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.
Abstract:
One of the most prominent historical stage feature that is well- known
nowadays in the world is democracy issue. This issue gives man the right to
reflect his concept and notions . It,s the world of freedom , human right and
liberation of women. This leads to the principle of equality between women
and men which is put in the top of liberty and Improvement lists .
Improvement can be defined as a group of means and ways that is
used to direct human work to improve their level of life economically and
socially .
This study contains three sections, the first presents the social state of
women in pre-history period . And the second section presents the theory of
improvement as an important social ph
Multiple sclerosis (MS) is a chronic, inflammatory demyelinating disease of central nervous system with complex etiopathogenesis that impacts young adults (Lee et al., 2015), and MS impacts younger and middle aged character and leads to a range of disabilities that can alter their daily routines (Yara et al, 2010). Although, the exact cause of MS is still undetermined, the disease is mediated by adaptive immunity through the infiltration of T cells into the central nervous system (Bjelobaba et al, 2017). MS causes the Focal neurological symptomsand biochemical changes in the molecular level and the variation of neural cells such as loss or alteration of sensation, motor function, visible signs such as blurred vision or transient blindness,
... Show MoreBackground: Recent advancements in molecular techniques have identified over 450 genotypes of Human Papillomavirus (HPV), classified into low- and high-oncogenic risk categories. The rise in high-oncogenic risk HPV genotypes has been linked to various cancers, including those affecting the oral, oropharyngeal, and nasopharyngeal regions in both pediatric and adult populations. Methods: In this study, a cohort of 102 tonsillar tissue samples was included. This comprised 40 specimens from pediatric patients aged 4 to 9 years with nasopharyngeal adenoid hypertrophies, and 42 specimens from pediatric patients aged 5 to 12 years with palatine tonsillar hypertrophies. Among the 82 tonsillar tissue samples analyzed, 38 were from pediatric patients
... Show MoreAdolescence important and sensitive stage in social terms, being a stage where learns teenager bear social responsibilities and composition of their ideas about family life, as well as it is the stage where the teenager looking to himself for an important place in the community to become independent socially people, so it highlights the role of Social Work to do better effort and I believe him in order to prepare for the adolescent stage of adolescence and help him overcome the problems so that makes it adapts to the society in which he lives
Expected to The organizational commitment by employees increases their loyalty towards their organization and thus contribute to enhancing their performance , therefore this study aimed to discover the relationship and the impact between the organizational commitment (emotional commitment, standard commitment, continuous commitment) and the performance of employees in the company researched, additional to know the available organizational commitment levels of employees in the company researched and its impact on the performance of employees, Research was conducted at the General Company for products in the dairy to achieve the goals of research has been developed questionnaire conation (22 ) items to collect data from the study s
... Show More Purpose - The study aimed at evaluating the accounting system of the Iraqi political parties, which is applied according to legislative texts, and then the ability to provide accounting information to evaluate the strategic performance and control of the party's operational and financial performance.
Findings- The research found that the unified accounting system applied to political parties does not provide relevance informations to judge the performance of the political party, the researcher a proposal for an accounting system that provides the necessary information to measure and monitor the performance of Iraqi political parties can be presented. The