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 performance of composite prestressed concrete beam topped with reinforced concrete flange structures in fire depends upon several factors, including the change in properties of the two different materials due to fire exposure and temperature distribution within the composition of the composite members of the structure. The present experimental work included casting of 12 identical simply supported prestressed concrete beams grouped into 3 categories, depending on the strength of the top reinforced concrete deck slab (20, 30, and 40 MPa). They were connected together by using shear connector reinforcements. To simulate the real practical fire disasters, 3 composite prestressed concrete beams from each group were exposed to high t
... Show MoreIn this study, a Hydroxyapatite (HA) coating was prepared on a titanium implant by an electrochemical deposition process. The titanium pre-treatment by anodizing in 1.65 mol/L sulfuric acid with (10V) at room temperature. The deposition was all conducted at a constant voltage of 6.0 V, for 1 h at room temperature. The coatings thus prepared were characterized with Fourier transform infrared spectroscopy (FTIR) and thickness of the coated layer.The electrochemical deposition of HA occurred on the titanium as a cathode. Coated titanium by HA after anodizing revealed a good corrosion protection efficiency even at a temperature ranged (293-323) K in artificial saliva. Activation energy and pre-exponential factor (kinetic parameters) were calcul
... Show MoreThe main objective of this paper is to study the behavior of Non-Prismatic Reinforced Concrete (NPRC) beams with and without rectangular openings either when exposed to fire or not. The experimental program involves casting and testing 9 NPRC beams divided into 3 main groups. These groups were categorized according to heating temperature (ambient temperature, 400°C, and 700°C), with each group containing 3 NPRC beams (solid beams and beams with 6 and 8 trapezoidal openings). For beams with similar geometry, increasing the burning temperature results in their deterioration as reflected in their increasing mid-span deflection throughout the fire exposure period and their residual deflection after cooling. Meanwhile, the existing ope
... Show MoreThe problem of the study and its significance:
Due to the increasing pressures of life continually, and constant quest behind materialism necessary and frustrations that confront us daily in general, the greater the emergence of a number of cases of disease organic roots psychological causing them because of severity of a lack of response to conventional treatments (drugs), and this is creating in patients a number of emotional disorders resulting from concern the risk of disease
That is interested psychologists and doctors searchin
... Show MoreA field experiment was carried out during the seasons 2016 and 2017 in the farm of the Department of Field Crops Science, College of Agricultural Engineering Sciences-University of Baghdad to evaluate the effect of(Aminopyralid + Flurasulam, Coldinafop-propargyl and Flucarbazone-sodium) herbicides and seeding rate (100, 125 and 150) Kg.ha-1 and the interaction between them in growth characteristics, grain and yield components in wheat (Var. IPA99). The results showed that herbicides used were significantly efficient in studied characteristics compared to weedy treatment. Herbicide Flucarbazone-sodium gave higher weed control after 60 and 90 days of spraying the he
This study dealt with the management strategy as an independent variable and the integrated industrial distribution as a variable. The study aimed at finding the integrated industrial distribution that fits with the management strategy in providing the needs of the firm on the one hand and reducing the cost of management that is reflected in increasing its profits.
The researcher selected the data from (130) decision makers in the corporation and used the questionnaire as a tool for collecting data and used a set of statistical tools and tools suitable for the nature of information and were processed using the data analysis system (SPSS version 24) Based on the analysis of the responses of the sample and the test of correlation and
Diabetes is a complex set of diseases require continuous medical care, to control blood sugar and prevent complications is .The aim of this research is to determine the effect of administration of L carentin to diabetics on the lipid profile. The research was conducted on sixty diabetic patients were selected from endocrinology and diabetes center / Al-Rusafa, within selected criteria. The patients divided into 3 groups (control group of healthy people and two groups of patients with diabetes who were on metformin and glibenclamide, one group took a L carnitine in a dose of 1000 mg twice daily and a group dealing with a placebo for a period of 3 months continuously). The study found that patients who took Lc
... Show MoreTo investigate the effects of losartan and enalapril on serum uric acid in hypertensive patients with metabolic syndrome, one hundred and twenty six newly diagnosed mild hypertensive patients, having markers of metabolic syndrome included in the study. The patients were divided into two groups. Group 1 (60 patients) was given losartan (50 mg/ day) and group 2 (66 patients) enalapril (20 mg/ day) for a duration of 2 months. A control group of seventy apparently healthy individuals were included. Metabolic syndrome was diagnosed according to diagnostic criteria of metabolic syndrome related to the American National Cholesterol Education Program-Adult Treatment Panel III. Serum uric acid levels were measured bef
... Show MoreAdenosine deaminase (ADA; Ec: 3.5.4.4), 5´- Nucleotidase (5´– NT; Ec: 3.1.3.5), and AMP – amino hydrolase (AMP – deaminase AMPDA; Ec: 3.5.4.6) activities were measured in sera of ovarian cancer patients before surgery, and after chemotherapy. The results indicated that ADA specific activity increased significantly (P<0.05), while 5´-NT and AMPDA specific activity decreased significantly (P<0.05) in ovarian cancer patients before surgery in comparison with those of their corresponding control women and benign tumors groups. When the activities of these enzymes were measured after chemotherapy, a significant decrease (P<0.05) in ADA activity, and a significant increase (P<0.05) in 5´- NT and AMPDA activities w
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