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 work involves studying corrosion resistance of AA 6061T6 butt welded joints using Two different welding processes, tungsten inert gas (TIG) and a solid state welding process known as friction stir welding, TIG welding process carried out by using Rolled sheet of thickness6mm to obtain a weld joint with dimension of (100, 50, 5) mm using ER4043 DE (Al Si5) as filler metal and argon as shielding gas, while Friction stir welding process carried out using CNC milling machine with a tool of rotational speed 1000 rpm and welding speed of 50mm/min to obtain the same butt joint dimensions. Also one of weld joint in the same dimensions subjected to synergistic weld
... Show MoreThe harvest of hydrocarbon from the depleted reservoir is crucial during field development. Therefore, drilling operations in the depleted reservoir faced several problems like partial and total lost circulation. Continuing production without an active water drive or water injection to support reservoir pressure will decrease the pore and fracture pressure. Moreover, this depletion will affect the distribution of stress and change the mud weight window. This study focused on vertical stress, maximum and minimum horizontal stress redistributions in the depleted reservoirs due to decreases in pore pressure and, consequently, the effect on the mud weight window. 1D and 4D robust geomechanical models are
Mobile advertising has become the product of an influential actor in the creation of design ideas that attract the recipient, according to the needs of the society and the interactions of the technological technical age, what the technologies of the mock programs do and what corresponds to the expectations of the recipient, and what the design methods achieve of synchronization and sound in which all The research has found ways to address the most exciting and important snapshots and focus on diversity and diversity, formality, image and color, and what the optical degrees and chromatography achieve sought to attract attention, which contributes from the point of view of the researchers in the field of accuracy, clarity, attention and co
... Show MoreThe present study develops an artificial neural network (ANN) to model an analysis and a simulation of the correlation between the average corrosion rate carbon steel and the effective parameter Reynolds number (Re), water concentration (Wc) % temperature (T o) with constant of PH 7 . The water, produced fom oil in Kirkuk oil field in Iraq from well no. k184-Depth2200ft., has been used as a corrosive media and specimen area (400 mm2) for the materials that were used as low carbon steel pipe. The pipes are supplied by Doura Refinery . The used flow system is all made of Q.V.F glass, and the circulation of the two –phase (liquid – liquid ) is affected using a Q.V.F pump .The input parameters of the model consists of Reynolds number , w
... Show MoreObjective: To assess prospectively functional outcome of interlocked intramedullary nailing fixation in management of closed tibia shaft fractures. Methodology: This prospective study included 134 patients with closed shaft tibia fractures with age 18-60 years and isolated closed fracture of shaft of tibia. The fractures were fixed by interlocking intramedullary nail. At follow-up after 12 months postoperatively, the functional outcome was assessed radiographically for the sign of union and clinically according to Klemm-Borner criteria. Results: The mean age was 38.55 years. Out of 134 patients, 55.2% were male. The cause was road traffic accident in 44.8%, majority of the fracture occur in the mid-shaft (41.8%), and oblique fracture was th
... Show MoreManipulation is a discursive concept which plays a key role in political discourse by which politicians can impose some impact on their recipients through using linguistic features, most prominent of which are personal pronouns (Van Dijk, 1995). The aim of this study is to investigate how politicians utilize the personal pronouns, namely; We and I and their possessive forms as a tool of manipulating the audience's mind based on Van Dijk's "ideological square" which shows positive-self representation and negative-other representation (Van Dijk,1998:p.69). To this end, American President Donald Trump's 2020 State of the Union speech was chosen to be the data of analysis. Only (8)
... Show MoreCurrent research aims to know the personality traits of gifted
and has been the preparation , students in the Hashemite Kingdom of Jordan
pedagogy of talented ) 60 ( views of a sample of of the search tool of the
And has been applied to the . items ) 52 ( formed from the search tool , teachers
sample, and after treatment results reached statistical research results and the
researcher presented a number of recommendations including:
: Recommendations
1. Need for the development and rehabilitation of mentally gifted and structure
their characters in line and mental abilities and knowledge.
ams and psychological guidance for personal Preparation of scientific progr . 2
. development for the gifted
3. Work to
Background: pregnancy as a systemic condition causes changes in the functioning of human body as a whole and specifically in the oral cavity and it also is considered as a stressful condition. These changes may favor the increase of oxidative stress. Aim: The aim of this study was to estimate the level of marker of oxidative stress (malondialdehyde) and antioxidant (uric acid) in saliva of pregnant compared to non-pregnant women and to assess the gingival health condition in both groups. Additionally, unstimulated salivary flow rate was determined in both groups. Subjects, materials and methods: The study group consisted of sixty pregnant women, they were divided into three equal groups according to trimester (20 pregnant women for each
... Show MoreThis study deals with the subject of violence, but from another perspective, it has not been emphasized in contemporary studies of violence in Arabic and raqi universities, which is the structural or institutional aspect of violence. Traditional studies have focused their analysis of violence on the direct side the violence, The other side of the violence is the hidden violence, which is characterized by a lack of clarity of the underlying factors and its effects are not arises, which makes it the most serious violence, which requires a deep research into the social, political, economic, cultural and psychological structure of society (individuals and institutions). This study was based on the theory of the Norwegian scientist (J
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