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.
Background: Arterial stiffness is related with atherosclerosis and cardiovascular disease events. Patients with atherosclerotic disease show to have larger diameters, reduced arterial compliance and lower flow velocities. Aim of study : To compare between patients of two age groups with concomitant diseases diabetes and hypertension in regard to intima media thickness and blood flow characteristics in order to estimate the blood perfusion to the brain via the common and internal carotid arteries. Subject and Methods : 40 patients with (diabetic and hypertension) diseases were enrolled , they were classified according to age. Color Doppler and B mode ultrasound was used to determine lumen Diameter (D), Intima – media thickness (IMT)
... Show MoreThe current study aimed to reveal the moral values available in the Arabic language textbook (Al-Mu’nes) for grades eleven and twelve for post-basic education in the Sultanate of Oman. The researcher adopted the descriptive approach using the sentence as measuring unit in the analysis process. The five fields of moral values and their subcategories values represented the categories of the analysis. Iterations of values and the percentages of iteration were calculated in those textbooks. Moreover and the analysis and stability of the process were confirmed.
After referring to previous studies, it was possible to de
... Show MoreThe research aims to develop a proposed mechanism for financial reporting on sustainable investment that takes the specificity of these investments.
To achieve this goal, the researcher used (what if scenario) where the future financial statements were prepared for the year 2026, after completion of the sustainable project and operation, as the project requires four years to be completed.
The researcher relied on the results of the researchers collected from various modern sources relevant to the research topic and published on the internet, and the financial data and information obtained to assess the reality of the company's activity and its environmental, social, and economic i
... Show MoreStandards of audit have been defined issued them by professional organizations the audit risk is: Failure of the auditor inadvertently to amend his opinion on the financial statements in suitable method, although these statements are Interpolated Essentially. As result the deep impacts caused by electronic operating systems in the accounting data in the audit process which audit risk has gained attention of many professional sides, especially the audit process and quality is relating with level of discovery the auditor for the mistakes of origin (misrepresentations) all their types and give the necessary confidence for the auditor to express his technical opinion in fidelity and certified financial statements which prepared electronicall
... Show MoreIn the United States, the pharmaceutical industry is actively devising strategies to improve the diversity of clinical trial participants. These efforts stem from a plethora of evidence indicating that various ethnic groups respond differently to a given treatment. Thus, increasing the diversity of trial participants would not only provide more robust and representative trial data but also lead to safer and more effective therapies. Further diversifying trial participants appear straightforward, but it is a complex process requiring feedback from multiple stakeholders such as pharmaceutical sponsors, regulators, community leaders, and research sites. Therefore, the objective of this paper is to describe three viable strategies that can p
... Show MoreResearchers have recently increased their focus on the link between autoimmune diseases and infections. Most of the recent research indicates that silent human cytomegalovirus (HCMV), may have diverse roles in the initiation, development, and exacerbation of autoimmune diseases, such as coeliac Disease (CD) and inflammatory bowel disease. The aim of this study is to evaluate the role of HCMV infection in Iraqi patients with CD. Serum samples were obtained from 60 patients with CD, and from 60 healthy subjects. Enzyme-linked immunosorbent assay was used to determine the Anti-Transglutaminase IgG/IgA, Anti-gliadin IgA/ IgG, as well as the HCMV IgM/ IgG levels in the serum samples. Significantly higher percentage of positivity for seru
... Show More