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 success of an organization is significantly influenced by strategic performance, a focal point in recent scholarly investigations and regulatory considerations. This study delves into the examination of the impact of strategy formulation, implementation, and evaluation on the strategic performance within the context of the oil industry in Iraq. Additionally, the research explores the moderating influence of leadership style on the relationship between strategy formulation, implementation, evaluation, and strategic performance in the Iraqi oil industry. Data collection involved the utilization of survey questionnaires distributed to selected employees of Iraqi oil companies. Statistical analysis, specifically SPSS-AMOS, was employed to s
... Show MoreThe studies on unbonded post-tensioned concrete members strengthened with Carbon Fiber Reinforced Polymers (CFRPs) are limited and the effect of strengthening on the strain of unbonded pre-stressed steel is not well characterized. Estimating the flexural capacity of unbound post-tensioned members using the design methodology specified in the design guidelines for FRP strengthening techniques of bonded post-tensioned members does not provide a reliable evaluation. This study investigates the behavior of unbonded post-tensioned concrete members with partial strand damage (14.3% and 28.6% damage) and strengthened with CFRP laminates using a near-surface mounted technique with and without U-wrap anchorages. The experimental results show
... Show MoreBackground: Hypertension is a major global health concern that increases the risk of cardiovascular disease. Understanding the impact of age and treatment types on blood pressure control is essential for optimizing therapeutic strategies. Aim: This study aims to assess how different treatment types and patient age influence blood pressure control in hypertensive patients. Methodology: A binary logistic regression model was employed to analyze data from 48 patients diagnosed with hypertension. The study investigated the impact of two treatment regimens and patient age on the likelihood of achieving optimal blood pressure levels. The statistical significance of the findings was evaluated using chi-square tests and p-values. Results: T
... Show MoreBackground: Breast cancer is the most common cancer in Iraq and the United Kingdom. While the disease is frequently diagnosed among middleaged Iraqi women at advanced stages accounting for the second cause of cancer-related deaths, breast cancer often affects elderly British women yielding the highest survival of all registered malignancies in the UK. Objective: To compare the clinical and pathological profiles of breast cancer among Iraqi and British women; correlating age at diagnosis with the tumor characteristics, receptor-defined biomarkers and phenotype patterns. Methods: This comparative retrospective study included the clinical and pathological characteristics of (1,940) consecutive female patients who were diagnosed with invasive b
... Show MoreBackground: Leukemia is a broad term given to a group of malignant diseases characterized by diffuse replacement of bone marrow with proliferating leukocyte precursors. Chemotherapy has been increasingly used to treat malignant conditions. The systemic sequelae as a result of these immunosuppressive techniques induce many oral and dental complications. This study was conducted to evaluate the effect of chemotherapy on oral health status and activity of salivary alkaline phosphates enzyme in patients with acute lymphocytic leukemia. Materials and methods: The study groups included 28 patients with acute lymphocytic leukemia; they were under chemotherapy, aged 20-25 year old. The control group includes healthy subjects matching with study
... Show MoreThe e-commerce is one of the best achievements of the twentieth century, since the conduct commercial transactions via the Internet may be the consumer easy selection process and purchase convenient manner different from traditional methods, and with the beginnings of the new millennium impose the emergence of e-commerce term significant challenges to the insurance industry as an important economic sectors Generally, and insurance companies in particular as a result of scientific development, which has led to a reduction in costs and innovation in the production, which led to intense competition on both levels local or global. The insurance industry is a vital part of the economy and it has a varied impact to the community and individual
... Show MoreThe present paper investigates the role of fear and predator dependent refuge in the prey-predator system. The system describes the interaction between prey and a stage structure of predator that incorporates Holling II functional response. The predator splits into two compartments immature (juvenile) and mature (adult). The mature predators can hunt and reproduce but this capability is not found in the immature predators, the immature depend on their parents. The growth rate of prey decreases due to the existence of mature predators. The existence, uniqueness, and boundedness of the solution of the system are investigated. Three equilibrium points of the system are determined. The local stability of the system is studied. The global stabil
... Show MoreThe study aims to test the relationship of work pressure to its dimensions (role conflict, ambiguity of role, workload and nature of work) as an independent variable and its effect on organizational alienation by its dimensions (disability, lack of power, indifference, animosity, social isolation and self-alienation) (Restraint and confidence in negation, initiative, adaptation and living conscience) as a mediator variable, in some faculties of Baghdad University of Science (Medicine and Engineering) and Humanity (Education and Literature). The data was collected on the practical side, which was applied randomly (306) of the teachers and teachers of the colleges (56) items, which included the main research variables
... Show MoreDyspepsia is a significant public health issue that affects the entire world population. In this work, we formulate and analyze a deterministic model for the population dynamics of Gut bacteria in the presence of antibiotics and Probiotic supplements. All the possible equilibria and their local stability are obtained. The global stability around the positive equilibrium point is established. Numerical simulations back up our analytical findings and show the temporal dynamics of gut microorganisms.