were allocated into three groups according to the dose of glibenc
... Show MoreRheumatoid arthritis is an autoimmune diseasecharacterized by chronic inflammationthat affects joints and cartilage. Bone complications such asRA-relatedosteoporosis are one of the most extra-articular manifestations. Many inflammatory mediators are released during RA disease pathophysiology; these mediators stimulate osteoclast genesis of bone by direct effects on RANKL and OPG. The study aimedto measure RANKL, OPG in RA patients treated with Etanercept only and other groups treated with Methotrexate onlyat baseline and after three months to evaluate bone state. An observational case-control prospective study was done on 30 RA patients who received MTX, 30 RA patients who received ETN, and 30 healthy,age-matched control groups. The
... Show MoreThe 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
The problem of this study lies in that NATO was formed in the first place to protect Europe from Warsaw Pact. The geographical and military strategy have been changed with the change of its mission and expanding its operation scope with the leadership of the USA in the international scens. The latter has made this organization as the military arm to tighten its control over strategic regions.
The research supposes that NATO state members confront security concerns and political and military issues that push to expand the organization. The importance of this study lies in knowing the new roles of NATO imposed by the United States. Therefore, the continuity and affi
... Show MoreThis research investigates the pre- and post-cracking resistance of steel fiber-reinforced concrete specimens with Glass Fiber Reinforced Polymer (GFRP) bars subjected to flexural loading. The purpose is to modify the ductility and cracking resistance of GFRP-reinforced beams, which are prone to early cracking and excessive deflections instigated by the low modulus of elasticity of GFRP. Six self-compacting concrete specimens (1500×240×200 mm), incorporating steel fibers of two lengths (25 mm and 40 mm) with varying distribution depths, were tested to assess their structural performance. The results indicate significant enhancements in cracking resistance, stiffness, energy absorption, ductility, and flexural strength. Tested beam
... Show MoreExamining and comparing the image quality of degenerative cervical spine diseases through the application of three MRI sequences; the Two-Dimension T2 Weighed Turbo Spin Echo (2D T2W TSE), the Three-Dimension T2 Weighted Turbo Spin Echo (3D T2W TSE), and the T2 Turbo Field Echo (T2_TFE). Thirty-three patients who were diagnosed as having degenerative cervical spine diseases were involved in this study. Their age range was 40-60 years old. The images were produced via a 1.5 Tesla MRI device using (2D T2W TSE, 3D T2W TSE, and T2_TFE) sequences in the sagittal plane. The image quality was examined by objective and subjective assessments. The MRI image characteristics of the cervical spines (C4-C5, C5-C6, C6-C7) showed significant difference
... Show MoreThis research explores the intricate relationship between environmental sustainability and urban design in Al-Jumhuriya Neighborhood, Baghdad, reflecting urban development challenges and opportunities. It highlights the need to balance growth, functionality, and quality of life with environmental responsibility in urban areas worldwide. The research includes a literature review on environmental sustainability in urban design and the utilization of multifunctional land in contemporary cities. The research employs a mixed-methods approach, combining quantitative and qualitative data collection methods. Survey results show a diverse range of perspectives, indicating concerns about air quality and local regulations but also positive views on co
... Show MoreAbstract: This research aims to investigate and analyze the most pressing issues facing the Iraqi economy, namely economic stability and inclusive growth Consequently, the present study investigates the effect of inflation and unemployment, which are significant contributors to economic instability, on inclusive growth dimensions such as GDP, education, health, governance, poverty, income inequality, and environmental performance. From 1991 to 2021, secondary data were collected using World Bank Indicators (WDI) and Organization for Economic Cooperation and Development (OECD) databases. The researchers also employed the autoregressive distributed lag (ARDL) model to determine the relationship between variables. The study revealed that fluct
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