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.
Objectives: 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 MoreThe administration on the basis of the activities designed to evaluate the performance of activities in terms of cost, time and quality by identifying activities that add value and those that are no add value and enables the administration of making up their own continuous improvement in production, through lower costs and reduce the time and improve the quality and reduce the incidence of spoilage and waste, y based search Ally premise that (the continuous improvement of the adoption of management style on the basis of the activities helps management in decision-making wise to reduce costs) to prove the hypothesis has sought research to achieve its goal of Alkadivh and Alkoppelan &nb
... Show MoreStudies on the flexural behavior of post-tensioned beams subjected to strand damage and strengthened with near-surface mounted (NSM) technique using carbon fiber-reinforced polymer (CFRP) are limited and fail to examine the effect of CFRP laminates on strand strain and strengthening efficiency systematically. Furthermore, a design approach for UPC structures in existing design guidelines for FRP strengthening techniques is lacking. Hence, the behavior of post-tensioned beams strengthened with NSM-CFRP laminates after partial strand damage is investigated in this study. The testing program consists of seven post-tensioned beams strengthened by NSM-CFRP laminates with three partial strand damage ratios (14.3% symmetrical damage, 14.3%
... Show MoreIraq's oil industry has been passed in different periods , began with domination of Western companies to invest in Iraqi oil at twenties of the last century , through the process of nationalization of the shares of those companies , beginning of the seventies , and ending with the new policies adopted by the government recently, which was contracting with international companies to develop the oil industry , because of what the outcome of the oil industry from a decline in artistic and physical ability as a result to the conditions of war and embargo imposed on Iraq before 2003.
The Iraqi government has introduced licensing of a contract to
... Show MoreObjectives: The main objective of this study is to examine the crucial role that Russian writers and intellectuals played in catalyzing the 1905 Revolution in Russia. Specifically, the study sought to analyze how their literary works, philosophical ideas, and political writings challenged Tsarist autocracy, depicted the suffering of the masses, and inspired opposition movements. The study aimed to highlight the defiant writings that contributed to the rise of political figures and the eventual overthrow of the repressive regime. Methods: The historical narrative and analytical methods were employed, conducting a comparative analysis of prominent works by renowned authors such as Tolstoy, Gorky, and Chekhov. This analysis focused on
... Show Moreبعد ثورة تموز عام 1958في العراق, لم يكن يسمح للقطاع الخاص بأن تكون له استثمارات كبيرة في القطاعات الاقتصادية. وذلك بسبب الإيديولوجيات التي كانت تؤطر الفكر السياسي. حيث كان النهج الاشتراكي هو الغالب في إدارة الأنشطة الاقتصادية. إذ قامت الدولة بتأميم معظم الاستثمارات الخاصة الكبيرة ،لاس
... Show MoreCardiovascular risk is independently increased by plasma lipids abnormalities (low- density and high density lipoprotein -cholesterol and triglycerides). Most patients have more than one lipid abnormality. Combination therapy with lipid-modifying agents could offer an important therapeutic option for improving the overall lipid profile. Combinations have demonstrated to provide additive efficacy and significant reductions in coronary events . This study was designed to evaluate the effect of ezetimibe, when used in combination with other hypolipidaemic agents ( statins) on lipid profile as well as on liver function ,renal function, oxidative stress, and platele
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