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.
Background: Laparoscopic cholecystectomy (LC) has become the treatment of choice for elective cholecystectomy.Objectives: To evaluate the safety and feasibility of early LC for AC and to compare the results with delayed LC.Methods: A prospective study done from April 2011 to October 2013, 88 patients with diagnosis of AC were divided randomly into two groups according to the mode of treatment; (early group n=40) treated by early LC within first 72 hours or (delayed group, n=48) initial conservative treatment for 4-6 weeks, followed by delayed LC.Results: There was no difference between the two groups (early & delayed LC), operating time (early 80min, delayed70min), conversion rate (early 7.5%, delayed 6.25%),postoperative complicatio
... Show MoreSurvival analysis is one of the types of data analysis that describes the time period until the occurrence of an event of interest such as death or other events of importance in determining what will happen to the phenomenon studied. There may be more than one endpoint for the event, in which case it is called Competing risks. The purpose of this research is to apply the dynamic approach in the analysis of discrete survival time in order to estimate the effect of covariates over time, as well as modeling the nonlinear relationship between the covariates and the discrete hazard function through the use of the multinomial logistic model and the multivariate Cox model. For the purpose of conducting the estimation process for both the discrete
... Show MoreThe aim of the research is to use this technique and to determine the effect of this method in reduce cost per unit of the company. The traditional method used in the company the research sample to determine the indirect costs, the definition of the concepts and characteristics of the method of cost-based activity and the cost method based on time-driven activity and justifications applied to companies. In order to achieve the research objectives, the main hypotheses were formulated. That was represented: (The applied of (TDABC) Time driven activity based costing method in reducing indirect costs, leads reduce cost per unit than the use of the traditional method of allocating indirect costs in the research sample company).&nb
... Show MoreIraq faces significant economic challenges, owing in part to its reliance on oil revenue and the country's overburdened public sector. The supremacy of State-Owned Enterprises (SOEs), obstructive rules, a lack of access to finance, a shortage of skilled labor, and inadequate infrastructure all impede private sector growth. This research relied mainly on information from global development organizations, most markedly the World Bank, as well as policy documents, and it discovered a scarcity of pertinent educational writings. The following are the key findings of this research: Recent economic growth has not resulted in poverty reduction; the stretched history of war and insecurity in Iraq has hampered progress and development; the private se
... Show MoreObjectives: To explore the correlation between maternal and cord blood prolactin, the correlation between cord prolactin and birth weight, and to compare cord blood prolactin in new-borns of women with normal pregnancy and women with pregnancy complications namely; gestational hypertension, gestational diabetes and preterm labour.Methods: This study was performed from September to December 2018. Thirty-two women, delivered at Baghdad teaching hospital, and their newborns (32) were included. Maternal blood (5 ml) was taken before labour and cord blood (5 ml) was collected after placenta expulsion. Maternal and cord blood prolactin were analysed using fluorescence immunoassay. Results: Cord blood prolactin was higher in babies b
... Show MoreA detailed experimental study was devoted to the anodic oxidation of oxalic acid using manganese dioxide rotating cylinder anode with the objective to evaluate in a systematic way the effect on the oxalic acid oxidation process of several relevant parameters, including the presence of sodium chloride, the current density (J), the rotation speed, the temperature, and the initial concentration of oxalic acid. Thin manganese dioxide film on graphite substrate has been prepared by electrochemical oxidation from MnSO4-H2SO4 electrolyte. The morphology of this electrode was investigated by XRD, SEM, EDS and AFM techniques. The results show that a firm γ-structure of MnO2 film on graphite rod can be obtained successfully. The results indicate tha
... Show MoreIntroduction and Aim: Graves ophthalmopathy is one of the pandemic public health disorders in Iraq. The current investigation attempts to determine the variation in the complete total blood cells on the recovery of individuals with Graves' ophthalmopathy following low and high-dose Radioactive Iodine 131 (RI-131) exposures. Materials and Methods: The complete blood CBC level in people with Graves' illness and healthy, normal controls were quantitatively identified using the CBC counter. Thyroid stimulating hormone was utilized to compare the recovery of ophthalmopathy patients in comparison to a control group. Results: In comparison to healthy controls, patients with Graves' ophthalmopathy disease who received 10 mci of RAI-
... Show MoreConstruction projects have a special nature and affect them many factors making them exposed to multiple risks as a result of the length of the implementation period and the multiplicity of stages, starting from the decision stage through implementation until the final delivery, which leads to increased uncertainty and the likelihood of risk.
The process of analysis and risk management is one of the effective and productive methods that are used in managing the construction projects for the purpose of increasing the chances of ending the project successfully in terms of cost, time and quality and at the lowest possible problems.
The research aims first to the effective planning for analysis and risk managemen
... Show MoreCommercial banks represent the main pivot in financing national economic activity and its development. The capital represents safety margin to depositors and represents a defense line that protects bank work from dangers. Basel committee requirements represent protection and comprehensive supervision to bank activities for depositors, debtors and the bank. It provides trust in bank dealings and tackles activities of high dangers. The most prominent of these requirements are capital adequacy that concerns bank management and supervision and auditing bodies such as the central bank and protecting banks that suffer weakness in its vital important borrowing activity that reflects weakness in implementing borrowing policy .The purpose
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