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.
Abstract
The decision maker needs to understand the strategic environment to be addressed through different means and methods. It is obvious that there is a difference between the three strategic environments (conflict environment, peace environment, post- peace environment) in terms of inputs and strategies to deal with each one of them. There is an urgent need to understand each pattern separately, analyze its inputs, and identify the factors and variables that affect the continuity of this situation (conflict, peace, post-peace). It is not appropriate to identify treatment without diagnosis of the condition, so it is very important to understand the type of strategic environment to be dealt with it.
... Show MoreThis paper deals with one of the most important issues in a foreign language teaching and learning, i.e. speaking test assessment. After giving a survey of literature written on the meaning and definition of a speaking test assessment, two sections have been devoted to tackle the most important issues in this topic. Section one, which is the theoretical part of this paper, sheds light on the basic definitions of the term ‘speaking assessment’ which are, according to the researcher’s point of view, sufficient to cover the area of the study. This section based on applied linguistic theories and researches in order to enhance our understanding of the what is meant by «a speaking test assessment«In addition,it explains the most importan
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Objective : the aim of the study is to evaluate the effectiveness of nurse’s practices and knowledge program toward care of patient with cardiopulmonary bypass .Methodology: A pre-experimental design (one group pretest- posttest design) was used to carry out this study in three governmental hospitals in Baghdad ( Iraqi Centre for Heart Diseases , Ibn – Albitar Centre for Cardiac Surgery and Ibn – Alnafees Centre for Cardiothoracic and Vascular Surgery ) for the period from 15th of May 2022 into 20th of April 2023.The construction and development of the program and instruments had carry out by the researcher to measured the purposes of the study , twenty two nurses was purposively assigned for the study group . The
... Show MoreDiabetic mellitus is one of the main risk factors of fungal infections because poor glycemic control is associated with a high level of glucose in blood and saliva which could be treated as nutrient to fungi. This study aimed to isolate and identification of pathogenic fungi from diabetic patient. 140 samples were taken from different places of human body from the national center of diabetic patients that related to Mustansiriyah University / college of medicine and Al-yarmuk Hospital in Baghdad. 84 sample (60%) tested positive to fungi and 56 sample (40%) tested negative to fungi. The most frequented fungi isolated have been chosen for molecular identification by PCR (Millerozyma farinosa and Candida orthopsilosis) using specific pri
... Show MoreBackground: Accurate measurement of a patient’s height and weight is an essential part of diagnosis and therapy, but there is some controversy as to how to calculate the height and weight of patients with disabilities. Objective: This study aims to use anthropometric measurements (arm span, length of leg, chest circumference, and waist circumference) to find a model (alternatives) that can allow the calculation of the height and the body weight of patients with disabilities. Additionally, a model for the prediction of weight and height measurements of patients with disabilities was established. Method: Four hander patients aged 20-80 years were enrolled in this study and divided into two groups, 210 (52.5%) male and 190 (47.5%) fe
... Show MoreObjectives: The aim of the study was, to assess the nurse's role regarding cardiovascular drug
administration in Erbil city.
Methodology: A descriptive survey was conducted in Hawler teaching and Rizgari teaching Hospitals. The
number of samples is 50 nurses; the period of the study was started from 15th of November 2008 up to
the end of March 2009. A questionnaire was developed by investigators based on extensive review of
available studies and literatures. Data were collected through application of observational check list
consist of two part, part one was demographic sheet and part two about nurse’s responsibility regarding
medication administration which include (before, during, after drug administration). Data
Objectives To tailor composites of polyethylene–hydroxyapatite to function as a new intracanal post for the restoration of endodontically treated teeth (ETT). Methods Silanated hydroxyapatite (HA) and zirconium dioxide (ZrO2) filled low-density polyethylene (LDPE) composites were fabricated by a melt extrusion process and characterised using infrared spectroscopy (FTIR), differential scanning calorimetry (DSC) and dynamic mechanical analysis (DMA). The flexural strength and modulus were determined in dry state and post ageing in simulated body fluid and fractured surfaces analysed by SEM. The water uptake and radiographic appearance of the experimental composites were also measured and compared with a commercially known endodontic fibre
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The open budget means everyone in the society can get information about the government budget in order to watch the governmental works. The aim of the research is to study the concepts of open budget, its advantage, limitations, role of supporting the transparency and questioning the administrative and financial corruption. Thus reflects positively on the national economy by providing governmental information to all users whether they are individuals or belong to the political class, or any other governmental or nongovernmental organizations which are interested in these information.
In order to achieve the objectives of the research aims, we make questionnaire to see aca
... Show MoreChronic lymphocytic leukaemia (CLL) patients display a highly variable clinical course, with progressive acquisition of drug resistance. We sought to identify aberrant epigenetic traits that are enriched following exposure to treatment that could impact patient response to therapy.
Epigenome-wide analysis of DNA methylation was performed for 20 patients at two timepoints during treatment. The prognostic significance of differentially methylated regions (DMRs) was assessed in independent cohorts of 139 and 1
Transportability refers to the ease with which people, goods, or services may be transferred. When transportability is high, distance becomes less of a limitation for activities. Transportation networks are frequently represented by a set of locations and a set of links that indicate the connections between those places which is usually called network topology. Hence, each transmission network has a unique topology that distinguishes its structure. The most essential components of such a framework are the network architecture and the connection level. This research aims to demonstrate the efficiency of the road network in the Al-Karrada area which is located in the Baghdad city. The analysis based on a quantitative evaluation using graph th
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