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.
The 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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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 MoreThese factors, as well as disasters and wars that the Arab homeland exposed to and still under this exposure, in addition to the severe stress upon.
Iraqi Academics have been subjected to direct consequences of 2003 war. Exact figures are not known. It was mentioned. Many people were killed, sacked from their academics jobs, threatened to leave directly or indirectly their jobs, houses, and Iraq. Others have been imprisoned, tortured, or kidnapped / threatened to be kidnapped etc. Their families have been subjected to similar traumatic experiences or threats. All theses stressors may have lead to Post Traumatic (PTSD) Experiences. These Traumatic experiences have lead to Dislocation, relocation and Immigration etc. All sectors of
... Show MoreThis research is carried out to investigate the externally post-tensioning technique for strengthening RC beams. In this research, four T-section RC beams having the same dimensions and material properties were casted and tested up to failure by applying two mid-third concentrated loads. Three of these beams are strengthened by using external tendons, while the remaining beam is kept without strengthening as a control beam. Two external strands of 12 mm diameter were fixed at each side of the web of the strengthened beams and located at depth of 200 mm from top fiber of the section (dps). So that the depth of strands to overall depth of the section ratio (dps
... Show MoreThe research aims to achieve a set of the most important objectives of the review of the role of creative administrative leadership in achieving aspects of economic reform in various government institutions and indicate the role of supervisory awareness of administrative leadership in the revitalization of the role of the internal control system to achieve the best use of available resources. This paper deals with three problems is the loss of financial resources of the state as a result of the growing phenomenon of administrative and financial corruption in the majority of government institutions, and the weakness of the role of the internal control system in the province on the resources available and to achieve the best use of these reso
... Show MoreThe ability of single and mixed bacterial culture to utilize Dora-refineries petroleum wastes was compared. Pseudomonas aeruginosa and Serratia ficaria mixed culture consumed the wastes better than the single bacterial cultures. The highest log. number of viable cells in mixed culture was 6.842 , while in single bacterial cultures it was 6.683 and 5.631, respectively. after 3 days in API medium containing the refinery wastes. The effect of some environmental conditions on the degradation of petroleum wastes was studied included aeration , NaCl concentration , pH and temperature. The growth of bacteria in the agitated culture was higher than stagnant culture the log. of cell no. was 6.021 in the first culture. The h
... Show MoreBackground: Orthodontic tooth movement is characterized by tissue reactions, which consist of an inflammatory response in periodontal ligament and followed by bone remodeling in the periodontium depending on the forces applied. These processes trigger the secretion of various proteins and enzymes into the saliva.The purpose of this study was to evaluate the activity of alkaline phosphatase (ALP) in saliva during orthodontic tooth movement using different magnitude of continuous orthodontic forces. Materials and Methods: Thirty orthodontic patients (12 males and 18 females) aged 17-23 years with class II division I malocclusion all requiring bilateral maxillary first premolar extractions were randomly divided into three groups according to t
... Show MoreBackground: Infection with Toxoplasma gondii (T. gondii) leads to activation of T-helper cells (Th-1 and Th-2) which are involved in the synthesis and release of different cytokines which may lead to endothelial dysfunction. Objectives: To evaluate the endothelial function in patients with acute toxoplasmosis. Methods: This case-control study involved 31 patients with toxoplasmosis aged 19 - 47 years matched with 20 healthy subjects. Anti-T. gondii antibody (IgG, IgM, IgA) was determined by direct antigen-antibody reaction. Interleukin-6(IL-6), endothelin-1 (ET-1) and human malondialdehyde (MDA) serum levels were measured. Results: IgM, IgG and IgA levels were high in the infected patients compared with controls (P < 0.01). Furthermore, IL-
... Show More This research deals with the financial reporting for the non-current assets impairment from the viewpoint of international accounting standards, especially IAS 36 "Impairment of assets”. The research problem focused on the non-compliance with the requirements of IAS 36 which would negatively affect the accounting information quality, and its characteristics, especially the relevance of accounting information, that confirms the necessity of having such information for the three sub-characteristics in order to be useful for the decisions of users represented