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.
This article discusses how women have significant abilities to cope with the difficulties of war times. They are not the weak and vulnerable victims who are thought to be. On the contrary, they have the power to control over many-sided fronts, like participating in the battlefield as nurses or activists for peace, or even fighters, as well as through the tasks and responsibilities assigned to them to protect and support their families during wartime. The researcher will examine the impact of war upon women. Like men, women suffer during wartime. They are being injured, tortured and killed. Yet, they are able to give examples of love and courage even in the difficult times of war. Hana is one of those women who lived during wartimes,
... Show MoreThis study was performd on 50 serum specimens of patients with type 2 diabetes, in addition, 50 normal specimens were investigated as control group. The activity rate of LAP in patients (560.46 10.504) I.U/L and activity rate of LAP in healthy(10.58 4.39)I.U/L.The results of the study reveal that Leucine aminopeptidase (LAP) activity of type 2 diabetes patient s serum shows a high signifiacant increase (p < 0.001) compare to healthy subjects. Addition preparation leucine amide as substrate of LAP, identification melting point and spectra by FTIR. K
The study aims to identify the symptoms of PTSD among displaced Yazidi women according to age, marital status, educational level, and type of status (displaced or survivor). The study also seeks to identify the effect of the relaxation program on reducing PTSD among displaced Yazidi women. The research sample included (60) Yazidis for the statistical analysis sample and (5) for the experimental sample in the Dohuk governorate. For achieving the research objectives, a scale was used from the PTSD Checklist for DSM-5 (PCL-5), as well as a relaxation program was prepared. The researchers reached the following results that there is an average level of PTSD symptoms among displaced Yazidi women, there are no statistically significant differen
... Show MoreThis research is carried out to study the effect of the external post-tensioning technique on the flexural capacity of simply supported composite castellated beam experimentally. In this research, seven composite castellated beams having the same dimensions and material properties were cast and tested up to failure by applied two concentrated loads at 700 mm from each end. Two external strands of 12.7 mm diameter were fixed at each side of the web of strengthening beams and located at depth 180 mm from top fiber of the section (dps) at each end of the beam. The strands have been tensioned by using a hydraulic jack with a constant stress of 100 MPa. This research aims to study the effect of the strengthening by different shapes of st
... Show MoreObjectives: The study aims to assess the nurses knowledge toward prevention of complications related to valvular replacement surgery and to find out the relationship between nurses knowledge and their demographic and occupational characteristic's Which as (Age, gender, level of education ,years of experience in Surgical Department , and training sessions)
Methodology: A descriptive design (a cross-sectional study ) was carried out from December 2017 to May 2018 in order to assess nurses' knowledge of preventing complications Valvular Replacement Surgery at Surgical Department in Nasiriyah Heart Center on a purposive (non-probability) sample
... Show MoreBackground: Atherosclerosis is well known related to age and certain cardiovascular diseases. Aging is one reason of arteries function deterioration which can cause loss of compliance and plaque accumulation, this effect increases by the presence of certain diseases such as hypertension and diabetes disease. Aim: To investigate the reduction of blood supply to the brain in patients with diabetes and hypertension with age and the role of resistive index in the diagnosis of reduced blood flow. Method: Patients with both diseases diabetic and hypertension were classified according to their age to identify the progression of the disease and factors influencing the carotid artery blood flow. By using ultrasound and standard Doppler techniq
... Show MoreThe research is based on a statement of the effect and nature of the relationship of elements of promotional mix represented by (advertising, personal selling, sales promotion, public relations and direct marketing) as the independent variable in the dependent variable represented in the competitive advantage in the General Company for the manufacture of medicines and medical supplies Samarra. Analytical descriptive in the theoretical side, through the use of a number of literature from scientific sources (books, research and studies published in Arab and foreign magazines) was also relied on the methodology of the case study in the practical side, Data collection using the questionnaire tool, which was designed using the triangular Like
... Show MoreThis day, we see the Significant role that social media platforms play, it plays a vital role in shaping the Social, political, and economic awareness of individuals. The Iraqi Society, which is experiencing rapid cultural and social transformations, is considered a fertile ground for social media and its influences, whether negative or positive. Research and studies indicate that the negative use of social media will lead to weaking of the sense of belonging and citizenship among members of Iraqi society. This, in turn, threatens moral and educational values, increases feelings of family estrangement, and leads to social isolation. On the contrary, if social is used correctly, it can significantly contribute to enhancing educational values
... Show More
