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 study seeks to use one of the techniques (Data mining) a (Logic regression) on the inherited risk through the use of style financial ratios technical analysis and then apply for financial fraud indicators,Since higher scandals exposed companies and the failure of the audit process has shocked the community and affected the integrity of the auditor and the reason is financial fraud practiced by the companies and not to the discovery of the fraud by the auditor, and this fraud involves intentional act aimed to achieve personal and harm the interests of to others, and doing (administration, staff) we can say that all frauds carried out through the presence of the motives and factors that help th
... Show MoreAbstract
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 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
Background: Mitral regurgitation (MR) is the most commonly encountered valve lesion in modern clinical practice. Severe mitral regurgitation may cause systolic dysfunction. Left ventricular ejection fraction may not be an accurate measurement of LV function in patients with mitral insufficiency. Myocardial performance index (MPI) is a simple non invasive measure of myocardial function. Methods: The study involved 50 patients with valvular mitral regurgitation and 50 healthy subjects as a control group. Transthoracic echocardiography was carried out for all patients and control group. The echocardiographic measurements included left ventricular end diastolic and end systolic dimensions, left atrial diameter, ejection fraction (EF), and myoca
... Show MoreBackground: The menopause is physiological changes in women that give rise to adaptive changes at both systemic and oral level. During menopause, ovarian function declines and the production of sex steroid hormones reduces significantly affecting the oral tissues and periodontal structures leading to chronic inflammation of the gingiva, increased risk of tooth loss. Aim of study: The present study was designed to estimate the oral hygiene status in relation to salivary estradiol level among pre and post-menopausal women. Materials and Methods: Ninety women aged 48-52 years old, the control group consisted of 45 pre-menopausal women and the study group consisted of 45 post-menopause were examined for gingival index, plaque index and calcu
... Show MoreDocumentary 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 MoreToday many people suffering from health problems like dysfunction in lungs and cardiac. These problems often require surveillance and follow up to save a patient's health, besides control diseases before progression. For that, this work has been proposed to design and developed a remote patient surveillance system, which deals with 4 medical signs (temperature, SPO2, heart rate, and Electrocardiogram ECG. An adaptive filter has been used to remove any noise from the signal, also, a simple and fast search algorithm has been designed to find the features of ECG signal such as Q,R,S, and T waves. The system performs analysis for medical signs that are used to detected abnormal values. Besides, it sends data to the Base-Stati
... 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 MoreThis research aims to numerous risks to the portfolio of the insurance company that arise from practicing the activity in general, and the risks arising from insurance contracts in particular, and what is the role of the company in the disclosure to help users (such as owners) to understand and concentration of risks in the financial reporting and identifying movable risks size to reinsurers that may affect the solvency of the portfolio and makes them at a given moment required to fulfill the obligations towards policyholders outweigh the financial capacity, which leads to stumble or bankruptcy.
So I sought this research is to identify the extent of the obligation to disclose the accounting for this risk and the extent of their i
... Show More