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: Cardiomyopathy (CM) is a cardiac muscle disorder that can lead to heart failure (HF). It has several phenotypes, including dilated, hypertrophic, and restricted. Pro-inflammatory cytokines play a crucial part in the development and advancement of CM. Objective: This study aimed to measure the concentration of certain cytokines [Interleukin- 1β (IL-1β), Interleukin-6 (IL-6), and Tumor Necrosis Factor (TNF-α)] in the serum of Iraqi patients with CM. Materials and Methods: Sixty CM patients and 30 healthy individuals with age ranged from 40 to 70 years old were enrolled in this study through their presence at Iraqi Center for Heart Diseases, Ghazy Al-Hariri Hospital for Surgical Specialties in the Medical City in Baghdad. The st
... Show MoreDuring recent years, there has been an increasing interest in the investigation of the cytokines roles in pathogenesis of cancer, thus the study aimed at evaluating the level of tumor necrosis factor-alpha(TNF-?) in sera of Iraqi multiple myeloma (MM) patients. Beta 2-microglobulion (?2-m) was assessed to determine if there was any association between this cytokine and the level of ?2- m, as the latter is related to the stage of the disease. In addition, the age and gender were also taken into consideration. Furthermore, we investigated the relationship between IgG and TNF-? in sera of patients. 49 Iraqi patients (27 males and 22 females).The patients were also divided into two groups: the first group included (17) patients who were
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Facing industrial companies many pressures and challenges due to rapid changes in the business environment of contemporary, which requires them to do their performance look more inclusive rather than limiting performance evaluation on the financial perspective in spite of its importance, prompting companies to rethink their reality competitive through the adoption of methodologies and new philosophies to manage competitiveness of total quality management, and re-engineering of production processes, and knowledge management,... etc., as This study framework cognitive and practical "to evaluate the performance of a company Diyala General Electric Industries and how to rehabilitate
Composite steel-concrete sections have a broad benefit through increasing structural strength as well as minimizing the self-loads. All past researches were concerned with pre-installed shear connectors (PRSC) in the manufacturing of composite sections. A new fabrication technique for steel-concrete-steel composite sections were presented in the current study by the post-installation shear connectors (POSC) passed-through an embedded polymerizing vinyl chloride (PVC) pipes. The performance of normal strength concrete prisms with a specified strength of 32 MPa connected to square steel tubes (SST) was investigated. Six specimens were fabricated in both methodologies, PRSC and POSC were experimentally tested by Push-out test. The spac
... Show MoreThe correct and sincere process of socialization is working on appropriate social climate in
which this process is the provision, and the climate is achieved in the presence of a positive
environment free of negatives and contradictions, but when there is a socialization processes
inadequate and contradictory was not based on the principles of punishment and reward nor a
balance between methods soft and intensity of treatment and interaction with small and
adolescent does not require intensive social care formulas do not create the conditions
essential items required by the successful and effective socialization, the young and the young
people who are going through in such Altanisah and educational operations will be
That the structural changes in the environment, business and finance and the spread of business and the diversity of transactions between economic organizations and breadth of a commercial scale in the world have left their clear on the need to keep up with the accounting for these variables as one of the social sciences affect and are affected by the surrounding environment because of the various economic and social factors, technical, legal and others.
As a result of these variables emerged a new field of accounting called Forensic Accounting, which involves the use of expertise of multiple pour in the end to the accounting profession, where the Forensic Accounting cover a large area of disciplines including strengthening
... Show MoreThis research aims to introduce the general tax on sales in gordan and the most important concepts related to this type of taxes and identify the most on characteristics and stand on its role in supplying the general budget of the necessary fundig to cover the over head of the state and the factorsinfluencing it and whether such a tax has been able to chieve the desired goals.including in contribute to an important and growing role in puplic revenues or not to be able to achieve these goals through the use of descriptive and analytical technique based on the data and information relevant.wasreached some conclusion and recommendations was most important is that the general sales tax comes in
... Show More3D models delivered from digital photogrammetric techniques have massively increased and developed to meet the requirements of many applications. The reliability of these models is basically dependent on the data processing cycle and the adopted tool solution in addition to data quality. Agisoft PhotoScan is a professional image-based 3D modelling software, which seeks to create orderly, precise n 3D content from fixed images. It works with arbitrary images those qualified in both controlled and uncontrolled conditions. Following the recommendations of many users all around the globe, Agisoft PhotoScan, has become an important source to generate precise 3D data for different applications. How reliable is this data for accurate 3D mo
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