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.
Lasmiditan (LAS) was formulated as a nanoemulsion based in situ gel (NEIG)with the aim of improving its oral bioavailability via application intranasally. The solubility of LAS in oils, emulsifiers, and co-emulsifiers was determined to identify nanoemulsion (NE)components. Phase diagrams were constructed to identify the area of nanoemulsification. LAS NE was formulated using the spontaneous nanoemulsification method. Four NEs (F19, F24, F31, and F34) containing 7-15 % oleic acid (OA) as an oily phase, 40-55% labrasol (LR), and transcutol (TC) as emulsifier mixture at (1:1), (2:1), (3:1), and (1:2) ratio with 30-53 % (w/w) aqueous phase, having suitable optical transparency of 95–98%, globule size of 104-140 nm and polydisper
... Show MoreThe current work aims to evaluate the association between genetic mutations in thymidylate synthetase (
Abstract:
The great expansion of teaching skills requires finding ways and methods to help teachers acquire experiences of all kinds. The researcher found in the subject of the teaching skills for teachers in public and private schools a fertile field for conducting a study that enables the measurement of these skills. Thus, the study aims to identify the skills of teaching lessons for teachers, the difference in teaching lesson skills for teachers according to the years of service, the differences in teaching lesson skills for teachers according to the specialized teachers and non-specialized teachers, the differences in teaching lesson skills for teachers according to the public and private school. The
... Show Morebackground: human epidermal growth factor receptor-2 (her2/neu) is related to growth factor receptors with alkaline kinase activity and it is regarded as important prognostic and therapeutic factor that can depended on in breast cancer therapy. HER2/neu expression by immunohistochemistry (IHC) is submitted to a great in terob server inconsistency. Subsequently additional confirmatory tests for assessment of gene alterations and amplification status are needed for patients with early or metastatic breast cancer. In situ hybridization techniques and specifically Chromogenic in situ hybridization (CISH) was arise as a practical, cost-effective, and alternative to fluorescent in situ hybridization in testing for gene alterationAims of the study
... Show MoreThe experiment was conducted to study the effect of leaves extract of Salvia sclarea , Rosmarinus officinalis and Thymus vulgaris with 10% and 30% concentration on germination of seeds and growth of seedlings . The effect of these extracts on infection percentage of seeds decay and surface growth of Rhizoctonia solani . The results showed that the three extracts effected significantly to reduced percentage of seeds germination, acceleration of germination , promoter indicator , infection percentage of seeds decay and surface growth of R. solani especially in 30% concentration .
In this work, the effect of ceramic coating on performance, exhaust gas temperature and gases emissions of diesel engine operated on diesel fuel and biodiesel blends was investigated. A conventional four stroke, direct injected, single cylinder, diesel engine was tested at constant speed and at different load conditions using diesel fuel and biodiesel blends. The inlet and exhaust valves, the head of piston and cylinder head of the engine were coated by ceramic materials. Ceramic layers were made of (210-240) μm of Al2O3 and (30-60) μm of 4NiCr5Al as a bond coat for inlet and exhaust valves and (350-400) μm of YSZ and (50-100) μm of 4NiCr5Al as a bond coat for head of piston and (280-320) μm of Sic and (40-80) μm of 4NiCr5Al as a b
... Show Morel development in addition to environmental reform, which is not possible at its best, and from this the faculties of physical education and sports science realize the scale of the problem and its importance in the development of society that this all puts on the faculties of education Physical and sports sciences are a very difficult task and an end in holiness, for it is the responsibility of the human development service and its leadership, because the community leaders and its elites are those who value their direction and future more than others. The importance of this study comes from the goal of sustainable development to maximizing pain. The net gain from higher education while ensuring the preservation of the quality of reso
... Show MoreSalmonella enteritidis one of more important as epidemiological bacteria between other salmonella types. It is very important pathologically that cause food poising and gastrointestinal tract infections. This study includes some of immunological changes that appear by ELISA test and antibiotic sensitivity test against these bacteria in mice. ELISA test results appears high immunological response happen after 3 days of inoculation, mean titration readings beginning 0.198 and the maximum mean titration after 15 days of inoculation 1.538 and begin to decrease after this time slowly to remain about 0.297 after 40 days of inoculation. An antibiotics sensitivity test result appears, this bacteria sensitive to Chloramphenicol, Ceftriaxone,
... Show MoreIn this research work, a simulator with time-domain visualizers and configurable parameters using a continuous time simulation approach with Matlab R2019a is presented for modeling and investigating the performance of optical fiber and free-space quantum channels as a part of a generic quantum key distribution system simulator. The modeled optical fiber quantum channel is characterized with a maximum allowable distance of 150 km with 0.2 dB/km at =1550nm. While, at =900nm and =830nm the attenuation values are 2 dB/km and 3 dB/km respectively. The modeled free space quantum channel is characterized at 0.1 dB/km at =860 nm with maximum allowable distance of 150 km also. The simulator was investigated in terms of the execution of the BB84 p
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