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.
It has become clear to see the role of the small and medium enterprises in the economy, and for the continuity of these projects it is necessary to supply finance from the banks, How ever the latter suffers risk of lending.
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... Show MoreBackground: Polycystic ovary syndrome is among the leading causes of fertility-related problems and menstrual irregularities in women of reproductive age. The granulosa cells of the developing pre-antral and antral follicles produce inhibin B, which triggers chemical responses in the ovaries. Inhibin B is most often observed in the follicular phase when levels peak early and then decline over time Objectives: This study was designed to investigate the role of serum inhibin B and the Luteinizing Hormone / Follicle Stimulating Hormone ratio in differentiation between the different phenotypes of polycystic ovary syndrome as well as to define the predominant PCOS phenotype. Methods: This cross-sectional research was conducted in the
... Show MoreThis research addresses a problem manifested in a main question: what is the role of the digital media in marketing the artistic products? in order to determine the role played by the digital media in the disclosure and promotion of the artistic product, its price and places of distribution, as the basic elements of the marketing mixture.
This is a descriptive research in which the researcher used the survey method to check the opinions of a sample chosen according to the (proportion) method from the research community represented by instructors and students of the college of Fine Arts- University of Dayala.
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Sought the search to find out what small businesses, the importance of funding, and the role of funders in supporting such projects, which have been addressed in the search through a sample of government banks (Rafidain and Rasheed) and private banks (the Middle East, the Gulf, North, Assyria) and a sample of Small projects borrowed from these banks, but in order to achieve that rely researchers on scientific methods discreet marked by the curriculum descriptive analytical method which is based on the compilation of facts and information then collated and analyzed to reach acceptable results, as well as data collection tool (checklist) was whereby examine questions of a sample of
... Show MoreMoisture-induced damage is a serious problem that severely impairs asphaltic pavement and affects road serviceability. This study examined numerous variables in asphalt concrete mixtures to assess their impact on moisture damage resistance. Mix design parameters such as the asphalt content (AC) and aggregate passing sieve No. 4 (PNo. 4) were considered as variables during this study. Additionally, hydrated lime (HL) was utilized as a partial substitute for limestone dust (LS) filler at 1.5% by weight of the aggregate in asphalt concrete mixtures for the surface layer. This study also investigated the potential enhancement of traditional asphalt binders and mixtures by adding nano-additives, specifically nano-silica oxide (NS) and na
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We can see the phenomena of small and medium-sized enterprises, by important and a new subject contemporary, thro related between important concept that develop and add. This research focused on the important concept of small and medium-sized enterprises, in public and privet sectors. small and medium-sized enterprises discrimination by large filer ratio in the especially at the first years when they started because of the limited managerial skills, financial recourses and marketing problems. On it they will creative new procedures. this research treatment the core issues about wakens local and international enterprises, so threat. the goals of this research are extended malty dimension concept o
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The objective of this study, is to attempt to explain the reality of the Structural Imbalances in the Iraqi Economy during the period of research, by providing a quantitative analysis of the most important types of Imbalances, Which are represented by the disruption in the Productive Structure, the imbalance of the structure of Public Budget, and the imbalance of the Structure of Trade. The problem of the research, is the fact that the economy structure in Iraq has long suffered from an Imbalances in its economic structure, which are represented in the unequal relations between its constituent elements, according to the proportions levels defined by the economic theory.
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The aim of the present research is to evaluate the child’s nutritional
method (2-5 years old) which is based on his resistance of the food highly rich
with nutritional elements and his acceptance of the food of a low nutritional
value in addition to his having forbidden food with other mates and making
use of all mates when having food, in establishing the sound social values and
affection since child hood. The required statistical equation have been used
by the researcher namely (Z test).
The sample of the present study consists of (26) children who were selected
intentionally and randomly from the kindergartens of Al-Bayaa region and the
college of Education for women. The questionnaires were d