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 aim of the research is to:. Preparation and implementation of special educational units using multimedia to learn the skill of scrolling from below. 2 to recognize the impact of the use of multimedia in learning the skill of scrolling from below. 3 to identify the differences between the tests after the two groups research in learning the skill of passing from the bottom volleyball. The research represented the students of the first stage and the sample of the research was drawn randomly and the number of (50) students were divided into two experimental and control groups and each group (25) students were used standardized tests and conducting pre-tests and the implementation of the main exp
... Show MoreIn the past years, the Algerian Economy has witnessed various monetary developments characterized by different monetary and banking reforms aimed by monetary authorities to achieve monetary stability and driving overall growth. It should be noted that there is evidence to initiate fundamental changes on the basis of which new monetary, financing and banking policy mechanisms must be formulated in Algeria by enhancing the pursuit of reforming the monetary system, in order to improve monetary and economic indicators.
The study a
... Show MoreThe heat transfer and flow resistance characteristics for air flow cross over circular finned tube heat exchanger has been studied numerically and experimentally. The purpose of the study was to improve the heat transfer characteristics of an annular finned-tube heat exchanger for better performance. The study has concentrated on the effect of the number of perforations and perforations shapes on the heat transfer and pressure drop across a staggered finned tube heat exchanger. The Numerical part of present study has been performed using ANSYS Fluent 14.5 using SST Turbulent model, while the experimental study consist from a test rig with different models of heat exchangers and all required measurement devices were build
... Show MoreMeasuring the level of communicative competence in news headlines and the level of stylistic and semantic processing in its formulation requires creating a quantitative scale based on the bases on building the scales and their standards. As judging by scientific of journalism studies lies in the possibility of quantifying the journalistic knowledge, i.e. the ability of this knowledge to shift from qualitative language to its equivalent in the language of numbers.
News headlines and editorial processing are one of the journalistic knowledges that should be studied, analyzed stylistically and semantically; their conclusions drawn and expressed in numbers. Press knowledge is divided into two types:<
... Show MoreThis article aims to determine the time-dependent heat coefficient together with the temperature solution for a type of semi-linear time-fractional inverse source problem by applying a method based on the finite difference scheme and Tikhonov regularization. An unconditionally stable implicit finite difference scheme is used as a direct (forward) solver. While by the MATLAB routine lsqnonlin from the optimization toolbox, the inverse problem is reformulated as nonlinear least square minimization and solved efficiently. Since the problem is generally incorrect or ill-posed that means any error inclusion in the input data will produce a large error in the output data. Therefore, the Tikhonov regularization technique is applie
... 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 MoreRandom matrix theory is used to study the chaotic properties in nuclear energy spectrum of the 24Mg nucleus. The excitation energies (which are the main object of this study) are obtained via performing shell model calculations using the OXBASH computer code together with an effective interaction of Wildenthal (W) in the isospin formalism. The 24Mg nucleus is assumed to have an inert 16O core with 8 nucleons (4protons and 4neutrons) move in the 1d5/2, 2s1/2 and 1d3/2 orbitals. The spectral fluctuations are studied by two statistical measures: the nearest neighb
Sickle cell disease (SCD) is a hereditary ailment that can cause severe pain and suffering to people who are affected. However, with continued investment in research and treatment options, we can make progress towards improving the lives of those with SCD. Over 40% of patients experience painful vaso-occlusive crises (VOCs), so we must work towards finding solutions and providing support for those living with this condition, These episodes, a hallmark of SCD, significantly contribute to morbidity, mortality, and a diminished quality of life, while also incurring substantial healthcare costs. Chronic pain particularly affects older adolescents and adults with SCD, with over half reporting daily discomfort. Opioid-based analgesics, though sti
... Show MoreA simplified parallel key was presented in this work for the Taxa of Stackys L. wildly grown in Iraq. Three records within this genus were newly recorded to our country in the present work and they are S. kermanshahansis Rech S. setifera C.A. Mey. subsp setifera, S. setifera ssp iranica (Reck.) The characteristics of these new records were also given with some representative specimens.
The research aims to measure the impact of the empowerment strategy on the performance of employees by mediating organizational trust in the organization. The problem of research was the weak ability of most business organizations to employ the strategy of empowerment in maximizing the performance of employees, and the importance of research in practice lies in the results of a guide to managers in how to use the strategy of empowerment in maximizing the performance of employees by mediating organizational trust dimensions of ability, benevolence, integrity. In order to achieve the objectives of the research and to answer the questions of the problem, the researcher has adopted the descriptive analytical approach as the questionnaire was
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