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 aimed to provide a conceptual model for the use and benefits of the e-Government as related to administrative fraud and financial corruption. The study also looked into their concepts, forms, dimensions and types and the role of e-Government on fraud reduction, corruption in administration and finance and its impact on the government performance. From the result, it is revealed that there is need for electronic government for implementation in order to curb the rate of fraud and administrative and financial corruption and improve the quality of service provision for better performance
The development of a future mechanism for sustainable development in Iraq to meet the current and future challenges requires an analysis of the indicators of sustainable development. This research aims at presenting and analyzing the social care aspect and highlighting the important role of taxes with a focus on social sustainable development to determine the extent and direction of changes. Level of progress, the researcher concludes the weakness of the financial allocations to the Ministry of Labor and Social Affairs and in line with the large number of people who apply the conditions and controls, and recommends the researcher the necessity of participation of all segments of society between the public and private sector In terms of o
... Show MoreThe concept of quality of auditing profession comes on top of the concerns of the international business community and international institutions particularly now following the impact of the several failures and financial hardships suffered by the major companies in the recent collapse of money markets in some countries of the world and fear of their recurrence in the future.An observer of the local and international rules and standards (or principles) finds that these include such implications have direct or indirect effects on the performance of the service of the accountant and auditor, which should upgrade their professional performance in these services to a high level of quality so as to be in line with the requirements, principles
... Show MoreBackground: Although expression of the HER-
2/neuoncogene may be of some prognostic importance
in advanced ovarian cancer, its role in early-stage
disease has not been established. The current study
examined the prevalence and significance of HER-
2/neu expression in different grades of different types
of surface epithelial ovarian carcinoma.
Methods: Thirty eight female patients with surface
epithelial ovarian cancer were included in this study.
The blocks of corresponding formalin fixed, paraffinembedded
ovarian biopsies were retrieved from the
archives and hematoxylin-eosin slides of each ovarian
biopsy were reviewed and marked their grades of
differentiation , then a new sections from each sampl
Artificial neural networks usage, as a developed technique, increased in many fields such as Auditing business. Contemporary auditor should cope with the challenges of the technology evolution in the business environment by using computerized techniques such as Artificial neural networks, This research is the first work made in the field of modern techniques of the artificial neural networks in the field of auditing; it is made by using thesample of neural networks as a sample of the artificial multi-layer Back Propagation neural networks in the field of detecting fundamental mistakes of the financial statements when making auditing. The research objectives at offering a methodology for the application of theartificial neural networks wi
... Show MoreGhrelin and leptin are hunger hormones related to type 2 diabetes mellitus (T2DM), and the pathogenesis of T2DM is the abnormality in insulin secretion and insulin resistance (IR). The aim of this study is to evaluate ghrelin and leptin concentrations in blood and to specify the relationship of these hormones as dependent variables with some biochemical and clinical measurements in T2DM patients. In this study, forty one T2DM and forty three non-diabetes mellitus (non-DM) subjects, aged between 40-60 years and with normal weight, were enrolled. Fasting serum ghrelin and leptin were estimated by enzyme-linked immunosorbent assay (ELISA). In our results ghrelin was significantly increased, and leptin was significantly decreased, in T2DM pa
... Show MoreBackground: The present study involved the following parts, the first part is evaluation of the levels of glycated hemoglobin(HbA1c), creatinine, uric acid(UA) and albumin in patients with diabetic nephropathy comparison with the group of healthy as a control group. The second part is the measurement and evaluation of oxidative stress represented in the malondihydehyde(MDA) as a biomarker of oxidative stress as well as the identification of vitamins C and E as an antioxidant in patients with diabetic nephropathy(DN) compared with the healthy group. Objective: The objective of this study is to estimate oxidative stress by calculate malondialdehyd as biomarker and evaluate some vitamins such as vit C and vit E as antioxidants in diabetic neph
... Show More