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.
running the requirement color important place in object of life activity both public and private, Fallon makes represents energy expressive and aesthetic in designing furniture street, especially (positions waiting buses passenger transport)which took looms large in attention receiver designer also, through civilized development and urban and change the city. Requirement, The positions of waiting progress jobs service and that would interact to produces Photos aesthetic Furniture for space street and understand receiver, affect the operation his life and the development of his environment and his psyche and culture of because they entity variable and sophisticated, impose on us to find foundations a design and conditions of chromatic esp
... Show MoreWith the growing number of Internet users, public and private arts activities have become increasingly popular. Adolescents have begun to establish aesthetic taste and new cultural values. This category is the most affected one by the published images and ideas especially in the social networking space and specifically the Facebook. It is the most important problem in their cultural composition. This research aims to detect the problems of social networking sites in nurturing the aesthetic taste of adolescents. The researcher used the analytical descriptive approach to obtain accurate information describing the current situation or depicting the social reality of adolescents. The research concluded that the public discourse in social med
... Show MoreThis paper studies the combination of fluid viscous dampers in the outrigger system to add supplementary damping into the structure, which purpose to remove the dependability of the structure to lower variable intrinsic damping. This optimizes the accuracy of the dynamic response and by providing higher level of damping, basically minimizes the wanted stiffness of the structure while at the same time optimizing the achievement.
The modal considered is a 36 storey square high rise reinforced concrete building. By constructing a discrete lumped mass model and using frequency-based response function, two systems of dampers, parallel and series systems are studied. The maximu
... Show MoreThis study is one of the descriptive studies, where the researcher used the survey method, which seeks to provide an accurate and appropriate description of the main and sub-categories of the content of the research for television documentaries on the Iraqi satellite channel, relying on the research questions and objectives to analyze the content of the documentaries according to the approach referred to above. The objectives of the research were summarized to identify the function of the documentary programs in Al-Iraqiya channel to detect the crimes of the former regime, to know the frameworks highlighted by the documentary programs in Al-Iraqiya channel to reveal the crimes of the former regime, to identify the extent of the circ
... Show MoreHumor is an interesting phenomenon that has been studied widely, yet it is considered a universal trait that cannot be an old subject for a study. This study is conducted to investigate humor from a universal pragmatic lens in a stand-up comedy show, namely, You Wanna Hear Something Crazy?. It aims to study humor as a coin with two sides, the production side and the understanding side. To achieve the aim of the study, the researchers use an eclectic contains Grice’s CP model (1975) and Habermas’s UP model (1979, 1984, 1987, 1998). The study has noted that while using the observance and the non-observance of the cooperative maxims to produce humor, the universal validity claims of truth, sincerity, and normative rightness for rea
... Show MoreThe current research deals with the specificity of the interior design of the classes of art education in the schools of excellence for the province of Muthanna and its center of the city of Samawah. In the first chapter، the problem of research was determined by the lack of internal spaces of the classes of art education to designs that meet the requirements and needs of students in these educational stages. The importance of the research in being an addition to knowledge in the field of interior design and engineering department of the general directorates of the Ministry of Education. The objectives of the research were determined through.
- Identifying the reality of the halls of art education for sch
Irinotecan induced-mucositis is an inflammatory event of intestine caused by an increase in concentration of active metabolite 7ethyl10-hydroxycamptothecin (SN38) in the intestine. Irinotecan must first be converted by a carboxylesterase (CES) to the active metabolite (SN38), which is subsequently glucuronidated by the hepatic enzyme to SN38G. The SN-38G is deconjugated in the intestine to SN-38 via ?-glucuronidase produced by the intestinal bacterial flora, which accounts for SN-38 delayed intestinal mucositis of irinotecan. To study the protective effect of mentha in irinotecan-induced mucositis, intestinal mucositis induced by I.P injection of irinotecan (75mg/Kg/day) for 4 days. Mentha ethanolic extract orally administered to
... Show MoreThe hydraulic behavior of the flow can be changed by using large-scale geometric roughness elements in open channels. This change can help in controlling erosions and sedimentations along the mainstream of the channel. Roughness elements can be large stone or concrete blocks placed at the channel's bed to impose more resistance in the bed. The geometry of the roughness elements, numbers used, and configuration are parameters that can affect the flow's hydraulic characteristics. In this paper, velocity distribution along the flume was theoretically investigated using a series of tests of T-shape roughness elements, fixed height, arranged in three different configurations, differ in the number of lines of roughness element
... Show MoreThe paper studies the science of “Biomimicry” or imitation of nature, and how to utilize it to create contemporary designs. It starts by defining biomimicry and innovation. Then, the style of imitating nature is highlighted, which is considered one of the most important methods of innovation. It includes simulating animals and plants (in their environmental conditions) to use the natural and dynamic design solutions to produce innovative designs, that enhance the concept of sustainability. Various forms of natural species are presented, to show their benefit in contemporary metal product designs. Finally, a model of a metal lighting unit is developed, where innovative ideas inspired by silkworm cocoon are used in its design. The stud
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