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.
This study was performd on 50 serum specimens of patients with type 2 diabetes, in addition, 50 normal specimens were investigated as control group. The activity rate of LAP in patients (560.46 10.504) I.U/L and activity rate of LAP in healthy(10.58 4.39)I.U/L.The results of the study reveal that Leucine aminopeptidase (LAP) activity of type 2 diabetes patient s serum shows a high signifiacant increase (p < 0.001) compare to healthy subjects. Addition preparation leucine amide as substrate of LAP, identification melting point and spectra by FTIR. K
For 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 MoreStudies 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 experiment was conducted in Al- Mahaweel Research Station in Babel Governorate, Ministry of Agriculture during autumn season 2016-2017 to determine the role of irrigation management processes and micronutrient fertilization in growth and productivity of two varieties of wheat IPA 99 and Al-Rasheed 22 in clay loam soil classified as Typic Torriflovent. The experiment included four irrigation treatments and six fertilization treatments. The experiment was designed under randomized complete block design (RCBD) with three replications. Wheat grain IPA 99 and Al-Rasheed 22 varieties were planted in 23/11/2016 and harvested in 13/5/2017. The amount and periods of irrigation depended on sensors reading of volumetric water content was measured
... Show MoreSystemic lupus Erythematosus is an autoimmune disease of unknown aetiology affecting multiple organ system. Reactive nitrogen and oxygen species are claimed to play a role in this disease. However, the potential of Nitrosative/Oxidative Stress to elicit an autoimmune, response remain till now largely unexplored in humans. This study was done to investigate the status and contribution of nitrosative/oxidative stress in Iraqi patients for systemic lupus erythematosus. Blood samples from 19 patients with systemic lupus erythematosus and 19 age-and sex- matched apparently healthy controls were evaluated for serum levels of nitrosative/oxidative stress markers including nitric oxide, peroxynitrite and malondialdehyde. Nitric oxide levels were
... Show MoreBackground: Crohn's disease (CD) is an immunological disorder associated with chronic inflammatory process of several unspecific regions of gastrointestinal tract but frequently detected in the terminal Ilium and proximal colon or both. This disease frequently presented with various oral manifestations as a consequence of inflammatory process of the disease, nutritional deficiency or medications side effects. Several therapeutic approaches have been developed for CD management that are targeting the inflammatory process and directed at controlling the host immune response. Immunosuppressants such as Azathioprine and anti-TNF α agents as well as the combination of them have been widely used as an effective therapeutic modality with a bett
... 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 MoreThis study included estimation of glutathione (GSH) and Malondialdehyde (MDA) levels in the serum of diabetic patients type II who are treated with a polyherbs mixture (Nigella sativa, Trigonella foenum-graeum, Cyperus rotundus and Teucrium polium) for three months of treatments. Seventy samples of diabetic patients Type II male and females with age about (35-60) years were taken including 44 samples for group one (24 male, 20 female) who used herbs accompanied with chemical treatment (drugs) and 26 samples for the second group (13male and 13 female) who used herbs only. These groups were compared with 60 samples obtained from healthy persons (29 male, 31 female) at the same age of patients as a control group. Effect of age and treatment fo
... Show MoreThis study aims to find the chemosensitive dysfunction incidence in COVID-19-positive patients and its recovery.
We collected the data from sixty-five patients, all COVID-19 positive, quarantined in-hospital between 5 April 2020 and 17 May 2020, by a questionnaire distributed in the quarantine ward.
Smell dysfunction appeared in 89.23% with or without other symptoms of COVID-19. 39.66% of them recovered the sense of smell. Taste dysfunction found in 83.08% patients with other COVID-19 symptoms. Only 29.63% of them recovered. The recovery took 1–3 weeks, and most