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.
It is necessary to examine the nature of the Turkish position and what Turkey seeks to achieve at the international, regional and Iraqi levels. Or is this external role an expression of foreign policy and has not yet reached the level of maturity that reaches the stage of strategy? The answer to this question is the essence of research in the Turkish role. The answer to this question requires the realization of the elements and pillars that guarantee Turkey's continuity and survival. Continuity is a cornerstone of the strategy. The continuity of the role and its interaction with the event and the ability to employ multiple alternatives are what qualify the state to describe its politics. The external strategy has evolved into. In order t
... Show MoreThe paper aims to build a model that supports organizational sustainability by analyzing the correlations and revealing the impact between the two main variables (entrepreneurial leadership) with its dimensions of proactive outlook, risk, and creativity (Van Zyl & Mathur-Helm, 2007), and (organizational sustainability) with its economic, environmental, and societal dimensions (Hansmann et al., 2012). As well as identifying the level of awareness and informing managers in the General Company for the Automotive and Equipment Industry, of the theoretical implications and performance, and its vital importance to society and the surrounding ecological environment, and drawing attention to that and improving performance, and indicatin
... Show MoreThe article examines metaphors as one of the fundamental means used by D. Rubina when writing the novel “Parsley Syndrome” to form images of dolls as equal heroes of the work. The author of the article continues research related to the work of Dina Ilinichna Rubina, a representative of modern Russian prose.
Three hundred samples of washing water of vegetables were collected from women aged ( 15- 6o) years from different area in Baghdad governorate and its suburbs include two rural area ( Jaddria in Baghdad university and Al –Wagif in Rashdia) and two urbane area (Mansoure and Escan) . The samples were examined by precipitation method and then by staining method ( Lugols –Iodine stain) . The percentage of infection of intestinal parasites 36.3% include 15.3% for urban area and 57.3% in rural area and a significant difference was found between those groups . .The results showed also increased in the prevalence of parasitic infection in group age (15 -30) year .Also the results showed only 109 sample infected with eight specie
... Show MoreRecurrent respiratory tract infections are responsible for about 85% of all diseases in childhood, and are associated with significant morbidity and mortality. The aim of this study is to evaluate the main causes underlying recurrent respiratory tract infections in 176 pediatric patients aged 2 month to 4 year and weight from 4 to11 kg referred to the child center hospital and Al-sader hospital prospective study.All parents were given information sheet which then analyzed and the percentage of incidence of causes were recorded, we found that higher % related to many causes; mostly related to the parent like poor family education, mother carelessness, incomplete vaccination, other related to empirical diagnosis, and short course of t
... Show MoreBackground: One of the most predominant periodontal diseases is the plaque induced gingivitis. For the past 20 years, super-oxidized solutions have be..
The advertising mail is considered as one of potential tools that followed to transfer the printed messages to the consumers and public customers whom are located at homes or works. This type of advertising is preferable due to the zero expense to receive the announcements of products, which became recently one of the successful procedures to create new customers and keep them in touch with direct communication. It is also possible to send them to specific group of people who can be classified by the advertisers to select even by name their own clients to give the personality to the clients for a long term of communication.
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... Show MoreThe present study illustrates observations, record accurate description and discussion about the behavior of twelve tested, simply supported, precast, prestressed, segmental, concrete beams with different segment numbers exposed to high fire temperatures of 300°C, 500°C, and 700°C. The test program included thermal tests by using a furnace manufactured for this purpose to expose to high burning temperature (fire flame) nine beams which were loaded with sustaining dead load throughout the burning process. The beams were divided into three groups depending on the precast segments number. All had an identical total length of 3150mm but each had different segment number (9, 7, and 5 segments), in other words, different segment length
... Show MoreBackground:No previous Iraqi study was done on the estimation of post mortem interval (PMI) from the medico-legal point of view; depending on the biochemical changes of vitreous humor.Objectives:To find out the relationship between some biochemical changes in vitreous humor and post mortem interval.To find out a new formula for estimation of PMI from some biochemical changes in vitreous humor.Method:The study was conducted on one hundred twenty two cases referred to the medico-legal institute in Sulaimani province during the period between 1st of February and 30th of July 2012.Complete classical autopsy was performed for each case and vitreous humor was collected at autopsy from the posterior chamber of the eye and the samples after coll
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