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.
Background: Ankylosing spondylitis (AS) is inflammation of the sacroiliac joints and spine, associated with clinical symptoms such as pain and stiffness in the vertebral column, after which, in a considerable number of individuals, new bone growth occurs. Objective: The current research study attempted to find out whether the presence of SNPs in TNF receptor [TNFRSF1A (rs767455), TNFRSF1B (rs1061622)] encoding genes could influence patients' outcomes to etanercept in a specimen of Iraqi AS patients. Patients and methods: Sixty patients with established AS receiving only etanercept were selected to be enrolled in this research with a mean age of 40.75 ± 8.67 years, 51 patients of them were males and only 9 patients were females. Patients we
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This research aims to study human error effects in the banking risks in the private banks through the measurement and testing of human error effect in every kind of banking risks types and stand on the most closely associated with the risks in order to focus on them and make appropriate processors have with respect to and increase the availability of skills and expertise required to carry out banking operations of error-free manner.
Find dealt with human error in terms of meaning and understandable, classifications and types, causes and consequences and its approaches and theories. Also addressed placed banking risks in terms of meaning and concept, species and entr
... Show MoreBackground: This in vitro study compares a self-etch primer (SEP) to an etch-and-rinse (EaR) for bonding sapphire brackets by evaluation of the enamel etch-pattern, shear bond strength, amount of remnant adhesive and enamel surface damage following thermal and fatigue cyclic loading. Material and Methods: Ceramic (sapphire) brackets were bonded to 80 extracted human premolars using two enamel etching protocols: conventional EaR using 37% phosphoric acid (PA) gel (control), and a SEP (Transbond Plus). Each group was subdivided into two subgroups (n=20 teeth) according to the time of bracket debonding: after 24 h water storage or following 5000 thermo-cycles plus 5000 cycles fatigue loading, to determine the shear bond strength (SBS), adhesiv
... Show MoreBackground: Menopause can bring oral health problems and also associated with significant adverse changes in the orofacial complex. After menopause, women become more susceptible to periodontal disease due to deficiency of estrogen hormone. Current study aimed to evaluate the periodontal health status in relation to salivary constituent including pH, flow rate and some elements (Magnesium, Calcium and inorganic phosphorus) of pre and post-menopause women. Materials and Methods: Periodontal health status of 52 women aged 48-50 years old (26 pre-menopause and 26 post-menopause) were examined including (gingival index, plaque index, calculus index, probing pocket depth and clinical attachment level). Salivary sample was collected for two women
... Show MoreThe success of the company's strategy depends to a large extent on the success of its functional areas, the marketing Mix makes the company more able to monitor the external environment and the rapid changes related to competitors and customers, as well as the innovation contributes to meet the needs of customers and the requirements of competition and try to find solutions to various problems in Innovation ways, and thus integrated marketing and Innovation efforts in the company towards the design of competitive services to meet the requirements of customers and competition. The research aims to determine how marketing Mix and innovation to design unique and distinct services compared to the competitors, through exporator a sample of en
... Show MoreIntervention in International Relations from the concepts that are still highly
controversial among those he considers a breach of international law and the UN Charter and
in violation of the rule , and those who felt that the need provided, however, that this is linked
motives humanity recognized by the international community , because the international
variables proved the inadequacy of the principle of non-interference and the principle of
sovereignty as the traditional variables international , and therefore most of the international
practice came a bus with many of the behaviors that reflect a decline in its entirety to these
principles , and became adapt these principles with international reality is too compl
This research explores the intricate relationship between environmental sustainability and urban design in Al-Jumhuriya Neighborhood, Baghdad, reflecting urban development challenges and opportunities. It highlights the need to balance growth, functionality, and quality of life with environmental responsibility in urban areas worldwide. The research includes a literature review on environmental sustainability in urban design and the utilization of multifunctional land in contemporary cities. The research employs a mixed-methods approach, combining quantitative and qualitative data collection methods. Survey results show a diverse range of perspectives, indicating concerns about air quality and local regulations but also positive views on co
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