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.
The interest in the issue of capital movement as an economic phenomenon has increased because of its effects and effects and its ability to influence the economic balance and the effectiveness of monetary policy. All countries seek to attract capital and benefit from it because of its effects and results such as supporting economic development process and optimal allocation of economic resources. The problem of the financing gap that most countries suffer from, and others, but sometimes the movement of capital creates challenges for monetary policy makers in achieving their goals.
After 2003, the Iraqi economy witnessed an openness and economic liberalization unlike previous years, which
... Show MoreThe aqueous extract of banana fruits peal was tested for its effect on mitosis . The root tips of Allium cepa were used as plant test system and the bone marrow cells of the albino mice Mus musculus were used as mammalians test system in vivo .Root tips of Allium cepa were treated for four hours with five concentrations of the extract (5 , 10 , 20 , 40 ,60 mg / ml.).The Metaphase was arrested in all the treatments , the highest percentage ( 100 % ) was recorded in the first concentration , the last concentration caused stickiness and clumping of the chromosomes. The treatments did not cause significant difference in the mitotic index. The peals extract (5 mg /ml) was compared with the extracts of fruits bulb, leaves and roots of
... Show MoreThe objective of this study is to apply Artificial Neural Network for heat transfer analysis of shell-and-tube heat exchangers widely used in power plants and refineries. Practical data was obtained by using industrial heat exchanger operating in power generation department of Dura refinery. The commonly used Back Propagation (BP) algorithm was used to train and test networks by divided the data to three samples (training, validation and testing data) to give more approach data with actual case. Inputs of the neural network include inlet water temperature, inlet air temperature and mass flow rate of air. Two outputs (exit water temperature to cooling tower and exit air temperature to second stage of air compressor) were taken in ANN.
... Show MoreThe aqueous extract of banana fruits peal was tested for its effect on mitosis . The root tips of Allium cepa were used as plant test system and the bone marrow cells of the albino mice Mus musculus were used as mammalians test system in vivo .Root tips of Allium cepa were treated for four hours with five concentrations of the extract (5 , 10 , 20 , 40 ,60 mg / ml.).The Metaphase was arrested in all the treatments , the highest percentage ( 100 % ) was recorded in the first concentration , the last concentration caused stickiness and clumping of the chromosomes. The treatments did not cause significant difference in the mitotic index. The peals extract (5 mg /ml) was compared with the extracts of fruits bulb, leaves and r
... Show MoreMRSA is one of the major pathogens in hospitals and the community, which have the ability to produce biofilm as a virulence factor, the impact of chalcone on biofilm formation, the synergism effect of chalcone and antibiotic in both in vitro and in vivo experiments, the gene expression of virulence genes (srtA, fnbA, fnbB) before and after treatment of it on MRSA biofilm cells in vitro, all these were the prime aims of this study. Chalcone at MBIC (20 μg/ml), significantly reduced the biofilm formation to 21.45% and at sub MBIC (15 μg/ml) to 36.58 %. While, Chalcone at MIC(5 μg/ml) reduced MRSA planktonic cells to 49.61%. Susceptibility of MRSA isolates against eight antibiotics showed that all isolates were sensitive to vancomycin and n
... Show MoreThe research dealt with the study of choice between a range of different words between the repetitive texts in the verses of the Koran and explain the reason behind this choice, and how the context has the greatest impact in this choice, and that each word in the Koran was placed in the most appropriate place, which can not be replaced by equivalent words, whatever The degree of similarity between them in the indication of the other because it remains at the end that each of those vocabulary synonyms are indicative, the first of them especially that makes the possibility of replacing them with the equivalent vocabulary impossible, and the second general significance and this connotation makes them share with their peers In one aspect of
... Show MoreThe objective of this research is to measure the training programs and identify the nature and then measure how it reflected on the quality of municipal services provided by the municipal departments investigated by measuring the quality of services based on quality standards, the researcher chose four municipal departments in the Rusafa / Baghdad (164 people) representing the directors and their assistants, officials of the municipal departments, the people and the engineering staff in charge of the task forces as well, including the survey of the views of the concerned persons in the management of the Vocational Training Institute in the Secretariat of the Republic, The quality of the municipal services
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