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 impact of television has made it an essential technology that can't be dispensed with in all circumstances and situations, measuring the society's need for it. Some argue that there is no stronger media than television in introducing people of the world to each other, as it has the most powerful impact and attracts millions of viewers.
Television is deemed as the most effective tool of media as it is designed to capture both sound and image. The image, in itself, has the ability to engage and interact with our thoughts. In light of the aforementioned, it is noticeable that this interactive medium (television) has significantly evolved over the years, thanks to modern technologies that have been introduced over time. These advancem
This paper discusses the role of Auditors' Technological Maturity in reinforcing the quality of auditing profession, through focusing on the concepts of Technological Maturity and quality of auditing profession, as well as designing a proposed model for Technological Maturity which includes five evolutionary and sequential stages, and this proposed model would contribute to reinforce the quality of auditing. This proposed model will be employed in the field of auditing profession because the importance of the development and investment in this profession and the importance of the need for specialized knowledge in Information Technology, and the result of a proposed model is development of technological knowledge for the auditor to reach
... Show MoreFinance is an essential element when developing any housing policy because of its role in providing funds to institutions concerned with housing lending. Therefore, the research aims to evaluate the financial aid provided by the Central Bank of Iraq in solving the housing crisis through the adoption of the Central Bank of Iraq initiatives to support the financing of the housing sector, and here The importance of the research is highlighted to determine the role of the initiative by drawing an effective strategy aimed at providing the housing sector with the necessary funding. By providing financing to financial institutions directed towards providing real estate credit, and that the percentage of the contribution of the implement
... Show MoreThe research aims to identify the administrative skills and their role in institutional performance, and used the descriptive approach in a survey style and correlational relations to suit the nature of the problem to be studied.The research community was identified with the directors of sports activity in the Iraqi universities in a deliberate manner, and their number is (134) directors, where two scales (administrative skills and institutional performance) were used and the two scales were distributed to the above-mentioned sample in order to obtain answers that meet the required and representative sample of the community on the day 3/12/2021. The answers to all the statements were completed and after processing the results statistically
... Show MoreTuberculosis (TB) still remains an important medical problem due to high levels of morbidity and mortality worldwide. A series of innate immune mechanisms that create a cytokine network control the pathogenesis of tuberculosis and this response has the capacity to modify the host genomic DNA structure through epigenetic mechanisms such as DNA methylation which could constantly alter the local gene expression pattern that can modulate the metabolism of the tissues and the immune-response. Interferon-gamma (IFN-γ) is an important pro-inflammatory cytokine regulator of the innate immune response to TB. This study aims to determine DNA methylation patterns of INF-γ gene promoter and measure serum IFN- γ level in newly diagnosed TB patient
... Show MoreThe study aims to build a model that enhances trust-building for public and private banks to compare and determine the significant differences between public and private banks, by testing the impact of governance mechanisms (transparency, accountability, justice, independence, and social responsibility) (Agere, 2000) on trust-building strategies (trust and trust building, people management, work relations, training and development, leadership practices, and communications) (Ngalo, 2011; Stone et al., 2005), to indicate the level of employees’ awareness of the theoretical contents of the two variables and their importance to banking work, with the aim of improving performance. The main question is the role of governance mechanisms
... Show MoreThe present study illustrates observations, record accurate description and discussion about the behavior of twelve tested, simply supported, precast, prestressed, segmental, concrete beams with different segment numbers exposed to high fire temperatures of 300°C, 500°C, and 700°C. The test program included thermal tests by using a furnace manufactured for this purpose to expose to high burning temperature (fire flame) nine beams which were loaded with sustaining dead load throughout the burning process. The beams were divided into three groups depending on the precast segments number. All had an identical total length of 3150mm but each had different segment number (9, 7, and 5 segments), in other words, different segment length
... Show MoreBackground:No previous Iraqi study was done on the estimation of post mortem interval (PMI) from the medico-legal point of view; depending on the biochemical changes of vitreous humor.Objectives:To find out the relationship between some biochemical changes in vitreous humor and post mortem interval.To find out a new formula for estimation of PMI from some biochemical changes in vitreous humor.Method:The study was conducted on one hundred twenty two cases referred to the medico-legal institute in Sulaimani province during the period between 1st of February and 30th of July 2012.Complete classical autopsy was performed for each case and vitreous humor was collected at autopsy from the posterior chamber of the eye and the samples after coll
... Show MoreThis research is carried out to investigate the externally post-tensioning technique for strengthening RC beams. In this research, four T-section RC beams having the same dimensions and material properties were casted and tested up to failure by applying two mid-third concentrated loads. Three of these beams are strengthened by using external tendons, while the remaining beam is kept without strengthening as a control beam. Two external strands of 12 mm diameter were fixed at each side of the web of the strengthened beams and located at depth of 200 mm from top fiber of the section (dps). So that the depth of strands to overall depth of the section ratio (dps
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The advertising mail is considered as one of potential tools that followed to transfer the printed messages to the consumers and public customers whom are located at homes or works. This type of advertising is preferable due to the zero expense to receive the announcements of products, which became recently one of the successful procedures to create new customers and keep them in touch with direct communication. It is also possible to send them to specific group of people who can be classified by the advertisers to select even by name their own clients to give the personality to the clients for a long term of communication.
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