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.
Documentary Credit passes through many practical phases starting from Opening credit and matching documents and payment of the amount of credit……etc. It is worthy to mention that there are several aspects that are varied and differed from Bank to another one which can offer Competitive Advantage for the bank …This will be shown in this research.
For the purpose of achieving the objective of this research within the theoretical aspect, the researcher had seen and briefed several books and researches which are mainly related to the subject of the research.
As for the practical aspect, has included Questionnaire which included many questions that are fit and suitable to the hypotheses.
Research sample has
... Show MoreThe performance and durability of the asphalt pavement structure mainly depend on the strength of the bonding between the layers. Such a bond is achieved through the use of an adhesive material (tack coat) to bond the asphalt layers. The main objective of this study is to evaluate the effect of moisture in conjunction with repeated traffic loads on the strength of the bonding between asphalt layers using two types of tack coats with different application rates. Using the nominal maximum size of aggregate (NMAS), the layers were graded (25/19) and (19/9.5) mm. The slabs of multilayer asphalt concrete were prepared using a roller compactor using two types of tack coats to bond between layers, namely rapid curing cut back a
... Show MoreObjectives: the aim of the study to assess the most common risk factors of pneumonia at adult and find the
socio-demographic characteristics of sample.
Methodology: the study performed at Ibn-Sina teaching hospital (intensive care unit) and out patient in the same
hospital period of (15 ) November (2006) till (1ا٤) February (2007).The sample of the study includes (65)
patients with pneumonia for different underlying causes who were attending Ibn-Sina teaching hospital age
range (59-68) years is the highest level and is the most common risk factor for pneumonia.
Results: the results of the study most patients' hospital acquired-pneumonia from contamination during
administration to hospital but community acquired-pne
Abstract
This research aims to assess and measure the quality of health services provided by the Baghdad Educational Hospital using five dimensions of 5Qs , Developer model by (Zinelidin), 2006), the problem of the research is to try to determine the quality of health services provided at the hospital as well as the investigation of the existence of the elements of quality contribute to achieve the requirements of customers and their needs, and used for the purposes of this research two approaches, first used Applied Research to 5Qs dimension model and use the Checklist as a Key tool to collection and analysis of data and the second descriptive analytical me
... Show MoreThe tourism activity is one of the pillars on which the economy of any country is based , the importance of the tourism sector is reflected in its potential to become an effective development alternative in many countries, especially Iraq ,this has a direct impact on the national economy as an important source in attracting hard currency and eliminating unemployment. Adding the Iraqi Marshlands to the list of effects makes it contribute to diversification of sources of income and stimulating rest of the economic sectors, the potentials and qualifications possessed by Iraq in the field of tourism and monuments have a significant impact on the state budget if they were exploited optimally. The research aims at identifying the contr
... Show MoreBackground: human paillomavirus infections (genital warts) are the most frequent sexually transmitted viral infections. a wide range of treatment options is available with different efficacy.
Objective: To evaluate the efficacy of podophyllin, trichloracetic acid (TCA) in the treatment of genital warts and side effects of them.
Subjects and methods: a total of sixty patients with genital warts were randomly selected, 30 in each group, in the Department of Dermatology, medical city for a Duration of 11 months from January 2009 to December 2009 treated with 35 % podophyllin in the tincture of benzoin or 50% TCA) .Forty-eight patients were followed up for three months.
Results: wart
... Show MoreGender mainstreaming is a goal for building a society characterized by justice and equality. Gender mainstreaming requires a clear understanding of the concept. Therefore, the research focuses on the concept of gender and how it was addressed in the literature through which the concepts related to gender were extracted which is represented by the role and social status through which the relationship of gender can be measured. In order to find out the basis for the different status and roles of both sexes in societies, the interpreted theories of gender were addressed, through which the most important factors affecting gender relations, such as biological, social and economic factors, as well as political systems, were discussed. Due to t
... Show MoreThe decorative supplements added are important factors in determining many decorative effects and how to implement them, whether in fabrics or fashion, and also work to determine the nature of perception for both the designer and the recipient and have a key role in shaping the human personality and determining his motives and emotional tendencies in the acquisition of fabrics and fashion and the vocabulary they carry A design that has certain connotations and symbols that gain its value from the effects it leaves on the physical formations of women. The problem of the research came with the following question (What are the decorative supplements and their role in the designs of fabrics and women’s fashion?) The research also dealt wit
... Show MoreThe study of the concepts of "democracy" and "human rights" and their impact on development, has taken a prominent place in the context of general political and cultural concerns, or in specialized studies even though researchers and scholars do not agree on defining the concepts: Democracy, Human Rights, Development or deriving a global definition hindering them, and that because of the importance of this topic, which proceeds from a number of considerations standing in the forefront, of which:
First: What the world witnesses today in the first decade of this century of consecration of the unipolar theory, trying to give its concepts and perceptions through the law ((excessive force)) to the power of international
... Show MoreAbstract\
Dealing economic units at the present time with an industrial environment characterized by competitiveness and the pace of change and its strength as a result of this changing environment shall be on those who made it to adopt strategies that allow them to confront these variables and work in order to meet the market requirements of quality and price appropriate products to suit and the demand for those products and conditions to maintain
its competitive position and its development.
As a result, it became the subject of competitiveness in recent years and enjoys widespread attention at the global level. And in order to keep up
... Show More