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 article considers the main reason for A. I. Herzen's address to obsolete words, which is their ability to acquire a stylistic coloring in the context of speech, as well as the possibility of combining, in some cases, with neutral lexemes of various functional styles. A certain stylistic effect of such characteristics of this type of vocabulary is represented, as a result of which their stylistic coloring in syntagmatic terms does not coincide with stylistic coloring in terms of paradigmatics, that is, in speech they have a completely stylistic meaning. Attention is focused on the role of outdated vocabulary, which consists in the fact that they serve to implement such features of the artistic style as imagery, emotionality, and their
... Show MoreBackground: clinically significant macular edema (CSME) is the commonest cause of visual loss in patients with diabetes mellitus and laser focal photocoagulation is the golden standard for treating it. Patients and Methods: A frequency doubled Nd: YAG laser was used to treat all eyes included in this study with diabetic maculopathy. Thirty eyes of three insulin dependent and twenty six non insulin dependent diabetic Iraqi patients were included. The study involved twenty six males, three females and followed for one year. Their ages were ranging between 36- 59 years, all of them from patients attending ophthalmic out-patient department in the medical city in the period between January 2005 and June 2006. Eyes divided in to two groups (fifte
... Show MoreRetreatment Efficacy of Continuous Rotation Versus Reciprocation Kinematic Movements in Removing Gutta-Percha with Calcium Silicate-Based Sealer: SEM Study, Raghad Noori Nawaf*, Ra
Pituitary adenomas are the anterior pituitary tumors. Patients with an Aryl Hydrocarbon Receptor-Interacting Protein (AIP) mutation (AIP- mut) tend to have more aggressive tumors occurring at a younger age. Single nucleotide polymorphisms (SNPs) in many studies have been related to metabolic comorbidities in the general population. Study aims investigated the role of AIP gene SNPs with susceptibility to acromegaly pituitary- adenoma, with levels of LH, FSH, TSH, Testosterone, IGF1,GH, FT4 , Prolactin hormones and blood sugar levels. The study was conducted on a group of acromegaly patients, including 50 patients) both Genders( with hyperplasia of the ends, and apparently healthy control group. Genotyping of
... Show MoreThe study the problem emerged in the inability of local companies to enter the field of active competition with other companies operating in the same economic sector due to the high cost of their products, hence, the companies that want to apply this technique can effectively compete in order to achieve those objectives.
So this study focused on the goal of reducing the cost of products by reducing the cost product to a minimum , as the study was based in its hypothesis on the ability of companies to application this technique which in turn leads to increased profits under conditions of normal working and the power available and their potential in improving the quality of its products, as well as the need for full coordina
... Show MoreThis study aimed to determine the level of spiritual intelligence among students of educational psychology course at the Jerash University. and whether this level of varies depend on the gender of the student as well as the college type. The study sample consisted of (180) male and female students of bachelor students at the University Jerash, in the second semester of academic year2014-2015. The main results of the study were that the level of spiritual
Intelligence of Jerash University students was high. More over There were no statistically significant differences at the level of significance (0.05) due to the effect of gender, college type or academic achievement
One of the globalization results is (VAT) , so it is important to consider its results and impact on the tax system.
The Iraqi economy having wittnisd an acute transition period , still in need for a better care in aim to back it, especialy from the tax system.
The research is concerned with the (VAT) and its details –And for five chapters all the problomes connect are displayed .But yet the new system does not comply with the modern development and this is one of the defects of (VAT) in Iraq.
The history of (VAT)was also studied mentiorned and studied.
As a conclusion (VAT) is one of the m
... Show MoreAcademic boredom is one of the most emotional problems that arouse an individual's fatigueness and lowers his interest. This is because of the environment's low efficiency and of spending long monotonous time. This state is characterized by having lack of interest, difficulties in concentration, and the desire to leave the class. It is considered one of the most prominent forms of boredom widespread among students and the most severe and dangerous one that has negative effects and severe psychological and social problems. The current research aims to investigate a randomly selected sample of 335 students from the first and third grades at the directorates of education (Karkh and Rusafa) who suffers from academic boredom. Similarily
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