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.
unacceptable social behaviors, particularly withdrawal behavior that appears in children with autism represent a major problem hindering the process of communication with those around them and therefore the process of mergence with them be difficult.
The withdrawal causes a real affect deficit for children with autism limits the possibility of development of their intellectual and mental growth due to their solitude and the weakness of their focus in the acquisition of pedagogical skills and lack the necessary social skills to maintain the relations of friendship and enjoyment of them.
withdrawal children fail to participate
... Show MoreBackground: Osteoarthritis is a complicated, chronic disorder of cartilage and bone, associated with homeostasis of bio-elements. The current study aims to assess the role of serum progranulin levels among Iraqi patients with knee osteoarthritis. Patients and Methods: The study encompassed 50 patients aged 52.50 ± 3.12 years (25 males and 25 females), admitted to the at the Baghdad Medical City through the period from November 2021 to March 2022. All individuals were identified by physicians in a Rheumatology and Rehabilitation Outpatient Clinic and the clinical data was collected along with the assess¬ment of biochemical parameters. Fasting serum glucose, lipid profile, calcium, magnesium, alkaline phosphatase, vitamin D3, and p
... Show MorePoor impurity in the right of the patient and the elderly
Abstract
urgent surgical intervention and appendectomy until now represent standard treatment for uncomplicated cases of appendicitis. Nausea, vomiting and pain after surgery are the most frequent issues facing patients and affecting patient quality of life and responsible for many cases of readmission after surgery. Ketorolac and diclofenac represent the most commonly prescribed non-steroidal anti-inflammatory used in postoperative setting and they cause many side effects as gastrointestinal, kidney and cardiac adverse effect in addition to increased risk of bleeding. Paracetamol is currently among the most frequently prescribed medication worldwide and it can be used safely for all age groups. This study aimed
... Show MoreThe incorporation of safety characteristics into the traditional pavement structural design or in the functional evaluation of pavement condition has not been established yet. The design has focused on the structural capacity of the roadway so that the pavement can withstand specific level of repetitive loading over the design life. On the other hand, the surface texture condition was neither included in the AASHTO design procedure nor in the present serviceability index measurements.
The pavement surface course should provide adequate levels of friction and ride quality and maintain low levels of noise and roughness. Many transportation departments perform routine skid resistant testing, the type of equipment us
... Show MoreIn this golden age of rapid development surgeons realized that AI could contribute to healthcare in all aspects, especially in surgery. The aim of the study will incorporate the use of Convolutional Neural Network and Constrained Local Models (CNN-CLM) which can make improvement for the assessment of Laparoscopic Cholecystectomy (LC) surgery not only bring opportunities for surgery but also bring challenges on the way forward by using the edge cutting technology. The problem with the current method of surgery is the lack of safety and specific complications and problems associated with safety in each laparoscopic cholecystectomy procedure. When CLM is utilize into CNN models, it is effective at predicting time series tasks like iden
... Show MoreBackground: Guillain Barré syndrome is an acute inflammatory demyelinating disease of the peripheral nerves. Its synonyms are: acute inflammatory demyelinating polyradiculoneuropathy, idiopathic polyneuritis, acute infective polyneuropathy and post infections polyneuritis. Objectives: We attempt to study the clinical presentations and complications in patients with GBS who were admitted to children welfare Teaching Hospital and to compare the results with the other studies.Type of the study: A retrospective study.Methods: A study done on seventy patients with GBS who were admitted to children Welfare Teaching Hospital in Medical City-Baghdad from different parts of Iraq between January 2002-December 2006.Results: Forty (57.14%) of them
... Show MoreBackground: Prolapsed intervertebral disc is an important and common cause of low backache. MRI has now become universally accepted investigation for prolapsed intervertebral disc. We, however, regularly come across situations, when MRI shows diffuse disc bulges, even at multiple levels, which cannot be correlated clinically and when such cases are operated, no significant disc prolapse is found resulting in negative exploration. Objective: To evaluate the role of M.R.I. finding not only for diagnosis of disc herniation at lumbar region but also for localization the level of herniation Methods: A prospective study on seventy five symptomatic low backache and MRI confirmed prolapsed intervertebral disc patients at lumbo-sacral region were op
... Show MoreBackground: Prolapsed intervertebral disc is an important and common cause of low backache. MRI has now become universally accepted investigation for prolapsed intervertebral disc. We, however, regularly come across situations, when MRI shows diffuse disc bulges, even at multiple levels, which cannot be correlated clinically and when such cases are operated, no significant disc prolapse is found resulting in negative exploration.Objective: To evaluate the role of M.R.I. finding not only for diagnosis of disc herniation at lumbar region but also for localization the level of herniationMethods: A prospective study on seventy five symptomatic low backache and MRI confirmed prolapsed intervertebral disc patients at lumbo-sacral region were o
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