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.
Intersectionality is a concept that focuses on social inequality towards black people and provides an analytical instruments for creating social justice issues in such a way in order to depict how social marginalization, or privilege occurs differently in various social positions. It does this by focusing on the interaction of multiple systems of oppression. Intersectionality is used to examines how the social factors; race, gender, and class can affect the people’s life especially the immigrants, black people, and refuges. This article will depicts how blacks in Canada are segregated and distinguished from white race. David Chariandy’s I’ve Been Meaning To Tell You: A Letter to My Daughter 2018 is analyzed through Kimberle Crenshaw
... Show MoreIntersectionality is a concept that focuses on social inequality towards black people and provides an analytical instruments for creating social justice issues in such a way in order to depict how social marginalization, or privilege occurs differently in various social positions. It does this by focusing on the interaction of multiple systems of oppression. Intersectionality is used to examines how the social factors; race, gender, and class can affect the people’s life especially the immigrants, black people, and refuges. This article will depicts how blacks in Canada are segregated and distinguished from white race. David Chariandy’s I’ve Been Meaning To Tell You: A Letter to My Daughter 2018 is analyzed through Kimberle Crenshaw
... Show MoreConcrete structures are exposed to aggressive environmental conditions that lead to corrosion of the embedded reinforcement and pre-stressing steel. Consequently, the safety of concrete structures may be compromised, and this requires a significant budgets to repair and maintain critical infrastructure. Prediction of structural safety can lead to significant reductions in maintenance costs by maximizing the impact of investments. The aim of this paper is to establish a framework to assess the reliability of existing post-tensioned concrete bridges. A time-dependent reliability analysis of an existing post-tensioned involving the assessment of Ynys-y-Gwas bridge has been presented in this study. The main cause of failure of this bridge was c
... Show MoreThe purpose of this study is to explore whether the adoption of Beyond Budgeting (BB) as a management accounting practice (MAP) contributes to developing intellectual capital (IC) and creating value in Iraqi companies. This requires an understanding of the views of the Iraqi managers about the nature of the information provided by this practice, which may be used to determine whether this information is relevant in the management of IC in the context of Iraq. This research aims also to explore the challenges of the adoption of the BB in planning and controlling IC in Iraq. The study adopts a qualitative approach and an interpretive paradigm. It also adopts a semi-structured interview method of collecting data from executive managers
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The research aims to study the problem of high production costs and low quality and the use of total quality management tools to detect problems of the high cost of failure and low quality products, diagnosis, and developing appropriate solutions.
To achieve the goal, we studied the overall quality tools and its relationship with the costs and the possibility of improving quality through the use of these tools.
Was limited to these tools and study the relation to the reduction of costs and improving quality have been studied serially by the possibility of the reduction.
To achieve the goal, the study of the concept of total quality management
This research seeks to clarify the regulatory and educational role of the regulatory and educational institutions in reducing the phenomenon of financial and administrative corruption as a dangerous phenomenon of the communities, as it touched search kinds of financial and administrative corruption and the causes and effects, as well as to the role of educational institutions in reducing this phenomenon, and finally between experiments some SAIs and accounting Arab and foreign countries on how to reduce the phenomenon of financial and administrative corruption.The research aims to several targets which shed light on the role of educational and supervisory institutions in reducing corruption, a statement origins and evolution of and justi
... Show MoreThis study concluded detection of Toxoplasma gondii in milk, immunologically by using Elisa and nested PCR)nPCR (based on B1 gene, also to investigate the effect of toxoplasmosis, parity, breed and flock on some milk composition in the Iraqi local and Shami goats in the middle of Iraq. A total of 80 milk samples of the lactating goats were collected. Results of this study showed the prevalence of Toxoplasmosis was 21.25% and 28.75% by Elisa and nPCR respectively without significant differences. The sensitivity of Elisa was a low (30.43%) whereas the specificity was a high (82.45%). The degree of agreement estimated by Kappa coefficient revealed a slight agreement (0.14) between two methods. The results indicated that goats infected
... Show Moreيلعب القطاع الصناعي التحويلي في أي قطر دوراً هاماً في تحقيق التنمية الصناعية، اذ تتحد تاثيراته فيها على طبيعة الدور المرسوم له وعلى مدى فاعلية هذا القطاع الحيوي الذي يعد اتجاه نحو التعاظم المضطرد لمستويات الانتاجية " Levels of productivity"والتنويع الانتاجي والتدفق المستمر للتجديد التكنولوجي من اهم دلائله.
ويعد مؤشر الانتاجية بصفة عامة وانتاجيتي العمل وراس المال بصفة خاصة من الم
... Show MoreThe importance of this research lies in shedding light on the concept of techno-strategy for information management from vital and important topics that showed response for change in all areas of life. As this necessitates the updating and changing of it in order to achieve its strategic goals and enhance its technological advantage. The research problem looked at the role of the information technology system (ITS) in enhancing risk management in general directorates for sports and school activity from the viewpoint of its department heads. The research aimed at the relationship of information techno-strategy in risk management and the ratios of the contribution of information techno-strategy in risk management from the viewpoint of heads o
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