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.
This study focused on determining the markers of Macrophage migration inhibitor (MIF), as well as the N-telopeptides of type I bone collagen (NTX), and some other parameters (alkaline phosphatase (ALP), vitamin D (Vit D), calcium (Ca), phosphorus (P), and magnesium (Mg), and their correlation with other parameters in osteoporosis. One hundred ten subjects were involved in the current study. There were two groups of patients: group I (30) women with severe osteoporosis and group II (30) women with mild osteoporosis. For comparison, 50 apparently healthy individuals were included as a control. Serum levels of MIF, and NTX were significantly higher in groups I and II as compared to the control group, which indicate that these two parameters
... Show MoreBackground: Rituximab is a chimeric IgG1 kappa immunoglobulin that has been genetically modified to incorporate human constant region sequences together with murine light- and heavy-chain variable region sequences. People use it to treat rheumatoid arthritis and certain malignancies. Objective: The study aimed to assess the potential association between the serum levels of Factor I, CD59, interleukins (IL)-6, and interferon-gamma (IFN)-γ and the response to Rituximab treatment in Iraqi rheumatoid arthritis patients. Methods: A cross-sectional study was conducted at the rheumatology center at Baghdad Teaching Hospital. Ninety adult patients who have been diagnosed with rheumatoid arthritis and are receiving Rituximab intravenous i
... Show MoreThe levels of circulating angiogenic and anti-angiogenic factors, namely vascular endothelial growth factor–A (VEGF-A) and soluble vascular endothelial growth factor receptor-1 (sVEGFR-1), have been linked to the development of renal dysfunction due to the proliferation of microvasculature within the kidneys of type 2 diabetic (T2DM) patients. The study aims to scrutinize serum levels of VEGF and sVEGFR-1 in a sample of Iraqi diabetic nephropathy patients to support their reliability as markers for the prediction of nephropathy in type 2 diabetes mellitus patients as well as to assess the ACE inhibitor’s effect on the levels of these two markers. Method: The ninety participants of this case-control study were split into three gr
... Show MoreThis research aims at answering many questions raised by the research problem concerning the view of the organizations under consideration for the concept of smart leadership and its most important dimensions, as well as the view of crisis management and its concept and most important methods through research objectives that define and clarify the smart leadership with its dimensions and methods of crisis management.
For the purpose of reaching the results of the research and testing the assumptions about the relationship between smart leadership and methods of crisis management, the researcher adopted a questionnaire, designed especially to be a criterion for the research, as the main tool for data coll
... Show MoreTraction force and power requirement when performing primary tillage occupy the minds of almost farmers, this field research had aim to determine and calculate the pulling force of the most commonly used moldboard and chisel plows, the research conducted in silt clay loam for chisel and moldboard plows as the main factor, two depths of tillage 18 and 25 cm as a second factor and three speeds of tractor 2.55, 4.30 and 6.15 km.h-1 as a third factor. Moldboard plow recorded least traction force 7.550 kN, drawbar power 11.583 hp, power losses due to slippage 1.088 hp, power on the rear axle of the tractor 15.770 hp and brake horse power 17.495 hp. Chisel plow recorded best traction efficiency 76.217 % and total traction efficiency 68.659 %. Dep
... Show MoreEnrollment in kindergarten child accomplishes many positive aspects, that’s what Im sure a lot of modern educational trends in child education preschool in the importance of exposing children to a variety of sensory stimuli that contribute to impart a range of sound concepts.
Current research aims to know:
1.the level of sensory perception in the first primary grade students a sample search.
2.differences in perception of elementary first-graders with variable gender male, female)) 3.differences in perception of the first primary grade students attending and not attending kindergarten in accordance with variable attendance (attending, not attending).
school students (first grade) from attendi
... Show MoreData <span>transmission in orthogonal frequency division multiplexing (OFDM) system needs source and channel coding, the transmitted data suffers from the bad effect of large peak to average power ratio (PAPR). Source code and channel codes can be joined using different joined codes. Variable length error correcting code (VLEC) is one of these joined codes. VLEC is used in mat lab simulation for image transmission in OFDM system, different VLEC code length is used and compared to find that the PAPR decreased with increasing the code length. Several techniques are used and compared for PAPR reduction. The PAPR of OFDM signal is measured for image coding with VLEC and compared with image coded by Huffman source coding and Bose-
... Show MoreIt can be said that the Security of water in Basra from the visual task vital strategic issues of concern to the attention of researchers in various attributions and those interested in water, environmental, economic, social, cultural and political affairs ... etc. This view of the great importance of the issue of water in the occupied Basra, which is characterized by parochialism and scarcity, When looking at the sources of our daily lives and in our reality today. We find that millions of people living on the two main exporters Tabaaan oil and water. And depleted oil wealth However Manfred him the most attention because we entered it surpasses all other sources of income, but is not it a littl
... Show MoreResearch Summary:
Seeking happiness and searching for it have been among the priorities of mankind from the beginning of his creation and will remain so until the end of this world, and even in the next life, he seeks happiness, but the difference is that a person can work in this world to obtain it, but in the next life he is expected to get what he done in this world. And among these reasons are practical actions that a person undertakes while he intends to draw close to God Almighty, so they lead him to attain his desired perfection, and to attain his goals and objectives, which is the minimum happiness in this life, and ultimate happiness after the soul separates the body, and on the day of the judgment, Amon
... Show MorePerceptions of deity have practical effects in a person’s life, especially in his attitudes toward natural things since nature was created, in which man has treated it as something sacred. The Greek philosophers before Plato and Aristotle did not find in them the idea of divinity clear. Rather, they all searched for the first substance or the first cause of existence, and then gave it all the attributes of God from eternity and eternity, and considered it a first reason without which the universe would not have existed. knowledg