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:
Under the state scenario, fiscal policy will not be able to use the oil surpluses optimally and economically and society, as long as these surpluses are not directed by public expenditure towards new productive investments and by following the path of fiscal policy after one year 2003 and until 2013 we note that it is based on the method of spending (excessive) consumption, and did not take any action towards the budget deficit planned at the beginning of the fiscal year, and the actual surplus at the end of the fiscal year, which represents the highest expenditure in the budget, Salaries and wages of workers in various government agencies with the expansion of spending on the security side.&n
... Show MoreAeromonas salmonicida is a fish pathogen and recognized to cause a variety of diseases in humans. There are a few information about A.salmonicida in Iraq and there is no any previous molecular study on it. During the period of December 2017 to May 2018; Sixteen isolates of the A. salmonicida were isolated and identified from 300 common carp (Cyprinus carpio) fishes stomach in aquarium of Erbil city/ Iraq by using manual, automated Vitek 2 compact system, and confirmed by PCR using gene TonB-dependent siderophore (364bp). Antimicrobial susceptibility was determined by disk diffusion method and the results found that all isolates 100% susceptible to imipenem, 100% resistant to nalidixic acid and variable resistan
... Show MoreThe human resources are considered to be the main pillar of the organizations , economic development and the foundation of moving wheels of individual growth. This is considered as the basic tasks for any productive and economic activity . The investment of the human resources is the economic pillar of production , but the most important element of the production . This research tried to access the method of resource investment and to identify the problems and training as key element in establishment of E –government . A questionnaire document have been distributed to the workers at different levels in the colleges and institutes. The research concluded the necessity of job description , continuous training of the workers , usi
... Show MoreThis study deals with the intellectual representations whose intellectual systems are incarnated in the Jewish personality, which is considered one of the complex intellectual systems that has caused controversy throughout the ages because of the ambiguity due to the religious and psychological factors that were reflected directly and strongly on the intellectual structure of the Jewish community in general and the Jewish - Zionist personality in particular, in an attempt (to create new dimensions embodied by intellectual representations of a human nature embodied by what that - peaceful - religiously oppressed - psychologically and socially isolated character presents, because of the curse of the peoples of the world that was a cause fo
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The research aims to measure, assess and evaluate the efficiency of the directorates of Anbar Municipalities by using the Data Envelopment Analysis method (DEA). This is because the municipality sector is consider an important sector and has a direct contact with the citizen’s life. Provides essential services to citizens. The researcher used a case study method, and the sources of information collection based on data were monthly reports, the research population is represented by the Directorate of Anbar Municipalities, and the research sample consists of 7 municipalities which are different in terms of category and size of different types. The most important conclusion reached by the research i
... Show MoreIn this study, iron oxide nanoparticles (α-Fe₂O₃ NPs) were prepared using a readily available chili pepper plant extract from local markets. This study aims to evaluate the magnetic properties of α-Fe₂O₃ prepared in green chemistry from Capsicum plant extract. After several simple preparatory steps, such as washing and cutting, they were treated with an inorganic complex (potassium hexacyanoferrate) (K3[Fe(CN)₆]). In the first analytical step, the in vitro detection of the plant extract solution after reaction with the potassium hexacyanoferrate (III) complex revealed characteristic adsorption bands of the cyanide group, which disappeared upon complexation. The iron oxide NPs were characterized using various methods, including X
... Show MoreSixteen polycyclic aromatic hydrocarbons (PAHs) concentrations were measured in aerosol samples collected for the period from April 2012 to February 2013 at thermal south power station of Baghdad. Fourty one aerosol sample were extracted with (1:1) dichloromethane and methanol using soxhlet for seventeen hour. The extraction solution was analyzed applying GC/MS. The PAH concentrations outside thermal south power station were higher than those inside it, and higher in summer season than in winter. Naphthalene, pyrene, Anthracene, Indeno [1, 2, 3-cd] pyrene and Phenanthrene were the most abundant PAHs detected in all points at the site sampling. The total polycyclic aromatic hydrocarbon (TPAH) and total suspended particles (TSP) concentrat
... Show MoreThis study investigates the performance of granular dead anaerobic sludge (GDAS) bio-sorbent as permeable reactive barrier in removing phenol from a simulated contaminated shallow groundwater. Batch tests have been performed to characterize the equilibrium sorption properties of the GDAS and sandy soil in phenol-containing aqueous solutions. The results of GDAS tests proved that the best values of operating parameters, which achieve the maximum removal efficiency of phenol (=85%), at equilibrium contact time (=3 hr), initial pH of the solution (=5), initial phenol concentration (=50 mg/l), GDAS dosage (=0.5 g/100 ml), and agitation speed (=250 rpm). Fourier transform infrared (FTIR) analysis proved that the carboxylic acid, aromatic, alk
... Show MoreIn this study, silver-tungsten oxide core–shell nanoparticles (Ag–WO3 NPs) were synthesized by pulsed laser ablation in liquid employing a (1.06 µm) Q-switched Nd:YAG laser, at different Ag colloidal concentration environment (different core concentration). The produced Ag–WO3 core–shell NPs were subjected to characterization using UV–visible spectrophotometry, X-ray diffraction (XRD), transmission electron microscopy (TEM), energy-dispersive spectroscopy, electrical analysis, and photoluminescence PL. The UV–visible spectra exhibited distinct absorption peaks at around 200 and 405 nm, which attributed to the occurrence of surface Plasmon reson
The research aims at determining the type of educational dimensions to be broadcasted in children's television programs, clarifying the technical forms used in children's TV programs, analyzing the educational dimensions provided by children's television programs, and studying the educational dimensions of children's television programs. The researcher used a sample of children's programs: all of us heroes, which is a daily program on the mbc3 channel as well as the program of Tel flowers on the Algerian channel. The researcher designed an analysis content form included categories of analysis. Spss program was used to process the collected data. The research reached several results; the concentration of educational dimensions in
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