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.
Objective: To evaluate the therapeutic activity of probiotics mixture of Lactobacillus plantarum and Lactobacillus acidophilus towards Cryptosporidium infection in experimentally infected mice. Oocysts of Cryptosporidium were separated from the stool of humans to infect mice. Methods: Forty male albino mice were split equally into four groups, every group contained 10 mice, the group I (early treated group), were treated from the 1st day from infection to the 11th post-infection, group II (late treated group), were treated from the 4th day from infection to the 15th post-infection, and group (III) (untreated group), were mice considered as a positive control group. Results: It was showed that daily application of a mixture of L. plantarum w
... Show MoreThe accounting information that is produced by any System a user either entering or leaving, since the needs of the users began to evolve where he became the information provided by the current reporting system that does not meet their requirements in terms of users began to demand information, more quickly, and as a result of the needs of the user accounting system and the development of information and communications technology has emerged a new system (real- time reporting system), which has the ability to produce information at the moment of data gathered, it is no longer dependent on local circumstance, but this case has become a global response where the computer has become a cornerstone of the culture of the communi
... Show MoreThe search (floors and transparent role in the design studios satellite channels) and presented as a study-oriented, and the research aims to identify the role of flooring transparent spaces studios satellite channels and side performative and aesthetic, and formulas design to highlight the role floors transparent spaces studios satellite channels. And highlight the importance of research, particularly in its contribution to the clarification of the concept of the relationship between transparency and performing aesthetic treatments for floors by clarifying its role in the designs of the internal spaces of the studios, as well as his contribution to the founding of the theory of looking at the base of such concepts. To achieve the object
... Show MoreThe present study was conducted on sixty five pregnant women that infected with acute toxoplasmosis, serum samples were tested for detection specific anti-Toxoplasma gondii IgM using the rapid Toxo IgG/IgM Chromatographic immune assay test cassette and ELISA, and fifty healthy married women (not pregnant) as was considered as control group. The level of serum IL-6, IL-8, IL-12, TNF-α, TGF-β1, IP-10, MIP-1, MIG and ICAM were significantly increased (P <0.005) in pregnant patients infected with acute toxoplasmosis, while serum level of MCP-1(14.46 ± 1.38pg/ml) was not significantly increased when compared to controls(11.25 ± 0.24pg/ml) , these levels can be used as i
... Show MoreBackground: Characterization of the ovarian masses preoperatively is important to inform the surgeon about the possible management strategies. MRI may be of great help in identifying malignant lesion before surgery. Diffusion Weighted Imaging (DWI) is a sensitive method for changes in proton of water mobility caused by pathological alteration of tissue cellularity, cellular membrane integrity, extracellular space perfusion, and fluid viscosity.
Objective: to study the diagnostic accuracy of DWI in differentiation between benign and malignant ovarian masses.
Type of the study:Cross-sectional study.
Methods: this study included 53with complex
... Show MoreThe skill of management educational activities gradually grow with the experience, but they differ from personal skill educator to another, because each style nanny personally and the way to work. There educator and active movement and vitality that look like happiness and clear during the implementation of the activity, and the other runs educational activities quietly, efficiently and without emotion and clear (dry, 2001: p. 274). And the stage of childhood is one of the most important stages that are based upon the future life as a whole because the man also confirmed by the School of analysis psychological is the son of his childhood and the best example to us what the Holy Prophet Muhammad (peace be upon him): (Every child i
... Show MoreThe Research aims to determine role of The Intellectual capital in the performance of small and medium enterprises , to achieve this goal through a researcher from the theoretical literature and studies related to the construction of the scheme shows the hypothetical relationship between the variables, which was adopted by the independent variable intellectual capital, distributed four variable are:( human capital, structure capital ,customer capital, innovation capital) as well as four variable (the financial perspective, the customer perspective, process perspective ,the learning & growth perspective) The study were getting to many results as bellow :the intellectual capital in the small and intermediate p
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