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.
מחקר זה עוסק בנושא (העיירה היהודית) שטטל ביצירותיהם של שני סופרים עבריים שהתמקדו בביקורת בשטטל. וזה נחשב להגבלה או למכשול לפיתוחם של היהודים, אז זה התרחש ביצירותיהם והם נתנו תשומת לב רבה לזה –לפי דעתם- גם זה נחשב להיבט בהיסטוריה והחיים של היהודים באירופה.
סופרים עבריים רבים התעסקו בנושא השטטל שנהיתה לחומר ביצירותיהם. גם כן נהיתה אצל כמה מהם לשאלה חשובה, כי אם אנו מוצאים שיצירותיהם לא נטשו את האזכור
... Show MoreAnchusa strigosa - prickly alkanet from Boraginaceae grows in roadsides, and fields of a broad range of habitats from mediterranean woodlands, to steppe vegetation, to true desert. It is commonly known as" him him" or "lisan al thawr". Anchusa can withstand hard weather conditions and hence is widely cultivated. The color of its flowers can range from pure white to deep cobalt blue. Various parts of A. strigosa are used in traditional medicine for treating several diseases or symptoms, such as abdominal pain, bronchitis, cough, and diarrhea. The goal of this study was to examine the cytotoxic effect of the crude extract of A. strigosa roots and leaves and their fractions against various tumor cell lines: adenoc
... Show MoreThis study tackles the contribution of the environmental audit in achieving the sustainability of the environmental balance in the Sudanese business environment. The study aimed at clarifying the role of environmental auditing in supporting sustainable development, and to recognize the role of environmental audit in urging businesses to abide by environmental protection. It also shows how effective the environmental audit reports are, in providing the reliable data for the concerned authorities, in order to use it in making the decisions that would help in the sustainability of the environmental balance. To achieve the goals of the study, a questionnaire was developed and distributed to the registered chartered accountants in Sud
... Show MoreThe Reasons behind the decadence of the studies concerning the evening school in Salah al Deen A field study
This study was based on the determination of aphid species that infested Chrysanthemum sp. (Asterales, Asteraceae) in the middle of Iraq; five aphid species belong to subfamily Aphidinae were recorded: Aphis fabae Scopoli, 1763, Aphis gossypii Glover, 1877, Coloradoa rufomaculata (Wilson, 1908), Macrosiphoniella sanborni (Gillette, 1908) and Myzus persicae (Sulzer, 1776). A. gossypii was the most dominant species throughout the study period while M. persicae is the lesser species.
A summary of the main taxonomic characters is presented here and a pictorial key which was designed to separate aphi
... Show MoreThe transfer of training process occupies a great importance in achieving the ultimate goal of participating in the training programs , it is sure that this does not take place without the support of the working environment for trainees, and The research aims to personification role the work environment characteristics of supporting the transfer of training.
The research problem is the weakness transfer of training to the work en
... Show MoreA field study aimed to improve administrative performance of the Heads of Departments in Wasit University in light of the administrative functions, a questionnaire constructed was c of 38 items, as have been applied during the academic year 2014/2015 to a group of experts from the deans and assistants, professors and heads of departments using the Delphi method by two rounds the adoption rate of 90% and an agreement was numbered 30 experts and study reached important results have been analyzed and discussed according to fields of study, a planning, organization and direction.
The Accommodation industry in Iraq suffers from many problems, especially after 2003, when the Accommodation industry was exposed to many crises due to the security and political situation in Iraq, which negatively affected the administrative operations inside the industry and created many problems, the most important of which are deterioration, high costs and poor performance, so some hotel administrations sought To find alternative solutions that help in the advancement of hotels, one of the proposals is to go to technology, as technology is currently one of the most important solutions to solve large complex problems, as the world has turned to automation to solve complex problems such as increasing production, reducing costs, and rai
... Show MoreTransformations of the actor when acting many characters are the product of joint work between the actor and the director through the instructions and the exercises that facilitate the reach for the desired goal.
The method or way has often been used which is Stanislavsky premises in his work with the actor in the role. The first section consists of two parts under the heading of the actor's work with himself. The two parts are preparing the actor in creative suffering (internal), and in coexistence and embodiment (outside). The second section is the book of the actor's work with the role. The current research aims at identifying the mechanism of the acting performance transformations among many characters of the same actor.
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