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.
شهدت العالم منذ نهايات القرن الماضي وبدايات القرن الواحد والعشرين تطورات دراماتيكية على صعيد الادبيات التنموية ، اذ تحولت التنمية من المفهوم التقليدي الذي اهتم بالنمو الاقتصادي الى رؤية جديدة هي رؤية التنمية البشرية ومن ثم الى التنمية المستدامة التي اعطت للتنمية البعد الانساني وجعلت من مشكلات واحتياجات البشر منطلق لها لتحويل الفرد والمجتمع الى مرحلة جديدة تضمن له العيش الكريم وتحقق معه
... Show MoreThe business environment is witnessing tremendous developments in the field of production and technology, which requires the development of production methods to go in line with these developments and the increasing competition, which has gone beyond the economic aspects to extend to the environmental aspects, as economic units tended to adopt a cleaner production strategy and through what they achieve by producing environmentally friendly products and achieving economic efficiency. Reducing costs, providing a safe and clean environment for workers, and reducing waste from production operations.
Endometriosis is an estrogen dependent inflammatory disorder plays a pivotal role in the reproductive system of the females which regarded as one of the most important gynecological disorders due to it is a key cause of infertility for women and also it has a remarkable impact on the women's life quality. Indeed, environmental pollution have an extremely importance in the etiology of endometriosis. Hence, the present article submits an abbreviated literature review to the biochemical role of environmental pollutants in the etiology and development of endometriosis. Anyway, this review article represented the major environmental pollutants: the organic pollutants of air, heavy metals, gaseous pollutants and the particulate matter. Th
... Show MoreThis research attempts to evaluate the role of the information system by highlighting its importance in providing date and information to the tax administration the process of tax accounting for those who are subject to income tax whether they are individuals or companies where the effective information system provides accurate and reliable information in a timely manner.
At the theoretical part of the research, the research approaches the problem of the research represented in that whether the information system, applied in the General Commission for Taxes, is capable of achieving its role in reducing the phenomenon of tax evasion. The existence of a set of things which in the Commission may lead to increase tax evasion by taxpa
... Show MoreThis study aims to identify how the Zakat Fund contributes to financing entrepreneurial projects; and the role that these projects play in achieving economic and social development, despite the importance that contracting projects have in most countries as the main engine of growth; however, they still face many challenges that In the forefront of which is the challenge of obtaining financing; in this regard, it is possible to resort to the use of Zakat funds in the Islamic economy as it is a funding source that is closely proportional to the characteristics and goals of entrepreneurial projects in achieving development;
 
... Show MoreWith the development of modern mass media and the prevalence of use continues to both researchers and practitioners their efforts to understand how the media affect Hzha on both the individual and the institutions, society and culture as a whole, which means that the need to develop models and theories explain and predict the effects of the use of such means, therefore, the study of modern technologies of communication and information as an area of research has become mature to establish the intellectual base cohesive, but they are not mature enough, which calls for more research developments therefore become social networking sites online, (Facebook, and YouTube, and straining) known today as the new social media, which is witness
... Show MoreThis article discusses the change of values in urban family, because of various communication media and modern technologies as one of the most important factors affecting the changing family values in urban areas, this means becoming part of urban life. And focuses on the family in urban areas, for the privacy of the social, economic, demographic and cultural help to this effect, and because cities are the most friction and interaction with modern technologies.
Background: Imaging has a critical role in the diagnosis and evaluation of cardiac diseases, beginning with chest radiography and fluoro-scopy and progressing to coronary angio-graphy, echocardiography, nuclear medicine and recently multidetector computed tomo-graphy (MDCT) as well as magnetic resonance (MR) imaging
Objective: To highlight the role of Multi-detector CT in the evaluation of coronary artery disease and its importance of being noninvasive diagnostic technique.
Methods: A cross sectional study for 20 patients. Patients were asked to fast 6 hours prior to the examination and the patients with heart rates above 65 beats per minute were given cardio-
... Show MoreThe study aims to identify the role of family in inculcating the moral values of voluntary work among adults, as it constitutes the basic social institution that is responsible for raising and control children. It has regarded as the first phase of constituting societies, where family plays a significant role in changing the behavior of individuals positively or negatively through provided patterns. The moral values act as organizer of human relationship in which misusing of these values would affect the interaction between people. This study focuses on how to employ the moral values in voluntary work as a civilized behavior helps in developing and strengthening societies. The researcher adopted the analytical-descriptive approach as mor
... Show Morehe study aims to build a model that revolves around the main question of the role of strategic agility (SA) in enhancing organizational excellence (OE). For the purpose of achieving OE and to determine the extent of interest and knowledge of managers at the Midwest Refineries Company (MRC) on the theoretical and practical implications, and on the performance foundations of these two vital variables with the aim of continuous improvement. A questionnaire was used and distributed to a random sample of 54 managers in this important energy production company. The study followed the descriptive analytical approach to answer the questions raised. The study model and dimensions were built according to reference models, most notably the models (Al-
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