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.
Multiple sclerosis (MS) is a chronic, inflammatory demyelinating disease of central nervous system with complex etiopathogenesis that impacts young adults (Lee et al., 2015), and MS impacts younger and middle aged character and leads to a range of disabilities that can alter their daily routines (Yara et al, 2010). Although, the exact cause of MS is still undetermined, the disease is mediated by adaptive immunity through the infiltration of T cells into the central nervous system (Bjelobaba et al, 2017). MS causes the Focal neurological symptomsand biochemical changes in the molecular level and the variation of neural cells such as loss or alteration of sensation, motor function, visible signs such as blurred vision or transient blindness,
... Show MoreBackground: Recent advancements in molecular techniques have identified over 450 genotypes of Human Papillomavirus (HPV), classified into low- and high-oncogenic risk categories. The rise in high-oncogenic risk HPV genotypes has been linked to various cancers, including those affecting the oral, oropharyngeal, and nasopharyngeal regions in both pediatric and adult populations. Methods: In this study, a cohort of 102 tonsillar tissue samples was included. This comprised 40 specimens from pediatric patients aged 4 to 9 years with nasopharyngeal adenoid hypertrophies, and 42 specimens from pediatric patients aged 5 to 12 years with palatine tonsillar hypertrophies. Among the 82 tonsillar tissue samples analyzed, 38 were from pediatric patients
... Show MoreCongenital absence of anterior cruciate ligament is highly uncommon occurrence. It has since been documented as a standalone anatomical entity or, more frequently, in conjunction with other congenital anomalies. Surgical treatment for this patient population has only been reported in very few cases. In this article, we share our experience in managing a case of unilateral congenital deficiency of anterior cruciate ligament (ACL) in a 13 years old female patient by physeal sparing arthroscopic ACL reconstruction, using All-inside technique.
Expected to The organizational commitment by employees increases their loyalty towards their organization and thus contribute to enhancing their performance , therefore this study aimed to discover the relationship and the impact between the organizational commitment (emotional commitment, standard commitment, continuous commitment) and the performance of employees in the company researched, additional to know the available organizational commitment levels of employees in the company researched and its impact on the performance of employees, Research was conducted at the General Company for products in the dairy to achieve the goals of research has been developed questionnaire conation (22 ) items to collect data from the study s
... Show MoreThe study started from the problems of wars and the damage that result from deterioration and destruction of infrastructure and the absence of planning and urban reconstruction. The study aims to address the condition of the bad destroyed bridges that have paralyzed traffic from the right and left sides of the city of Mosul. The study is based on the assumption that the reconstruction of bridges will improve the transportation network in the city of Mosul. The study relied on several approaches, including: the historical approach by reviewing global and local experiences and the descriptive approach to review the reality of the state of Mosul after the liberation process, through maps and the analytical approach through statistics and da
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