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.
Abstract
The research aims to identify the application of corporate governance requirements according to the international standard (ISO 26000:2010) in the National Insurance Company. Strengths and weaknesses were identified to study the current state of this requirement's application in the company under investigation. The descriptive-analytical approach was utilized through a checklist derived from ISO 26000:2010. Several personal interviews and field visits were conducted to understand the extent of application and documentation based on various statistical methods. The results revealed a level of applic
... Show MoreThis dissertation studies the application of equivalence theory developed by Mona Baker in translating Persian to Arabic. Among various translation methodologies, Mona Baker’s bottom-up equivalency approach is unique in several ways. Baker’s translation approach is a multistep process. It starts with studying the smallest linguistic unit, “the word”, and then evolves above the level of words leading to the translation of the entire text. Equivalence at the word level, i.e., word for word method, is the core point of Baker’s approach.
This study evaluates the use of Baker’s approach in translation from Persian to Arabic, mainly because finding the correct equivalence is a major challenge in this translation. Additionall
... Show MoreAcute Respiratory Distress Syndrome (ARDS) causes up to 40% mortality in humans and is difficult to treat. ARDS is also one of the major triggers of mortality associated with coronavirus-induced disease (COVID-19). We used a mouse model of ARDS induced by Staphylococcal enterotoxin B (SEB), which triggers 100% mortality, to investigate the mechanisms through which Δ9-tetrahydrocannabinol (THC) attenuates ARDS. SEB was used to trigger ARDS in C3H mice. These mice were treated with THC and analyzed for survival, ARDS, cytokine storm, and metabolome. Additionally, cells isolated from the lungs were used to perform single-cell RNA sequencing and transcriptome analysis. A database analysis of human COVID-19 patients was also performed t
... Show MoreIn this study, from a total of 856 mastitis cases in lactating ewes, only 34 Streptococcus agalactiae isolates showed various types of resistance to three types of antibiotics (Penicillin, Erythromycin and Tetracycline). St. agalactiae isolates were identified according to the standard methods, including a new suggested technique called specific Chromogenic agar. It was found that antibiotic bacterial resistance was clearly identified by using MIC-microplate assay (dilution method). Also, by real-time PCR technique, it was determined that there were three antibiotics genes resistance ( pbp2b, tetO and mefA ). The high percentage of isolate carried of a single gene which was the Tetracycline (20.59%) followed by percentage Penicillin was
... Show MoreThe study aims at analyzing the inconsistent structural and semantic aspects found in the plays of N.A Ostrovsky. The analysis, that includes all the linguistics schools of thoughts in modern Russian language, is performed chronologically to clarify all the ambiguities that the Russian language learners may face. Such difficulties lie in the use of inconsistent aspects with complete declarative sentences and adverbial clauses. Hence, it constructs a new sentence category that consists of secondary clause and its syncretism semantic.
The study illustrates the wide scope of both studying the sentence inconsistent
... Show MoreVarious visual media are becoming an increasingly important and active instrument of communication. This fact has led some political parties and leading personalities in Iraq to make use of them as an accepted forum for the discussion of public affairs usually in a manner that conforms to their declared policy. They have to draw as much popular support as they could for the causes which they fight for. As a result, a state of great confusion has been created from the contradictory statements made by the contending parties and gave left grave consequences on all types of the audience receiving them. The problem of the study can be summarized in one major question: What is the opinions of the audience as regards the statements made by the
... Show MoreAbstract
Should be the goal of Government controls, including environmental controls and safety laws to protect citizens from the harmful effects of negative secreted by human's additions and changes in the environment. and perhaps the protection aspects of the protection of citizens from the adverse effects of communications towers, including those produced by towers of health effects. The people the right to choose the nature of the physical environment, which should not be imposed on them by others. Communications towers are one of the main problems that have been
... Show MoreThe primary objective of root canal therapy is adequate biomechanical preparation of root canal system followed by 3D obturation.in clinics we are encountered with several anatomical variations, which we need to manage efficiently. One of the major factors responsible for failure of root canal therapy is missed canals. Recent technological advances have given the clinician opportunity to identify anatomical variations and treat them to satisfaction.