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.
Abstract:
In light of the development in the banking environment and the increasing reliance on electronic systems in providing banking services and due to the intense competition witnessed by the banking sector, the need has emerged to apply the comprehensive electronic banking system, which works on the Internet in providing new and diverse banking services regardless of time and place by linking all branches to one central database, and despite the advantages achieved from the application of the comprehensive system, there is a set of risks that accompany the use of that system, What requires the auditors to develop the audit method in line with the size of the development in the
... Show MoreThe studies on unbonded post-tensioned concrete members strengthened with Carbon Fiber Reinforced Polymers (CFRPs) are limited and the effect of strengthening on the strain of unbonded pre-stressed steel is not well characterized. Estimating the flexural capacity of unbound post-tensioned members using the design methodology specified in the design guidelines for FRP strengthening techniques of bonded post-tensioned members does not provide a reliable evaluation. This study investigates the behavior of unbonded post-tensioned concrete members with partial strand damage (14.3% and 28.6% damage) and strengthened with CFRP laminates using a near-surface mounted technique with and without U-wrap anchorages. The experimental results show
... Show MoreThe research is based on a statement of the effect and nature of the relationship of elements of promotional mix represented by (advertising, personal selling, sales promotion, public relations and direct marketing) as the independent variable in the dependent variable represented in the competitive advantage in the General Company for the manufacture of medicines and medical supplies Samarra. Analytical descriptive in the theoretical side, through the use of a number of literature from scientific sources (books, research and studies published in Arab and foreign magazines) was also relied on the methodology of the case study in the practical side, Data collection using the questionnaire tool, which was designed using the triangular Like
... Show MoreThis day, we see the Significant role that social media platforms play, it plays a vital role in shaping the Social, political, and economic awareness of individuals. The Iraqi Society, which is experiencing rapid cultural and social transformations, is considered a fertile ground for social media and its influences, whether negative or positive. Research and studies indicate that the negative use of social media will lead to weaking of the sense of belonging and citizenship among members of Iraqi society. This, in turn, threatens moral and educational values, increases feelings of family estrangement, and leads to social isolation. On the contrary, if social is used correctly, it can significantly contribute to enhancing educational values
... Show MoreThe goal of current research to the definition of environmental awareness in the curriculum and its role in sustainable environmental planning, was the research community official regular educational schools (kindergarten, primary, secondary) for the province of Baghdad - Iraq, the sample consisted search of (100) teacher and a teacher, and what research was descriptive analytical, researchers have selected the right tool for the research procedures (closed) questionnaire, distributed to the research sample, has been used by researchers appropriate statistical methods for procedures including: the weighted average extraction unit paragraph,
... Show MoreBackground: Hypertension is a major global health concern that increases the risk of cardiovascular disease. Understanding the impact of age and treatment types on blood pressure control is essential for optimizing therapeutic strategies. Aim: This study aims to assess how different treatment types and patient age influence blood pressure control in hypertensive patients. Methodology: A binary logistic regression model was employed to analyze data from 48 patients diagnosed with hypertension. The study investigated the impact of two treatment regimens and patient age on the likelihood of achieving optimal blood pressure levels. The statistical significance of the findings was evaluated using chi-square tests and p-values. Results: T
... Show MoreBackground: Breast cancer is the most common cancer in Iraq and the United Kingdom. While the disease is frequently diagnosed among middleaged Iraqi women at advanced stages accounting for the second cause of cancer-related deaths, breast cancer often affects elderly British women yielding the highest survival of all registered malignancies in the UK. Objective: To compare the clinical and pathological profiles of breast cancer among Iraqi and British women; correlating age at diagnosis with the tumor characteristics, receptor-defined biomarkers and phenotype patterns. Methods: This comparative retrospective study included the clinical and pathological characteristics of (1,940) consecutive female patients who were diagnosed with invasive b
... Show MoreBackground: Leukemia is a broad term given to a group of malignant diseases characterized by diffuse replacement of bone marrow with proliferating leukocyte precursors. Chemotherapy has been increasingly used to treat malignant conditions. The systemic sequelae as a result of these immunosuppressive techniques induce many oral and dental complications. This study was conducted to evaluate the effect of chemotherapy on oral health status and activity of salivary alkaline phosphates enzyme in patients with acute lymphocytic leukemia. Materials and methods: The study groups included 28 patients with acute lymphocytic leukemia; they were under chemotherapy, aged 20-25 year old. The control group includes healthy subjects matching with study
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