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 study objectives were to (1) describe the characteristics of the pharmacy professionals and (2) explore the association between job satisfaction and factors, such as work control, work stress, workload and organization and professional commitments.
This study was a cross-sectional design. The survey items were mainly adapted from the US National Pharmacist Workforce Survey. An electronic (Qualtrics) questionnaire was posted on pharmacist social media in several A
Utilizing phase change materials in thermal energy storage systems is commonly considered as an alternative solution for the effective use of energy. This study presents numerical simulations of the charging process for a multitube latent heat thermal energy storage system. A thermal energy storage model, consisting of five tubes of heat transfer fluids, was investigated using Rubitherm phase change material (RT35) as the. The locations of the tubes were optimized by applying the Taguchi method. The thermal behavior of the unit was evaluated by considering the liquid fraction graphs, streamlines, and isotherm contours. The numerical model was first verified compared with existed experimental data from the literature. The outcomes re
... Show MoreThe aim of this paper is to shed the light on the concepts of agency theory by measuring one of the problems that arise from it, which is represented by earnings management (EM) practices. The research problem is demonstrated by the failure of some Iraqi banks and their subsequent placement under the supervision of the Central Bank of Iraq, which was attributed, in part, to the inadequacy of the agency model in protecting stakeholders in shareholding institutions, as well as EM, pushed professional institutions to adopt the corporate governance model as a method to regulate the problem of accounting information asymmetry between the parties to the agency. We are using the Beneish M-score model and the financial analysis equations in
... Show MoreThe increase in the number of trucks and other heavy vehicles in Iraqi highways lead to cracking and deteriorations in the flexible highway. The use of polymermodified asphalt may solve this problem to match the required performance standards. This study investigates the effects of styrene-butadiene-styrene (SBS) polymer on the performance behaviour of Iraqi bitumen binder. The characteristics of bitumen binder were analysed to observe the compatibility of bitumen with SBS polymer. The bitumen binder was mixed with three different contents of SBS (4%, 4.5%, and 5%) by weight of asphalt cement. Viscosity tests were conducted on the SBS polymer-modified asphalt at 135 oC and 165 oC in addition to conventional binder tests. The prepar
... Show MoreThis Study Deals with one of the Assyrian Functions (The Position of Abarraku Minister of Finance). This Position has been Characterized by an important Historical Position in Mesopotamia in General and in the Assyrian Empire in Particular Because of its Role not limited to Administrative Duties related to financial affairs. Rather, the Duties Varied and included Also The military and political, in particular. He who holds this position governs a province, and in studying this position we have Relied on the Assyrian Cuneiform Texts that were Found by the British College of Archeology During its excavations in Nimrud in the years 1949-1962 AD, as it Included these Texts (letters, Economic, legal and Administrative Documents). These T
... Show MoreCurrent design codes and specifications allow for part of the bonded flexure tension reinforcement to be distributed over an effective flange width when the T-beams' flanges are in tension. This study presents an experimental and numerical investigation on the reinforced concrete flanged section's flexural behavior when reinforcement in the tension flange is laterally distributed. To achieve the goals of the study, numerical analysis using the finite element method was conducted on discretized flanged beam models validated via experimentally tested T-beam specimen. Parametric study was performed to investigate the effect of different parameters on the T-beams flexural behavior. The study revealed that a significant reduction in the
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