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 present study attempts to examine verbal/nonverbal impoliteness in the classroom interaction and outside it in one of the movies, namely, The Marva Collins. Impoliteness, which is significantly studied within pragmatics, is a negative attitude towards particular behaviors. It always presumes to have emotional concerns for at least one participant who has caused it. This study is an attempt to examine verbal/nonverbal impoliteness in The Marva Collins movie. The study aims to investigate the different types of impoliteness strategies used in the four selected scenes and find out whether the speaker’s status has anything to do with the types of impoliteness. Besides, the functions performed are also examined by following a qual
... Show MoreThis research contributes to environmental sustainability by recycling natural waste resources in making clothing products. The research aims to employ palm trees waste in designing belts suitable for contemporary women's fashion trends. Both descriptive and applied research approaches were used. Therefore, a collection of belts was designed and implemented. Then, a questionnaire was used to assess the extent to which the implemented belts achieved in sustainability standards using Likert scale. The sample size was 60 women. The data were analyzed using the SPSS program to calculate the arithmetic mean and standard deviation. One of the significant results of the research is the high average scores of the criteria for achieving sustainab
... Show MoreBackground: The recognized procedures that have been used to treat gynecomastia are said to have relatively a long operative time, less patient satisfaction rate, they are merely used, in mild to moderate gynecomastia, leaves a mild bulging over the nipple areola complex, resulting in aesthetically unsatisfactory results. The more the grade of gynecomastia, the more complicated the used surgical techniques. This study evaluates the success rate of these simplest surgical technique in higher grades of gynecomastia.
Objectives: to present the experiences with use of Modification of Combined Vibrated Power Assisted Liposuction with Periareolar Gland Excision in management of in
... Show MoreAbstract:
In light of globalization and internationalization of financial markets, issues arising from financial crises have become increasingly serious and fundamental, creating a lot of debate among experts around the world. So, many studies have attempted to investigate what measures can be taken to detect and prevent crises before they devastate the economies.
Therefore, this paper examines the Effectiveness of the Monetary Policy (MP) to Avoid, Reduce or Treat the Financial Crisis in Malaysia. Scholars have yet to agree on the issue
... Show MoreThe research aims at the scholars’attention to the importance and role of Arab Muslim women through books and historical studies that historians and scholars have taken up like Ibn Al-Jawzi (597 AH) and his book Safwat Al-Safwa, where he presented the conduct of worship and their words and deeds, and explained to women worshipers other aspects of their lives, such as the scientific aspect Crafts and works as well as their prominent role in preaching and religious guidance, and the impact of this on their morals and qualities. This study showed the strength of the personality of women and their high interest in worship. The importance of the study lies in knowledge.The research followed the role of Muslim women to carry t
... Show MoreThe article describes a certain computation method of -arcs to construct the number of distinct -arcs in for . In this method, a new approach employed to compute the number of -arcs and the number of distinct arcs respectively. This approach is based on choosing the number of inequivalent classes } of -secant distributions that is the number of 4-secant, 3-secant, 2-secant, 1-secant and 0-secant in each process. The maximum size of -arc that has been constructed by this method is . The new method is a new tool to deal with the programming difficulties that sometimes may lead to programming problems represented by the increasing number of arcs. It is essential to reduce the established number of -arcs in each cons
... Show MoreChange the morphological characteristics with the change of the factors affecting it has been shown that the Tigris River has the characteristics of the morphology of the low values in terms of depth, width and perimeter wet and gradient which in turn affected the morphological and other characteristics in terms of the direction and pattern of runoff came through the study of 48 cross-section is taken of the Tigris River Year 2008 by section for each 1 km, it has been shown that the average width of the Tigris River does not exceed 221.1 meters and the average depth of 3.9 meters either wet ocean amounted to 268.9 meters and changed the cross-section area of the last section at a rate of 4594.3 square meters, and through the study turned
... Show MoreTo evaluate the toxicity of benzalkonium chloride in aquaculture, the hemato-serological indices of Nile tilapia Oreochromis niloticus are used as biomarkers. Following exposure to three concentrations of benzalkonium chloride BAC 0.1, 0.25, 0.50, and 1 mg/l (BAC1,2,3 and 4) in aquaria for two durations 21 and 42 days, the microbiological assay in fish aquaria, in addition to blood parameters were assessed. Except for the mean difference between BAC2 and BAC3 (P > 0.05) at 42 days, the mean values of the bacterial counts revealed a significant difference between all compared groups (0.05 ≥ P ≤ 0.01). Following exposure to the lower concentrations of BAC (1, 2 and 3), the main blood parameters of Oreochromis niloticus namely red bl
... Show MoreIn this study, a total of 209 individuals of leeches were collected from Al-Hindyia River / Babil Province. 116 individuals were identified as Erpobdella octaculata (Linnaeus, 1758), 50 individuals as Erpobdella punctata (Leidy,1870) and 43 individuals as Hemiclepsis marginata (Müller, 1774). Four samples were collected monthly during a period from February to June 2018. Some physical and chemical water properties were also examined, including air and water temperature, potential of hydrogen pH, Electrical Conductivity EC, Total Dissolved Solid TDS, Dissolved Oxygen DO, and the Biological Oxygen Demand BOD₅. Air and water temperature were r
... Show More