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: War represents a major human crisis; it destroys communities and results in ingrained consequences for public health and well-being
Objective: We set this study to shed light on the public health status in Iraq after the successive wars, sanctions, sectarian conflicts, and terrorism, in light of certain health indicators.
Design: The primary source of data for this analysis comes from the Iraqi Ministry of Health, and The World Health Organization disease surveillance.
Results: Most of the morbidity indicators are high, even those that are relatively declining recently, are still higher than those repor
... Show MoreThere is a natural problem raised by the issue of media performance. As a separate activity and express its own capabilities. This problem can be framed in the form of a question: Is media performance merely a reflection of the activity of other sectors of society, especially political and economic, and what links them to other societal sectors of interrelated relations? Is the media limited to mere transfer, or is it an industry with its own mechanisms and rules? The answer may seem somewhat complicated if we handle media with research and study in general, but the issue may be less complicated when it comes to Arab media, because its data may add another setback to the overall Arab setbacks.
The Russian foreign policy of the post-cold-war era faced dilemmas in the light of the international and regional realities of the disintegration of the Soviet Union and the formation of a new unipolar international order led by the United States of America. Thus, Russian foreign policy-making was divided over the nature of the foreign policy to be followed. The achievement of the Russian goals, especially as the objectives of Russian foreign policy have been set within the framework of trying to regain the status and leading role, as well as the establishment of some fundamental changes to be consistent with the new international situation of the post-one The Russian Federation has adopted in the sphere of its foreign policy to the vari
... Show MoreObjective: to evaluate the increase in weight after biological agents and the association of weight gain with the body mass index among a sample of patients attending Baghdad Teaching Hospital Methods: A prospective study is carried out in Baghdad teaching hospital biological units and outpatient clinic of rheumatology for a period of one year starting On April 2015 and ending on March 2016. 120 patients were included in the study 40 psoriatic arthritis .40 ankylosing spondylitis and 40 rheumatoid arthritis Results : The study findings indicate that significance differences are seen regarding weight gain and b
Methotrxate (MTX) has become the standard of care and first-line therapy for patients who have RA and consider as a gold standard of treatment for RA. The role of MTX in the treatment of RA has now been well established. The use of MTX treatment of RA inhibits proliferation of the lymphocytes, reduces signs and symptoms this disease, reduces progression damage of the joints and improves quality of life outcome. Progranulin (PGRN) acts a role in autoimmune inflammatory, has important function in several processes including immune response. Present study has conducted to find the effect of MTX drugs as a therapeutic target for RA patients because of its ability to bind with tumor necrosis factor receptor (TNFR), with progranulin, obestatin an
... Show MoreIf the State attaches great importance to its foreign relations and intends to strengthen them in order to ensure the achievement of the highest national goals and interests. External relations between countries are one of the most prominent features of foreign policy, which depends on a combination of internal and external factors, the modern relations between Tunisia and Tunisia, which goes back to the pre-independence of Tunisia, when Iraq was a supporter of Tunisia's independence from France in the 1940s, Although these relations did not cause any disturbance by the two countries, but they remained weak relations did not develop in all areas except the sports and cultural field, which we will determine the reasons and the pos
... Show MorePolycystic ovary syndrome (PCOS) is the most endocrine problem in women of regenerative age. PCOS women typically belong to an age and sex group which is at higher risk for severe coronavirus disease (COVID-19). COVID-19 targets cells through angiotensin-converting enzyme 2 (ACE2) receptor presents on cells in veins, lungs, heart, digestion tracts, and kidneys. Renin-Angiotensin System (RAS) over activity has likewise been described in metabolic disorders; type 2 diabetes mellitus (T2DM), and conditions shared by women with polycystic ovary condition. The point of this study is to know the job of renin and ACE2 in PCOS and coronavirus and its relationship with hormones and other metabolic parameters related. The study groups consist of 1
... Show MoreThe Iraqi political and social arena has been characterized, subjectively and objectively, by the weakness of leadership building. This has led to a leadership crisis, which is reflected in the quality of the outcome of the process of rebuilding the state in Iraq. Thus, this building process has lacked the simplest requirements and conditions of success. It has suffered from a major and obvious failure: the situation in Iraq has raised conflict leaders, not constructive leaders, and this confirms the existence of a cultural crisis in the production of conscious, aware leadership compatible with democratic action. The weakness of leadership in Iraq is reflected in a series of ongoing crises that require radical solutions in accordance with l
... Show MorePatients with decompensated cirrhosis have typically prescribed a combination of therapeutic and prophylactic medications. Polypharmacy increases the probability of medication errors and drug related problems. Clinical pharmacists are highly effective at identifying, resolving, and preventing clinically important drug-related problems in their patients' care. The objectives of the study were the identification and classification of drug-related problems, as well as the discussion of these problems with health care providers (physicians, pharmacists, and nurses) and patients. Reduce their incidence as effectively as possible and educate all research participants on the significance of following their prescribed drug regimen
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