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.
Studies on the flexural behavior of post-tensioned beams subjected to strand damage and strengthened with near-surface mounted (NSM) technique using carbon fiber-reinforced polymer (CFRP) are limited and fail to examine the effect of CFRP laminates on strand strain and strengthening efficiency systematically. Furthermore, a design approach for UPC structures in existing design guidelines for FRP strengthening techniques is lacking. Hence, the behavior of post-tensioned beams strengthened with NSM-CFRP laminates after partial strand damage is investigated in this study. The testing program consists of seven post-tensioned beams strengthened by NSM-CFRP laminates with three partial strand damage ratios (14.3% symmetrical damage, 14.3%
... Show MoreThe current work was undertaken to obtain the crude extract of PPO and laccase enzyme from the leaves of Malva parviflora. All leaves were washed with tap water, then the extraction was performed to acquire the crude extract’s enzymes. One gram of Malva parviflora leaves was homogenized in various volumes of distilled water (1:10, 1:5, and 1:2 w: v). The results showed that polyphenol oxidase and laccase with a ratio of 1:10 (w:v) gave the highest specific activity of 112.3 with 0.394 U/mg proteins. In addition, Malva parviflora leaves were homogenized with several types of buffers with two concentration (0.2 and 0.1 M) for PPO and laccase extraction. These buffers were potassium
... Show MoreFor the time being, the cold-formed sections are widely used due to their simple manufacturing and construction processes. To be feasible, the strength of cold-formed columns should be determined based on their post-buckling behavior. Post-buckling relations are cumbersome and need design aids similar to those of American Iron and Steel Institute (AISI) to be applicable. These design aids have been developed to sections and materials other than those available in the local market. Therefore, this paper tries to develop a general finite element model to simulate the postbuckling behavior of cold-formed steel columns. Shell element has been used to discretize the web, flanges, and lips of the column. A linear bucking analy
... Show MoreAbstract:
Organizations need today to move towards strategic innovation, which means the analysis of positions, especially the challenges faced by the change in the external environment, which makes it imperative for the organization that you reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures. Now this research dilemma intellectual two-dimensional, yet my account in not Take writings and researchers effect strategic innovation in re-engineering business processes, according to science and to inform the researcher, and after the application represented in the non-application of such resear
... Show Morethe reality of small and medium enterprises analysis reflects weaknesses plaguing these enterprises and strengths that are characterized by, and thus the formulation of appropriate solutions to the obstacles faced by these enterprises to enhance its contribution to the achievement of economic and social development. Iraqi small and medium enterprises suffer from several obstacles stand in front of development and support their competitiveness, the finance one of the main obstacles which impede growth and development of these enterprises, noting the banking system in Iraq reluctance to lend to small and medium-sized enterprises, as a result of the high cost of lending these enterprises compared to large projects, as well as
... Show MoreBackground: Propolis has received great interest because of its wide range antimicrobial activity. Propolis also called (bee glue) due to its collection by (Apismellifera) honeybees from various plants resinous substance. The aim of this study was to determine the antibacterial effect of propolis extracts (aqueous and alcoholic) on anaerobic periodontal pathogen namely Aggregatibacteractinomycetemcomitans. Materials and Methods: Strains of Aggregatibacter actinomycetemcomitans wasisolated from pockets of systemically healthy patients aged between 35-55 years old suffering from chronic periodontitis with pocket depths of 5-6 mm, the bacteria cultured on special blood Agar plates solid media. Propolis was extracted by using water and alcohol.
... Show MoreChronic kidney disease (CKD) is a major public health concern around the world. UMOD gene variants are linked to a higher incidence of hypertension and CKD in the general population. This study aimed to investigate the role of uromodulin rs13333226 and rs13333144 genes association with chronic kidney disease.The study samples were divided into two groups. The first group included 100patient samples and 70 chosen among them were under the dialysis and had kidney failure aged between 18-88 years old. The second group included 30 samples from healthy individuals who were used as a control. One of the ways used to identify the genotype is the tetra-primers amplification refractory mutation system–polymerase chain reaction (ARMS
... Show MoreEffect Anti-Mullerian Hormone (AMH) on thyroid levels in patients with and
without polycystic ovarian syndrome PCOS was studied, The results showed an
increase in AMH ,T3 ,T4 with increase of age while TSH , BMI decreased with
increase of age comparing to control in hyperthyroidism with PCOS patients.
Otherwise an increase in AMH, TSH, BMI, T3 and T4 with increase of Age
compared to healthy group in hyperthyroidism without PCOS. Effect of ovarian
hormones (AMH) on inventory levels of thyroid and perturbations in terms of
increases and its impact obesity as well as fertility in women was declared in this
research. Serum Anti-Müllerian Hormone (AMH) was assessed using enzyme linked
immunosorbent kit [Elisa] whil