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.
Banks 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 MoreBreast cancer is the second most common cancer in women world. Multiple Cytokines appear to have a dominant role in human breast cancer formation. Estimation of the in situ expression of IL-6 and IL-1β in breast cancer patients. A sixty patients with breast cancer BC were divided into two clinical subgroups, (30) with malignant breast cancer MBC and (30) with benign breast tumor as a control group according to histological examination. In situ hybridization technique used for detection of IL-6 and IL-1β mRNA sequence in two groups. The results showed that percentages of mRNA expression of IL-6 and IL-1β were in (≥ 11-50%) for malignant breast cancer. This research also investigated that (73.3%) of beni
... Show MoreThe present study was performed to evaluate the level of some risk factors (biochemical and immunological) in hypothyroid Iraqi patients considering the different thyroid functional states (hypothyroidism and subclinical hypothyroidism).The study includes 82 patients clinically diagnosed with hypothyroidism. Three study groups have been investigated: (47 clinical hypothyroid patients, 12 subclinical hypothyroid patients 23 healthy individuals) of different ages. This study, show that the proportion of females (83.3 %), (87.2%) in subclinical and clinical hypothyroidisim respectively higher than the proportion of males (16.7%),(12.8%) in subclinical and clinical hypothyrodism respectively of the total patients.The majority of subclinical hyp
... Show MoreBackground: coronavirus 19 is a beta-coronavirus, enveloped and roughly spherical with approximately 60 to 140 nm in diameter with positive-sense single-stranded RNA genome.
Objectives: Measurement of interleukin 6 (IL6) level in a group of patients with confirmed Covid19 infection and its correlation with many hematological and biochemical parameters , mainly lymphocyte , neutrophil count and their ratio , platelet count , serum ferritin , C reactive protein as well as D-dimer level
Subjects and Methods: This study was conducted on 60 PCR positive patients variably affected by COVID-19 , cases collected sequentially from June till November 20
... Show MoreThe function of internal auditing has become an important function that aims at achieving objectives that are compatible with these developments and changes that have occurred in many countries in the world, which required the emergence of professional associations and institutes in the profession of internal auditing. Improve the guideline of the internal audit units issued by the Federal Audit Bureau to enhance the efficiency of internal audit performance in Iraqi government units. The researchers adopted the statistical method of proving the hypothesis by constructing a questionnaire that included three main axes: supporting the senior management in adopting the current guide, and the second being the importance of improving t
... Show MoreThe global trend towards the use of fair value accounting is increasing, so the current study aimed to maximize the impact of fair value application on achieving relevance and representation faithfulness of accounting information in accordance with the common conceptual framework. To achieve the objective of this study, the researcher has determined in the theoretical framework the relationship of fair value with the characteristics of relevance and representation faithfulness of accounting information and the extent of achieving these characteristics, as well as conducting a field study by preparing a questionnaire distributed to a sample of academics (50) and auditors (50) with a total number of selected participants (100) of acad
... Show MorePurpose: The aim of this study is to examine knowing the real role and impact of manufacturing flexibility on competitiveness through operations management practices, which is to determine the role and impact of manufacturing flexibility on competitiveness directly in the General Company for the Battery Industry. On the other hand, identifying the indirect role of flexible manufacturing systems in enhancing competitiveness. Theoretical framework: The main purpose of the theoretical framework is to identify all the dimensions and variables included in the current study, and thus form a deep scientific view of the study and its variables. Design/methodology/approach: field coexistence, personal interviews, and classification of
... Show MoreThe process of coordination and joint cooperation between SAIs and internal auditors in the public sector is considered one of the very important matters in performing efficient audits and are of high quality, especially if this coordination and cooperation is implemented in accordance with international standards, as it leads to avoiding duplication in auditing work. And the distribution of work in a distribution that achieves the objectives of auditing in general and is of general benefit to the economic unit.
The research problem lies in the weakness of the relationship between internal auditing and external auditing as a result of not applying INTOSAI Standard (9150) coordination and joint cooperation
... Show MoreBackground: Osteoporosis is an extra-articular complication of rheumatoid arthritis that results in increased risk of fractures and associated morbidity, mortality, and healthcare costs. Objective: To evaluate changes in bone mineral density in a sample of rheumatoid arthritis (RA) patients on biological (anti tumor necrosis factor (TNF) alpha) and non-biological agent disease modifying antirheumatic drugs (DMARDs). Patients and Methods: A cross sectional study enrolled 60 RA patients diagnosed by rheumatologist according to the 2010 American College of Rheumatology/European League Against Rheumatism (2010 ACR/EULAR) classification criteria for RA. Thirty patient on biological agent (anti TNF alpha) and 30 patient on non-biological agent (D
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