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.
خلاصة (استطاعت اليابان بعد الحرب العالمية الثانية ان تنهض من جديد، وان تحقق تجربة تحديث سياسي جعلها تشهد تبدلات جذرية من الفقر الى الغنى ومن سيطرة الحكم العسكري الى الدولة المنزوعة السلاح ومن التخلف الى التكنولوجيا الاكثر تطورا في العالم, ومن الانغلاق والعزلة وذهنية سكان الجزر الى الانفتاح على ثقافات عصر العولمة ووسائل اعلامها. فكيف يمكن الاستفادة من هذه التجربة الحديثة سياسيا بل وحتى اقت
... Show MoreDiabetes mellitus type 2 [DMT2] is a disturbance of metabolism and complex diseases influenced by environmental, genetic agents, and linked with inflammation, happens when the pancreas either does not use the insulin as it should or the body does not make enough insulin, lead to insulin resistance [IR] alongside with gradual loss of ß-cell secretory ability. The aim of this study was to investigate the role of soluble L-selectin (sL-selectin) in diabetes mellitus type 2 patients in Iraqi Arabs patient. Study includes seventy six Iraqi Arabs patients (male and female) having newly diagnosed type 2 diabetes mellitus (T2DM), with Fifty three Iraqi Arabs healthy subjects matched in age, sex and ethnic group. Patients and healthy subjec
... Show MoreAbstract:
The research aims to diagnose the relationship between the environmental tax and the development of the sustainable social dimension, where the environmental tax is considered a tool in promoting sustainable development according to its economic, social and environmental dimensions through the application of legislation and instructions for environmental protection, and that imposing an environmental tax will have a clear impact in achieving the dimensions of sustainable development and compliance With regard to the social dimension, the research relied on the financial data for the years (2019-2022) in obtaining information. The research reached a set of results, the most prominent of which was
... Show MoreThe research sheds light on an important religious sect that played a fundamental role in the structure of the Iraqi society in general and the Baghdadi society in particular, in which the Jews in general and the Jewish women in particular played an active role in the culture and heritage of Baghdadi society. The educational, cultural and artistic activity of Jewish literacy is a model for study.
One of the management accounting tools is responsible accounting. In this system, the organisation is divided into responsibility centres that help to connect an individual performance responsible to perform through a combined system of reports according to the implementation of the mechanism of exception tools which gives assistance in planning. The exploitation of the organisation's available resources is achieved through the application of responsible accounting. Also, the best exploitation will lead to the provision of low-cost products through the disposal of all types of waste or loss during the cost centres. By providing products at a lower cost and satisfying the wishes of the needs of customers, the result reflects the competitive
... Show MoreKhadija Al-Hadithi was known for her love of the Arabic language. She was a distinguished and serious phenomenon in Arabic science and culture. She was born in Basra Governorate, one of the ancient and important cities in the history of Arabic grammar and one of the centers of the intellectual and scientific movement. The Basra Grammar School emerged there and made numerous achievements in the field of Arabic linguistics that remain an important source for students of the specialty.
In this paper to isolate and study the properties of the cyclooxygenase-2 (EC: 1.14.99.1) enzyme in the blood of a patient suffering from rheumatoid arthritis and study the effect of natural products of the Soapwort on the activity of purified enzyme. The study involves taking 30 ml of blood from an adult woman 40 years old, who suffers from rheumatoid arthritis disease for 13 years. Serum is separated and subjected to a series of purification processes including: precipitation by ammonium sulfate, filtration by centrifugation radiator, dialysis in presence of ammonium bicarbonate, separation using the technology of ion exchange, lipholization and then estimating approximate molecular weight of the enzyme using gel filtration techni
... Show MoreCholesteryl ester transfer protein gene contains some single nucleotide polymorphisms, which have been associated with serum high-density lipoprotein concentration and other lipoproteins. This study is done for determining of cholesteryl ester transfer protein polymorphism and evaluate its effect on serum lipid profile concentrations in some hyperlipidemic patients compared with healthy subjects in Salah Al-din governorate-Iraq. Blood samples were taken from (90) patients suffering from hyperlipidemia, and (70) samples that were apparently healthy controls. Serum lipid concentrations were measured by enzymatic assays. The polymorphism was genotyped using polymerase chain reaction restriction fragment length polymorphism analysis.&n
... Show MoreTransient drop in the heart beat or transient heart block (AVB) may be consider the main cause of syncope or presyncope inpatients with bifascicular block and syncope According to the Guidelines for cardiac pacing pacemaker consider part of treatment. Aims of our study were to evaluate whether there is role for EPS in patients BFB and to evaluate the symptoms after pacing. 42 patients were enrolled in this study, with mean age value (63.4± 12.2years), suffer from interventricular conductive defect and syncope; patients underwent EPS on admission time, and pacemaker implantation accordingly and programmed follow up for the device in the last four years. Our patients were 25 (59.5%) male and 17 (40.5%)female, all of them with syncope o
... Show More« The emergence of satellite channels has led to fundamental changes in the supposed role of television, making it a center of culture and an important tributary to social upbringing and influencing the attitudes and values of individuals and in making public opinion regarding various issues, some television programs target ordinary people at home by virtue of the nature of their subjects, where there is a large audience of viewers, who consume and absorb what is offered to them from the cultural production of those satellite channels that play with the aspirations of groups of society to find metaphysical or magic solutions to their social problems or psychological delusions. The media, through its various messages, contributes to brin
... Show More