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.
An essential tool for studying the web is its ability to show how energy moves through an ecosystem. Understanding and elucidating the relationship between species variety and their placement within the inclusive trophic dynamics is also beneficial. A food web ecological model with prey and two rival predators under fear and wind flow conditions is developed in this article. The boundedness and positivity of the system’s solution are established mathematically. The stability and existence constraints of the system’s equilibria are examined. The proposed system’s persistence limitations are established. Additionally, the bifurcation analysis of every potential equilibrium is examined using the Sotomayor theorem. To describe the
... Show MoreThe research has tackled about an important transformation within the whole region of middle east, especially there were more challenges which revealed under the huge pivotal interests of global powers that ruled the new world order by United states of America ; being very affected over the international and regional relations than any situations appeared previously within political realities. So that, many of variables inside the international scene which happened during of this period of contradicting strategic policies by the process of reforming and restructuring of difficult equations that imposed by international and regional allies and blocs . This article had concentrated over various strategic and political studies which reflect
... Show MoreThe issue of the research lies in the non-representation of the models developed for the communication process in the interaction and networking processes through social media, as the research sought to build a network model of communication according to the specific data and features of social media platforms in order to reach a special generalization to understand how the process of networking operates in cyberspace.
The researcher followed the analytical survey approach as she described the communication models outwardly in order to be able to build a networked communication model that represents the flow of post-reactive communication. Therefore, it has been named "Nebula - Sadeem" after the concept of post-space and cosmic g
... Show MoreThis study explores the role of nanomaterials in the performance of asphalt binders and mixtures. Two commonly available nanomaterials, i.e., nanosilica (NS) and nanoalumina (NA), were used at contents of 0%, 2%, 4%, 6%, and 8% by weight of asphalt binder. A set of experiments was carried out at the binder level to investigate properties such as penetration, softening point, aging-related mass loss, nanomaterial dispersion (storage stability), and workability (rotational viscosity). In addition, the suitability of NS and NS was also assessed through the testing of nanomodified asphalt mixtures, which focused on Marshall properties, the resilient modulus, moisture susceptibility, permanent deformation, and fatigue resistance. The findings in
... Show MoreField experiment was conducted by using two fertilization systems (i.e.) biofertilizers (inoculation with Pseudomonas putida and with Azotobacter chroococcum and non - inoculation) and chemical fertilization (100%, 50% and 25% of recommended by Ministry of Agriculture) to study the influence of these system and interaction on water and grain yield productivity, some growth phytohorones and number of bacterial cells in soil rizosphere of root of wheat crop under water scarcity. The result showed that the integrate fertilization (inoculation with Pseudomonas putida and Azotobacter chroococcum bacterial + 50% of the recommended chemical fertilizer) recorded 5.70 and 5.55 t ha-1, respectively with reducing the chemical fertilizer app
... Show MoreABSTRACT The importance and objectives of the study were an attempt to understand the methodology of disseminating radical thought and the reasons of social acceptability that make young people embrace this thought. It also sheds light on the impact of this phenomenon on the regional role of Egypt and examines the strategic means and standards that the Egyptian state focuses on in immunization and prevention of extremism.
The 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 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 MoreBackground :Alkaline phosphatase (ALP) was a widely used marker for skeletal and hepatobiliary disorders, but its activity was also increased in atherosclerosis and peripheral vascular disease. Several study has showed that ALP activity was increased in the sera of diabetic patients. The current study was conducted to evaluate ALP activity in type 2 diabetic patients and optimum conditions for enzyme activity in their sera.Methods: This study was carried out at in AL-Yarmok hospital(diabetic center) between February /2009 and April /2009. Fifty two patients with type 2 diabetes have been enrolled. Besides BMI, WHR, serum fasting blood glucose, ALP, HbA1C,uric acid and lipid profile levels have been performed .The relationship bet
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