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.
Biomarkers such as Interleukin-6 (IL-6), Procalcitonin (PCT), C-reactive protein (CRP) and Neutrophil-Lymphocyte Ratio (NLR) have a role in the pathogenesis of severe coronavirus disease 2019 (COVID-19). The aim of this study was to explore the differences between serum levels of such biomarkers in severe and non-severe COVID-19 cases and compare them with normal people and to evaluate the sociodemographic variables and chronic diseases effect on the severity of COVID-19. The study included 160 subjects, divided into two groups, a case group of 80 patients, and a control group of 80 normal persons. The case group was divided into two subgroups: 40 severe COVID-19 patients and 40 patients with non-severe disease. Blood IL-6 was asses
... Show MoreForensic accounting (FA) is an important tool in exposing financial manipulation and corruption within institutions, making the role of FA essential in the Iraqi judicial system (IJS). This role suffers from limited implementation due to the lack of specialized legislation and insufficient awareness of its importance. The role of FA in the IJS can be enhanced by enhancing professional training, amending university curricula to include FA, and developing legislation regulating this field. Furthermore, cooperation between courts and the FA should be strengthened to ensure adequate financial evidence (FE) in judicial cases. For example, the experiences of developed countries, such as the United States and the United Kingdom, demonstrate how FA
... Show MoreThe purpose of this research shed light on the analysis of the relationship between training needs and organizational commitment and the role of a variable contract psychological, and start search of a dilemma thought provoking fundamental questions revolve around the search was the answer to all those questions of tricks theoretical framework to the variables of research first and test models of the relationship and impact secondly During six hypotheses major, The objective of the research the impact of the factors that affect training needs in organizational commitment center the psychological contract, and applied research on a sample of 100 individuals working in the engineering department and maintenance at the D
... Show MoreThe Risks Faced by Britain in their Areas of Influence at the Beginning of the Twentieth Century Drove her to the Alliance with the State of European such as France, and Contributed to the Tireless and made by the British and French Politicians in the Consolidation of Friendly Relations between the two Countries Efforts and Strengthened Cooperation in a Positive Way to Visit the king of Britain's Edward VII to France, Offset by Visit French President Loubet to Britain in the Same Year, those Negotiations Bore Fruit between the two Countries for Reaching a Contract Arbitration and Decisiveness between Britain and France Treaty on the Fourteenth of November 1903, Promised that Treaty First Step that Paved the Way for a General Agreement be
... Show MoreThe subject of youth care of important issues in view of what constitutes the importance
to the development of societies in general and as much as enjoy young people in any society
are good psychological health and agree psychosocial be healthy to be effective to invest their
energies and their potential for the progress of that society and development of the social
aspects and economic. The universities of the most important educational institutions that
provide care for young people, they are as well as providing information and expertise
necessary to prepare young people for life and the development of mental abilities, they are
different activities that will satisfy their needs physical, psychological, social and
The research aims to employ one of the most important strategies for recovery from the crisis of the Covid-19 pandemic, which ravaged the economies of the entire world and its various sectors, including the banking sector, through financial technology that is based on digital transformation to achieve financial sustainability and the creation of innovative financial value chains in light of the decline in the banking sector as a result of The negative effects of the Covid-19 pandemic, be guided by the relevant international accounting standards to control the risks associated with financial technology. To recover from the Covid-19 crisis, the research came out with a set of recommendations, most notably financial technology from
... Show MoreThis study evaluates the flexural behavior of ultra-thin (50 mm) one‑way reinforced‑concrete (RC) slabs retrofitted with near‑surface mounted (NSM) carbon‑fiber‑reinforced polymer (CFRP) rods under quasi‑static loading. T300‑grade CFRP rods (≈4 mm diameter) were bonded in pre‑cut 7 mm × 7 mm grooves using a two‑part epoxy. As a proof-of-concept experimental baseline, three simply‑supported specimens (1000 mm × 500 mm × 50 mm) were tested in a six‑point bending configuration (four applied loads + two reactions): two conventional controls and one strengthened slab. A load‑control rate of ~15 kN/min was applied; the controls were cycled twice and the strengthened slab four times. Relative to the average of
... Show MoreThis research focuses on the services provided by news websites (IMN, Youm7, Huffington Post Arabic) to its audience of Internet users, as well as materials posted through its pages, trying to monitor and explain them to identify their types & features, and it›s functions, whether informational or non-informational, to know the technical potential of each of the news sites, with the entry of the latest technology information. The research used the analysis method to achieve the research objectives within the period from 1/1 to 31/1/2017. The researchers used the content analysis tool as a research tool to analyze the news sites and to know the services they provide through their pages. The research was divided into three parts, the
... Show MoreThe present study examines the main points of differences in the subject of greetings between the English language and the Arabic language. From the review of the related literature on greetings in both languages, it is found that Arabic greeting formulas are more elaborate than the English greetings, because of the differences in the social customs and the Arabic traditions and the Arabic culture. It is also found that Arabic greetings carry a religious meaning basing on the Islamic principle of “the same or more so”, which might lead to untranslatable loopholes when rendered in English.