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 aims at re-transmit the spirit of the national democratic project of Iraq post of the chaos left by the Daesh terrorist group stage(The Islamic State of Iraq and Syria, ISIS) , Which controlled large parts of Iraq, and had an adverse effect on the political scene in Iraq, inspired everyone that there are deficiencies in the political, economic, religious and ethnic structure of the Iraqi people in non-response to democratic thought.The researcher relied on the hypothesis that " the requirements of building a democratic project are based on the need to provide the requirements ranging from two interrelated aspects, like the institutional aspect and the aspect that related to the general and necessary requirements for the establ
... Show MoreThe aim: In this study, we present and evaluate the vest-over-pants technique as a simple way to correct urethrocutaneous fistulas after hypospadias. Materials and methods: Between October 2018 and June 2020, twenty male patients aged 5 to 20 years came to us with post hypospadias repair fistula, these patients underwent vest-over-pant repair of their fistula. The size of fistula was ranging between 2.5-5 mm. The distribution of fistula was coronal (3 patients), distal penile (9 patients), midshaft (2 patients) and proximal penile (6 patients). In 14 patients there were single fistula and 6 patients had more than one fistula. Eleven of patients were exposed to a previous failed fistula repair procedure. Results: Six months after the operati
... Show MoreThis study aims at re-transmit the spirit of the national democratic project of Iraq post of the chaos left by the Daesh terrorist group stage(The Islamic State of Iraq and Syria, ISIS) , Which controlled large parts of Iraq, and had an adverse effect on the political scene in Iraq, inspired everyone that there are deficiencies in the political, economic, religious and ethnic structure of the Iraqi people in non-response to democratic thought.The researcher relied on the hypothesis that " the requirements of building a democratic project are based on the need to provide the requirements ranging from two interrelated aspects, like the institutional aspect and the aspect that related to the general and necessary requirements for the e
... 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
Abstract:
The research aims to improve the insurance service through the marketing commission as a tool that enables the insurance companies to achieve a competitive advantage. The researcher, by observing the challenges faced by insurance companies, insurance agents and brokers, raised the main question of the research: Is there an effect of the marketing commission on the competitive advantage of insurance companies? The data was obtained through the financial statements and annual reports of the research sample companies (the National General Insurance Company, the Iraqi General Insurance Company, Al-Hamra Private
... Show MoreThe research aims to shed light on the importance of forensic accounting and its role in winning compensation claims against the company because of the ability of the forensic accountant (the judicial expert) to interpret and analyze the data. The research community represents the insurance companies in Iraq. The research sample was represented by the National Insurance Company. Coverage of the theoretical and deductive approach in covering the practical side, based on the financial records of the National Insurance Company for years of research.One of the most important conclusions reached by the researchers was that forensic accounting has a role
... Show MoreIraqi industrial units face strong competition due to many problems including1- high production costs2- weak interest in studying the market3- lack of government support for their products4- dumping the market with imported products with specifications and a competitive price as well as adopting the traditional cost system in calculating costs that do not provide appropriate information for pricing decisions Which requires studying and analyzing these problems and dealing with them by adopting modern technologies so that they can compete, so the research aims to show the knowledge bases of technology Activity- Based Costing, with an indication of the role of technology Activity- Based Costing in rationalizing the tax In, and the
... Show MoreBanks represents financial institutions that influence the economy of any country and their evolution and development is the need to seek all states , communities, maintain and control a guarantee of the beneficiaries investors and to promote confidence, so the specialized organizations trying to set principles and rules must be adhered to and are Basel (II) of the necessary effects to be introduced and work on their application. Banks exposed by various risks one of them operational risks that have multiple effects on the activity of the institution itself, as well as the national economy, so this study was to find out what those effects and to find solutions and appropriate proposals to avoid Iraqi banks from the effects of risk,
... Show MoreThe research aims at conducting a follow-up evaluation of a number of strategic projects implemented by the Directorate of Public Municipalities, one of the Ministry of Construction, Housing and Municipalities and Public Works. The sample included (35) varied strategic projects implemented in most Iraqi governorates. Buildings, municipal buildings, minarets, massacres, multi-story parking, paving and rehabilitation of streets and residential neighborhoods. The difference between the actual and planned times and costs of these projects was then measured and analyzed. These projects were used as a tool for collecting data and information. The questionnaire included four axes, each representing one of the parties to the project, whi
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