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.
Multiple myeloma is hematological disease produces many complications in the bone, kidney, neural and other complications. The study aims to measure serum biomolecules like fetuin-A and resistin and determined the possibility to use these biomarkers as disease predictor. blood samples were isolated from 58 patients and 24 sex and age-matched control, serum then isolated, and proper ELISA kit then used to a determined level of B2 microglobulin, resistin, and fetuin-A. The result demonstrated significant increase in B2 microglobulin, fetuin-A and resistin in patients compare to control (1.3470.714 vs. 0.9130.253), p = 0.000, (14.00310.352 vs. 9.2594.264), p= 0.005, (1.9673.595 vs. 0.6040.622), p = 0.009, respectively. &
... Show MoreRheumatoid arthritis (RA) is characterized by persistent joint inflammation, which is a defining feature of this chronic inflammatory condition. Considerable advancements have been made in the field of disease-modifying anti-rheumatic medicines (DMARDs), which effectively mitigate inflammation and forestall further joint deterioration. Anti-tumor necrosis factor-alpha (TNF-α) drugs, which are a class of biological DMARDs (bDMARDs), have been efficaciously employed in the treatment of RA in recent times Adalimumab, a TNF inhibitor, has demonstrated significant efficacy in reducing disease symptoms and halting disease progression in patients with RA. However, its use is associated with major side effects and high costs. In addition,
... Show MoreThe research aims to analysis of the current financial crisis in Iraq through knowing its causes and then propose some solutions that help in remedy the crisis and that on the level of expenditures and revenues, and has been relying on the Federal general budget law of the Republic of Iraq for the fiscal year 2016 to obtain the necessary data in respect of the current expenditures and revenues which necessary to achieve the objective of the research , and through the research results has been reached to a set of conclusions which the most important of them that causes of the current financial crisis in Iraq , mainly belonging to increased expenditures and especially the current ones and the lack of revenues , especially non-oil o
... Show MoreThis study is concerned with the effect of adding two kinds of ceramic materials on the mechanical properties of (Al-7%Si- 0.3%Mg) alloy, which are zirconia with particle size (20μm > P.S ≥ 0.1μm) and alumina with particle size (20μm > P.S ≥ 0.1μm) and adding them to the alloy with weight ratios (0.2, 0.4, 0.6, 0.8 and 1%). Stirring casting method has been used to make composite material by using vortex technique which is used to pull the particles to inside the melted metals and distributed them homogenously.
After that solution treatment was done to the samples at (520ºC) and artificial ageing at (170ºC) in different times, it has been noticed that the values of hardness is increased with the aging time of the o
... Show MorePurpose: To determine the effect of information technology governance (ITG) under the control objectives for information and related technologies (COBIT) on financial performance is the objective of this study. Additionally, the article seeks to look into the relationships between the factors under consideration. Theoretical framework: Information technology and operational processes are evaluated and ensure their compliance with the instructions of the Central Bank of Iraq. Therefore, the research dealt with a conceptual framework by reviewing the literature on the importance of the COBIT framework in assessing financial performance. Design/methodology/approach: To investigate the effect of information technology; we the valu
... Show MoreThe most important topic for psychologist generally is factor of education and it's active tools because learning needs active perception for stimulus that recived by the educator and give it avalue and meaning , Need for cognition is
very important in the various daily fields of life , especially in learning and teaching and the academy work , it help with shifting the learning level for people , and icreas the intense and challenge between them
The research endeavored to achieve the following aim :
1- Measuring the level of peripheral perception for the university student .
2- Measuring the level of need for cognition for the university student .
3- Measuring the level of peripheral perception for the university student
The aim of the research is to study the comparison between (ARIMA) Auto Regressive Integrated Moving Average and(ANNs) Artificial Neural Networks models and to select the best one for prediction the monthly relative humidity values depending upon the standard errors between estimated and observe values . It has been noted that both can be used for estimation and the best on among is (ANNs) as the values (MAE,RMSE, R2) is )0.036816,0.0466,0.91) respectively for the best formula for model (ARIMA) (6,0,2)(6,0,1) whereas the values of estimates relative to model (ANNs) for the best formula (5,5,1) is (0.0109, 0.0139 ,0.991) respectively. so that model (ANNs) is superior than (ARIMA) in a such evaluation.