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.
Vitamins play an important role in the human health, and thus they are the kind of major nutrients in the body. Chemical products perform numerous physiological functions and can jeopardize health jointly in their absence and surplus. Therefore, it is necessary to establish methods for observation vitamin levels in various molds. In this review paper, the most methods of determination used are high performance liquid chromatography (HPLC), spectrophotometric and potentiometric techniques by listed the value of : slope, linear range, correlation coefficient, detection limit, the max of wavelength and PH and compared with these methods.
Checkpoint inhibitors are a type of immune therapy used to treat different types of cancers. These drugs block different checkpoint proteins, for example, CTLA-4, PD-1, and PD-L1 inhibitors.
They block proteins that stop the immune system from attacking the cancer cells. Checkpoints are also described as a type of monoclonal antibody that antagonizes binding between B7 to CTLA-4 and PD-L1 to PD-1.
Immune checkpoint inhibitors are used to treat BARCA mutated triple-negative breast cancer (TNBCS) in patients who do not respond to chemotherapy, and also in the treatment of highly mutated and solid tumors such as brain tumors, liver, and pancreatic cancers.
Immune checkpoint inhibitors exhibit an effect on solid tumo
... Show MoreThe development of information systems in recent years has contributed to various methods of gathering information to evaluate IS performance. The most common approach used to collect information is called the survey system. This method, however, suffers one major drawback. The decision makers consume considerable time to transform data from survey sheets to analytical programs. As such, this paper proposes a method called ‘survey algorithm based on R programming language’ or SABR, for data transformation from the survey sheets inside R environments by treating the arrangement of data as a relational format. R and Relational data format provide excellent opportunity to manage and analyse the accumulated data. Moreover, a survey syste
... Show MoreHashimoto Thyroiditis (HT) is the most common autoimmune thyroid disease and the commonest cause ofhypothyroidism. C-reactive protein (CRP) is synthesized in hepatocyte in response to autoimmune disorders;strongly induced by IL-6. This study aimed to estimate serum IL-6 and CRP levels in autoimmune and non-autoimmune hypothyroidism. The present study included 60 Iraqi female hypothyroid patients divided to 30autoimmune and 30 non-autoimmune, with age ranged between 24-50 years and 30 healthy controls withage ranged between 27-52 years. Serum samples were collected from study groups. The levels of thyroidhormones (TSH, T4 and T3) were determined by using automated Chemiluminescence Immunoassay (CLIA)analysis system. Detection the levels of t
... Show MoreAbstract
Shorten the research problem that there is no system or model to evaluate the financial performance of the departments of municipalities where it is not possible for a person or institution both to know or to know their success in terms of the financial work of failure and where it is now than those without assessing the financial performed, authorized to be and necessities FATF is the financial performance assessment, which is the work unfinished aspects without Hence the work came in this study to study and diagnose and analyze financial data in a sample of municipal departments in order to develop a model to assess the financ
The developing countries, like our country Iraq suffer from deep comprehensive structural crisis, manifestations and a clear imbalance between the demand and the supply sides. The overall imbalance in the external balance. As a consequence, this caused the accumulation of foreign debts or failure in the implementation of economic development programs. The countries which are forced to resort to the International Monitoring Funds, and the World Bank for assistance and to express an opinion on policies that include restrictions controls that belong to the monetary, and fiscal side group, imposed on the economies crisis, as a condition for returning to normal which called reform programs. The organize of the events of radical changes in the
... Show MoreThe study aimed to identify the role of public relations management in its dimensions (mental image, media, advertising, and the public) on green human resource management practices in Jordanian private hospitals in Amman, and this study relied on the quantitative approach (descriptive and analytical) to test hypotheses. Where the questionnaire was relied upon to collect data and their number was (1771) workers, and the study population consisted of workers in the hospitals that were studied on them and their number was 10 hospitals, where 316 questionnaires were distributed, 300 questionnaires were retrieved, and 16 questionnaires were not valid for analysis. That is, 91.7% of the sample, and the study relied on proportional stratified
... Show MoreKE Sharquie, RA Najim, RK Al-Hayani, AA Al-Nuaimy, DM Maroof, Saudi medical journal, 2008 - Cited by 74