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.
Introduction The pathophysiology of appendicitis likely stems from obstruction of the appendiceal orifice leading to an increase in intraluminal and intramural pressure, resulting in small vessel occlusion and lymphatic stasis. Organ supplied by an end artery, such as the appendix, are more prone to the deleterious effects of arterial occlusion. The continuous cigarette smoking might be associated with a greater risk for developing atherosclerosis.
Objectives The aim is to evaluate the effect of cigarette smoking on the incidence of complications of acute appendicitis.
Methods Patients suffered from symptoms and signs suggesting a
Objectives: ٨ descriptive study has been conducted in the premature baby unit in Al-Khansaa' and Al-Batool
hospitals for maternity and children in Mosul city to assess knowledge and practice of the nursing staff in the
caring of premature infants. A descriptive study has been conducted in the premature baby unit in Al-Khansaa'
and Al-Batool hospitals for maternity and children in Mosul city to assess knowledge and practice of the nursing
staff in the caring of premature infants.
Methodology: the data were collected by using knowledge assessment and practice measurement tool.
Results: the results of the study show that high percentages (about 40%) of the staff who work in the premature
baby units are of the young age
The main objective of the central bank is to achieve price stability and target in fractionates. Therefore, the bank sought to use modern tools and policies in order to reduce the negative effects of the accumulation of foreign reserves represented by monetary sterilization, similar to developed and developing countries alike, but with different available tools that are possible and imposed by the local financial and monetary environments, such as the window for buying and selling foreign currency, open market operations and deposit facilities. And lending existing. Because any in crease in the monetary base resulting from the accumulation of foreign reserves will affect price stability directly due to the consumer nature of the
... Show MoreThis study deals with the orthographic processing ability of homophones
which can account for variance in word recognition and production skills due to
phonological processing. The study aims at: A)Investigating whether the students
can recognize correct usage and spelling comprehension of different homophones
by using appropriate word that overlapped in both phonology and orthography.
B)Assessing spelling production word association to the written form of the
homophone in the sentence comprehension task. To achieve these aims, two tests
have been conducted and distributed on 50 students at first stage at the College of
Education(Ibn-Rushd) for the academic year 2010-2011. The two tests are exposed
to a jury of
The reconciliation of tax reconciliation is one of the legal methods used by the financial authority in Iraq, which is done with the taxpayer
The research dealt with the weakness of tax revenues for many reasons, including tax evasion, which led to the search for ways to reduce evasion to increase the tax revenue, and settlement reconciliation one of these means .
The research proceeded from the premise that the use of a more broadly settled settlement would govern the tax evasion of taxpayers.
The researchers used a series of studies and previous research, books and other sources related to the subject of research, and this was done through the theoretical framework, and the practical aspect that included the fin
... Show MoreAssessment of the in service behavior of asphalt stabilized subgrade soil under environmental impact has got little attention by the research workers. However, the sustainability of the roadway depends mainly on the welfare of its subgrade soil condition. In this work, Gypseous soil was stabilized with asphalt emulsion for subgrade usage, the durability of the mixture has been assessed in term of its ability to maintain the compressive strength when practicing the environmental impacts. Specimens of 38 mm in diameter , and 76 mm in height have been prepared with various water-asphalt percentages, and subjected to 30 cycles of (freezing-thawing), (heating-cooling) and (wetting-drying) processes. Specimens have been tested for unconfined comp
... Show MoreAsthma is a chronic inflammatory disease of respiratory airways characterized by distinctive history of respiratory symptoms due to variable airflow obstruction which reverses either spontaneously or in response to certain medications. Acetylcholine is a parasympathetic neurotransmitter which plays fundamental roles in the development of persistent asthma. Treatment guidelines recommend using medium doses of inhaled corticosteroids in addition to another controller bronchodilator instead of using high doses inhaled steroid alone for treatment of moderate to severe persistent asthma. The inhaled long acting muscarinic antagonist, tiotropium, was approved recently to control unresponsive asthma to inhaled corticosteroid with or without a long
... Show MoreThe research tacklets the role of risks arising from the excessive use of derivative contracts for trading in financial crises, including the recent global financial crisis in (2008) which is known the mortgage crisis.
In order to prove the hypothesis of the research, the risk index of derivative contracts has been chosed as expressed in the measure of (value at risk) to be the main field for testing the hypothesis of research. The duration of the contract has been also chased for (15) years between the years (2001- 2015), the period preceding the global financial crisis, while the second represents the period of time that followed. The research reached a number of conclusions, bu
... Show MoreBackground: Psoriasis is an immune-mediated inflammatory disease with unknown aetiology that may be associated with the defect in proliferation and differentiation of the keratinocytes related to inflammatory cell infiltration. According to published reports, it is universal in occurrence; its prevalence in different populations varies from 0.1% to 11.8%. Receiving Apremilast resulted in a strong reduction in interleukin 17 and interleukin 23, as well as reduced expression of other inflammatory cytokines and improvement of psoriatic lesions. Objectives: This study aimed to assess the impact of Apremilast on levels of IL-17, IL-23, and lipids in obese psoriatic patients. Methods: Thirty obese patients with psoriasis were included in
... Show MoreThe research seeks to identify the comprehensive electronic banking system and the role of the auditor in light of the customer's application of electronic systems that depend on the Internet in providing its services, as a proposed audit program has been prepared in accordance with international auditing controls and standards based on the study of the customer's environment and the analysis of external and internal risks in the light of financial and non-financial indicators, the research reached a set of conclusions, most notably, increasing the dependence of banks on the comprehensive banking system for its ability to provide new and diverse banking services, The researcher suggested several recommendations, the most important of whi
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