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 aimed to identify the role of digital transformation in improving the quality of the internal audit process. The researchers used the descriptive analytical approach, and the questionnaire was relied on as a study tool that was applied to the study population consisting of internal auditors working in banks listed on the Palestine Stock Exchange, and their number was (85). A checker and a comprehensive inventory method was used due to the small size of the community, where the response data of the questionnaire was analyzed and interpreted using the Statistical Packages Program (SPSS).
The results of the study showed that the use of digital transformation contributes to ensuring the quality of
... Show MoreThis study aims to identify the concepts of financial crisis and its reasons of creation , also explain the effects of the accounting disclosure and the International Accounting Standards in current financial crisis, In addition to, indicate the role of accounting in the reform of the financial system from the impact of financial crisis.
The methodology of this study orientied to two main aspects, the first is an identifying approach through exploring the opinion of financial experts, the second aspect is based on an analytical approach to satisfy the requirements of experts to get there opi
... Show MorePurpose: Determining and identifying the relationships of smart strategic education systems and their potential effects on sustainable success in managing clouding electronic business networks according to green, economic and environmental logic based on vigilance and awareness of the strategic mind.
Design: Designing a hypothetical model that reveals the role and investigating audit and cloud electronic governance according to a philosophy that highlights smart strategic learning processes, identifying its assumptions in cloud spaces, choosing its tools, what it costs to devise expert minds, and strategic intelligence.
Methodology:
Prostate cancer is the commonest male cancer and the second leading cause of cancer-related death in men. Over many decades, prostate cancer detection represented a continuous challenge to urologists. Although all urologists and pathologists agree that tissue diagnosis is essential especially before commencing active surgical or radiation treatment, the best way to obtain the biopsy was always the big hurdle. The heterogenicity of the tumor pathology is very well seen in its radiological appearance. Ultrasound has been proven to be of limited sensitivity and specificity in detecting prostate cancer. However, it was the only available targeting technique for years and was used to guide biopsy needle passed transrectally or transperineally
... Show MoreObjective: Aimed to asses the role of PT estimation in early diagnosis and predicting the extent and the outcome of head injury with ICerH and/ or Contusion
Method :PT was measured by Digiclot 818
Group –1: One hundred consecutive head injured patients admitted at Neurosurgical and Al Ramadi teaching hospitals were initially estimated for prothrombin time and subsequently scanned
Group-2 : Two hundred twenty five consecutive non scanned head injured patients admitted to Neurosurgical and Al Ramadi teaching hospitals were estimated with prothrombin time at the time of insult and subsequently for the next two weeks Al – Kindy Col Med J 2012; Vol. 8 No. 1 P: 54
Clinical and neurological evaluation (GCS) score in addition to
The present study tackles the complex issue of the urgent need for Environmental Auditing (EA) in Iraq in the absence of laws that support environmental management and in the light of the high rates of cancerous diseases in Iraq, which coincided significantly with the increase in oil production, according to the numbers indicated in the Iraqi Ministry of Health. The study aimed to investigate the mediating role of Management Systems (MS) related to the role of EA supporting sustainability reports concerning the reduction of the negative effects of gas emissions from oil companies. We adopted the descriptive approach which relies on studying relationships through a questionnaire that was distributed to a group of workers at Doura Refinery in
... Show MoreMarketing is one of the most important pillars on which most industrial and commercial sectors depend on evaluating their performance, improving their financial position, development and economic growth. The presence of effective marketing activities in any industrial or commercial organization (which works to meet the requirements of customers in order to ensure the integration of trading and handling rings with consumers and to ensure the growth of the marketing process regularly and not to retreat) effectively contributes to maintaining the company's position between its competitors and its customers. It is necessary to have these marketing activities in order to meet the requirements of the organization on the one hand and to
... Show MoreIn this research, a number of the western al-Anbar clays (red iron clays, Attapulgite) were modified by treating them thermally with a temperature of 650oC. After that, these clays reflux with sodium hydroxide 5% for 1 hour by using microwave as a power supply. The research included fractionation alqayaira crude oil the fractionation included removing the asphaltene by precipitation from the crude using a simple paraffin solvent (normal hexane) as a non-soluble substance. After that it was filtered using the ash-free filter paper 42, the dissolved part, maltinate, was taken, drying a temperature of 75oC and weight, and to find the percentage of the two parts. Malatine was divided into three main parts (paraf
... Show MoreBackground: The association between periodontal diseases incidence and development and the metabolic diseases as Diabetes Mellitus and Obesity are recently have attract great deal of researchers attention and investigation. The periodontal health proved to reduce the systemic inflammatory reactions and positively improve the glycemic control of diabetes Type2 patients. The aim of the study was to investigate the influence of oral hygiene control on the glycemic control of obese and normal weight moderately controlled Diabetic Type 2 patients, in addition to study the association of obesity with the gingival inflammation. Materials and Methods: Cross sectional study of three months duration. Included 30 moderately controlled diabetic type2 p
... Show MoreBackground: Chronic myeloid leukemia is a cancer of the white blood cells characterized by the increased and unregulated growth of predominantly myeloid cells in the bone marrow. This study aimed to determine the effect of chronic myeloid leukemia on Dental caries and Oral health status including Gingivitis, Loss of attachment, Plaque index and Calculus index as well as evaluation of salivary flow rate and salivary interleukins-6 and tumor necrosis factor-?. Material and methods: Study group consisted of (75) subjects, (25) were newly diagnosed with chronic myeloid leukemia, (25) were taking medications (Glevic), and (25) were control subjects, all ag
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