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.
Despite the multiplicity of institutions contributing to the decision-making process in the United States of America, they interact to crystallize positions regarding international and strategic situations. The formulation of the national security policy depends on a number of institutions that complement each other in order to achieve an advanced security situation. Thus, the decision reflects the process of interaction of the existing regulatory institutions. This is because the essence of the national security and achieving its requirements also stems from the existence of a coherent system of shared beliefs and principles in the American society. Besides, these elements are the bases for achieving
... Show MoreAbstract:
Sought the search to find out what small businesses, the importance of funding, and the role of funders in supporting such projects, which have been addressed in the search through a sample of government banks (Rafidain and Rasheed) and private banks (the Middle East, the Gulf, North, Assyria) and a sample of Small projects borrowed from these banks, but in order to achieve that rely researchers on scientific methods discreet marked by the curriculum descriptive analytical method which is based on the compilation of facts and information then collated and analyzed to reach acceptable results, as well as data collection tool (checklist) was whereby examine questions of a sample of
... Show MoreBackground: Polycystic ovary syndrome is among the leading causes of fertility-related problems and menstrual irregularities in women of reproductive age. The granulosa cells of the developing pre-antral and antral follicles produce inhibin B, which triggers chemical responses in the ovaries. Inhibin B is most often observed in the follicular phase when levels peak early and then decline over time Objectives: This study was designed to investigate the role of serum inhibin B and the Luteinizing Hormone / Follicle Stimulating Hormone ratio in differentiation between the different phenotypes of polycystic ovary syndrome as well as to define the predominant PCOS phenotype. Methods: This cross-sectional research was conducted in the
... Show MoreIt has become clear to see the role of the small and medium enterprises in the economy, and for the continuity of these projects it is necessary to supply finance from the banks, How ever the latter suffers risk of lending.
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... Show MoreThis research addresses a problem manifested in a main question: what is the role of the digital media in marketing the artistic products? in order to determine the role played by the digital media in the disclosure and promotion of the artistic product, its price and places of distribution, as the basic elements of the marketing mixture.
This is a descriptive research in which the researcher used the survey method to check the opinions of a sample chosen according to the (proportion) method from the research community represented by instructors and students of the college of Fine Arts- University of Dayala.
... Show MoreSmall and Medium Enterprises (SMEs) in Iraq have experienced low performance due to the limited usage of accounting information systems (AIS) and the inability to exploit knowledge of management capabilities (KMC). These deficiencies have led to competitive pressures in the marketplace that have adversely affected their sales and production. This study investigates the role of AIS in terms of operation support, knowledge support, regulatory support, and the role of KMC, including knowledge acquisition, knowledge transfer, and knowledge utilized to enhance organizational performance in Iraqi SMEs. The target population was managers and owners in SMEs using AIS in Iraq’s cities. A non-probability purposive sampling technique was use
... Show MoreThis study aims to highlight the role of financial control in the development of government performance through the use of "GFS" system and its application in the service of government units, which will help them in how to use financial resources efficiently through the quality of accounting information provided by this system in the financial statements that reflect the predictability in that fiscal policy of the state through government programs and activities fee as well as to identify weaknesses and address them quickly in order to avoid wastage and loss of public money, which leads to the possibility of utilization of available financial resources of the state to effectively and efficiently, has been reached that the failure of gove
... Show MoreThe parasite E.histolytica was first isolated from a stool sample, and then cultivated and maintained in vitro using Locke-egg medium (LEM) and Liver infusion agar medium (LIAM) . Then, the effect of some types of erythrocytes (human and sheep), on the growth and activity of the parasite in the two culture media was investigated. The parasite was able to ingest and lysis erythrocytes of human and sheep that were supplemented to the culture media and such manipulation was able to augment the reproduction rate of the cultivated E. histolytica, however, such consequence was media- and concentration-dependent. The reproduction rate was significantly increased (66.0, 57.5 and 58.6%, respectively) in LEM medium containing human erythrocytes ty
... Show MoreBackground: Low-level laser therapy (LLLT) has been extensively applied to improve wound healing due to some biostimulatory properties presented by laser arrays apparently able to accelerate the repair of soft tissue injuries. However, the role of proinflammatory interlukines not been studied yet. IL_1 ? represent one of the most important poroinflammatory interlukines that involved in wound healing. The goal of this study was to investigate the effect of 790-805nm diode laser on the expression of IL_1 ? during wound healing in mice. Materials and Methods: Standard-sized wounds (1.5cm) were carried out in the face of 96 white albino mice. Half of them underwent LLLT treatment (360 J/cm 2) at 790-805 nm delivered immediately after wound pro
... Show MoreObjective: To identify the role and importance of the clinical pharmacist in the Emergency Department on prevent
or reduced the medication error.
Methodology: We collected the medical file of 3400 patients, 1400 patient's file in (A) hospital, and 1000 patient's
file in each of (B and C) hospital, who admitted to the ED, at primary weekdays between 8 am to 2 pm, and
recorded all the intervention made by clinical pharmacist through an active search in clinical charts, with analysis
of the daily medical prescription. The potential severity of harm of the medication error judged by two reviewers,
a permanent emergency physician, and clinical pharmacist based on the National Coordinating Council (NCC) of
Medication Error