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
This research deals with the two item namely, the monetary policy central Bank of Iraqi and money supply . that contribute in up the problem of the paper that is concerned with the fact that to what extent the effectiveness of monetary policy conducted by the central Bank of Iraqi is valid in controlling money supply as well as the possibility of applying it in practical environment restricted to the scope of financial in stitiutions particularly in research population represented by central Bank of Iraqi .
For the purpose of a practical contribution for monetary and financial institutions . To achieve this , A hypothesis has been carried out and it suggested that the mon
... Show MoreRepresenting banking supervision An important function performed by the Iraqi Central Bank, in order to achieve stability in the financial and banking system, and safeguard the rights of depositors, investors and other targets, and to realize the Iraqi Central Bank banking supervision actors on banks, there must be an awareness of regulatory bank's existing control and subject them, as well as the role of banking oversight interested in spreading this awareness.
So sought search to find out the role played by the Iraqi Central Bank in raising awareness of the regulatory banking between the parties to the regulatory process, through the presentation and analysis of the legal framework for banking supervision and awareness supervisory
The aim of the research is to identify the extent of the ability to ensure the integrated reports by the auditor in verifying the credibility of these reports, and their implications for the benefit of all parties dealing with the economic unit, as well as measuring the impact of the assurance procedures followed by the auditors and their role in confirming these reports.
The research methodology was designed after studying the previous literature related to the research variables, and then the relationship between these variables was tested, through the use of a questionnaire list. A questionnaire targeting the community of auditors in the local environment, and the results of the study wer
... Show MoreThis study provides valuable information on secondary microbial infections in H1N1 patients compared to Seasonal Influenza in Iraqi Patients. Nasopharynx swabs were collected from (12 ) patients infected with Seasonal influenza (11 from Baghdad and 1 Patient from south of Iraq) ,and ( 22 ) samples from patients with 2009 H1N1 ( 20 from Baghdad and 2 from south of Iraq). The results show that the patients infected with 2009 H1N1 Virus were younger than healthy subjects and those infected with seasonal influenza. And the difference reached to the level of significance (p< 0.01) compared with healthy subjects.Two cases infected with 2009 H1N1 virus (9.1%) were fro
... Show MorePermanent deformation, fatigue and thermal cracking are the three typical distresses of flexible pavement. Using hydrated lime (HL) into the conventional limestone mineral additive has been widely practiced, including in Europe, to improve the mechanical properties of hot mix asphalt (HMA) concrete and as the result the durability of the constructed pavement. Large number of experimental studies have been reported to find the optimum addition of HL for the improvement on HMA concrete mechanical properties, moisture susceptibility and fatigue resistance. Pavement in service is under complex thermomechanical stress-strain conditions due to coupled atmospheric and surrounding environment temperature variation and the traffic loading. To predic
... Show MoreThe key objective of the study is to understand the best processes that are currently used in managing talent in Australian higher education (AHE) and design a quantitative measurement of talent management processes (TMPs) for the higher education (HE) sector.
The three qualitative multi-method studies that are commonly used in empirical studies, namely, brainstorming, focus group discussions and semi-structured individual interviews were considered. Twenty
The economic units always sought to maintain its market position and Trchinh the technology management and modern methods that will support success factors .vdila about it has become a customer and one profitability analysis of the most practical way benefit of economic units as modern management focus their attention on achieving this satisfaction, as the customers make up the axis of the success of every organization and that there are many government units aiming to profit directs attention to customers and the number of these units increased continuously. The administration used the customer profitability analysis in order to obtain information to assist in making and decision-making process. How to use modern tec
... Show MoreSustainable development is launched through the interaction between the economy and natural resources and preserving them from exhaustion as well as the efficient management of natural and social resources and includes a diversified economic condition and thus is the focus of attention to the development of economic structures, which is intended to improve the level of human well-being by increasing its share in the necessary goods and services and their relationship With economic growth, which is the most important driver of economic transformation, because it reflects the ability of society and increasing its productive capabilities and investing in the optimal way Although the Iraqi economy is considered one of the diversified
... Show MoreElectrochemical Grinding (ECG) process is a mechanically assisted electrochemical process for material processing. The process is able to successfully machine electrically conducting harder materials at faster rate with improved surface finish and dimensional control. This research studies the effect of applied current, electrolyte concentration, spindle speed and the gap between workpiece and tool on hardness and material removal rate during electrochemical grinding for stainless steel 316. The characteristic features of the electrochemical grinding process are explored through Taguchi-design-based experimental studies. The better hardness can be obtained at 10 A of the current, 150 g/l of the electrolyte concentration, 0.3 mm of gap an
... Show MoreThe talk about the relationship between the media and industrialists can be the core of a bigger and deeper subject which is the role of these means in increasing sales : First, increasing the customer’s awareness of the importance of goods and the result of the promotion of products. Secondly, increasing investments which do require continuous studies and deep research in order to understand the constantly changing market conditions, and the public’s taste. In this research, we try to find out how industrialists see the role of media in the promotion of products in Iraq today, and how it develops in the future.
There was a reluctance of the industrialists to advertise in the local media, also industrialists see the role of t
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