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
On 11/1/2008 amounts of snows fell on various sections of Iraq, one of
which is Baghdad. The analysis process of climatic maps proved that the
advance trough of Sudanese depression towards the city is the reason behind
the formation of this weather state supported by could trough in the (500) mb
pressure level. .
The research concluded that the phenomenon of global warming
witnessed by the world recently had a main role in the occurrence of this
phenomenon due to the raise in earth temperature as a result of evaporation
rate increase leading to an increase in water vapor and cloud formation with
high tops and low bases which form sows with high rates accumulating at high
and moderate latitudes le
The serum protein test includes measurement of the level of total protein(albumin, globulin). Fetuin-A is a blood protein made in liver. It can inhibit insulin receptor, enhance insulin sensitivity and make the individuals more likely to develop type 2 diabetes, then disorder in lipid profile (Total cholesterol(TC), low density lipoprotein cholesterol (LDL-c), high density lipoprotein cholesterol (HDL-c), Triglyceride(TG) and very low density lipoprotein cholesterol (VLDL-c) . To evaluate Fetuin-A, total protein, albumin, globulin, HbAlc and lipid profile in 200 adult and elderly Iraqi patients with type 2 Diabetes Mellitus were taken and compare them with 200 subjects as a healthy control. The laboratory analysis(for patients and
... Show MoreBackground: Type 2 diabetes mellitus is a condition characterized by an elevation of oxidative stress, which has been implicated in diabetic progression and its vascular complications. Aim: Assessing the impact of gliclazide modified release (MR) versus glimepiride on oxidative stress markers, glycemic indices, lipid profile, and estimated glomerular filtration rate in uncontrolled type 2 diabetic patients on metformin monotherapy. Methods: This was an observational comparative study conducted in Thi-Qar specialized diabetic, endocrine, and metabolism center. Sixty-six patients were randomized into two groups based on the addition of the sulfonylureas (SUs). Group 1 (33 patients) was on gliclazide MR, whereas Group 2 (33 patients)
... Show MoreMarketing information system (KMIS) is an essential factor of developing business’ performance and getting sustainable success. The main goal of the research is to measure effect of MIS on customer orientation and product innovation. Also, another goal is to analyze the mediation role of product innovation in relationship MIS and customer orientation. This study sought to analyze the marketing information system and measure its effect on the customer orientation and product innovation. The data of the study were collected using questionnaire. The data were analyzed using statistical tools and SPSS programming. The results of the study showed that the KMIS can positively and significantly effect product innovation. Also, t
... Show MoreBACKGROUND: Nebulized Salbutamol have great advantages for patients with respiratory problems by depositing drugs directly to the lungs, inspite of reported adverse metabolic effects on different electrolytes and glucose heamostasis of patients.AIM OF STUDY: To evaluate the effect of nebulized salbutamol used in the management of patients with asthma who have normal serum potassium and blood glucose levels. in the emergency department after 30 and 60 minutes of administration and to find out if these results are of clinical importance that should be taken in consideration when treating patients especially those with abnormal glucose hemostasis or electrolyte disturbance. PATIENTS & METHODS: The study is a prospective follow
... Show MoreIn the years recently city planning projects have been confirmed sustainable high concentration on planning streets and pedestrian paths being the most prominent component of the urban structure in the city and these me and diverse departments link the city’s sectors and serve as a space for economic, service, and social activities. On the other hand, pedestrian traffic is an essential component of the various means of transportation within the city. Suffer cities in the Middle East and Arab cities in particular are neglecting pedestrian paths in the vital urban environment. Vehicle control mechanisms on roads, and changing the uses of pedestrian paths as result of encroaching on the sidewalks designated for pedestrians. Which leads to a
... Show MoreCopper (Cu) Zinc (Zn) and Magnesium (Mg) in serum, RBC, urine and dialyzate fluids were
studied in 39 patients, who have been undergoing chronic haemodialysis treatment. They were
divided in to polyuric , oliguric and anuric depending on their urinary output. Elevated serum and
RBC Mg was observed before dialysis, while decreased serum and RBC level was noticed except
serum Mg of polyuric patients. Before dialysis elevated serum and RBC Zn were observed. While
after dialysis these parameters were increased. Normal RBC Cu value before dialysis was observed.
While low serum Cu was noticed. After dialysis serum Cu showed raised value, while RBC level
decreased in oliguric and increased in polyuric patients. Zn / Cu rati
Cox regression model have been used to estimate proportion hazard model for patients with hepatitis disease recorded in Gastrointestinal and Hepatic diseases Hospital in Iraq for (2002 -2005). Data consists of (age, gender, survival time terminal stat). A Kaplan-Meier method has been applied to estimate survival function and hazerd function.
The research deals with financial and supplies support from the rulers and governors of the
Arab cities and Islamic regions to the poor of common people and the poor of their own . The
Islamic Arab community was characterized , since the prophet's era , with great humanistic
features that formed the cultural characteristic which organized individual's economic life .
The prophet , senior Muslims and the rich cared a lot about this side . There was a large
variation in the degrees of wealth and poverty in the Muslim Arab community as a heritage
from the pve – Islamic society where there is no concern about helping the needy and poor .
Thus , the research sheds light on the different forms of help offered by rulers a
The annealing temperature (200–500 °C) effects of optical frequency response on the dielectric functions of sol–gel derived CuCoO