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.
A problem of solid waste became in the present day common global problem among all countries, whether developing or developed countries, and can say that no country in the world today is immuning from this dilemma which must find appropriate solutions. The problem has reached a stage that can not ignore or delay, but has became a daily problem occupies the minds of ecologists, economists and politicians took occupies center front in the lists of priorities for the countries in terms of finding solutions to the rapid scientific and radical them. and that transport costs constitute an important component of total costs borne by the municipal districts in the process of disposal of solid waste, so any improvement in the
... Show MoreObjective: The aim of this study is to find out the impact of life events upon onset of depression, to describe the
prevalence of life events among depressed patients.
Methodology: Retrospective a case-control study conducted in AL-Diwanyia Teaching Hospital, Psychiatric
Department on A non-probability (purposive sample) of (60) depressed patients and (60) of healthy person were matched
with them from general population. The data were collected through the use of semi-structured interview by
questionnaire, which consists of two parts (1) divide, section A. cover letter and B. Sociodemographic data which consists
of 9-items, (2) Life events questionnaire consists of 51-items distributed to six dimensions include, family
In light of the increasing interest in Child-rearing in nurseries and kindergartens and the most important experiences gained by the child at this stage that form the basis for the subsequent stages of her/his physical mental and social growth.
The significance of the research concentrates the need to asses the affecting variables on the child growth to create opportunities for her/him to have intact rearing.
The research also aims to classify these variables at each age level and highlight its moral role.
The problem of the research is the lack of clarity of different variables impact of the child growth in different age levels in nurseries and kindergart
... Show MoreIrak Türkmen edebiyatının divan şiirlerinde büyük simalardan sayılan , ve
Irak Türklerinin en içli şairi olan Osman Mazlum .Şiirleri yalnızlık hem ve kederle
dolu olan şairin , her zaman büyük bir üzüntüye kablandığı için bunun tüm
şiirlerinde yansıtmıştır . Her zaman kaderden şikayetci olan şiirlerinde (Mazlum)
mahlasını kullanmıştır . Şairin klasik edebiyatında önemli bir yeri vardır . Hoyrat
yoluyla edebiyata giren mazlum'un gönül yarası bu aşıkla dolunca feyizlenmeye
ve türlü nağmelerle seslenmeğe başladı . İşte bu güne kadar yazmış olduğu şiirler
o sesler hep ahang , terennüm ve tesavırıdır . Bende bu araştırmada i
... Show MoreThe printing designer's creative thinking is a deliberate mental process based on specific skills that stimulate the motivation of the student to learn and call for new information for the investigation and research to discover the problems and attitudes and through reformulating the experience in new patterns depending on the active imagination and the flexible scientific thinking through providing the largest number possible of various unfamiliar printing design models, and testing their suitability and then readjusting the results with the availability of suitable educational, learning and academic atmosphere.
The designer's creative thinking depends on main skills. Fluency skill is to put t
... Show MoreThe research aims at introducing the principles of six sigma and if it had any effect of the dimensions of six sigma to improve the performance of the dentists and the availability of an appropriate environment in the center Specialist respondent to the application of six sigma principles and how to adopt Specialized Center under the dimensions of the six sigma and if there informed enough with the management methodology six sigma, and if you can adopt six sigma as one of the entrances to reduce medical errors. So Search creating six sigma five dimensions and are (the commitment and support of senior management, the focus on the patient, continuous improvement, training and civil, and infrastructure) as a variable int
... Show MoreCorruption has become the subject of great interest, and the subject of research and scrutiny in recent years, because of its penetration in all fields of life, whether these fields are political, economic, social, and administrative. It is one of the biggest challenges and problems that are facing communities. Therefore, this study is focused on the evaluation of measures implementing the national strategy to combat corruption in Iraq.
This study was launched, first because of its intellectual dimensions to ensure a conceptual presentation of the strategy and operational management in general with a special focus on the processes of implementation and control str
... Show MoreThe scientific studies that deal with Herminutia (interpretation) as the art of reading the interpretation practiced by the recipient after his understanding of the literary texts and works of art that he sees or read them so that these readings to make the act of reading and allow him the opportunity to mature and rational reflection of each text or artistic work.
Based on this, the researchers considered the establishment of the problem of their research through the search for the problematic overlap of concepts in the interpretive practices of the literary text?
The second chapter dealt with the definition of the term interpretation as well as interpretation as a theory and concept, and then the indicators reached by t
... Show MoreThis paper aims at the analytical level to know the security topics that were used with data journalism, and the expression methods used in the statements of the Security Media Cell, as well as to identify the means of clarification used in data journalism. About the Security Media Cell, and the methods preferred by the public in presenting press releases, especially determining the strength of the respondents' attitude towards the data issued by the Security Media Cell. On the Security Media Cell, while the field study included the distribution of a questionnaire to the public of Baghdad Governorate. The study reached several results, the most important of which is the interest of the security media cell in presenting its data in differ
... Show MoreAbstract:
The research seeks to identify the role of the International Assurance Standard (3402) in the auditor's procedures, as the importance of the research stems from providing assurance services for control tools through reports that are prepared according to this standard, which contribute to strengthening audit procedures through a proposed assurance program. Many conclusions were reached, the most important of which The assurance operations are considered among the operations with a special assignme
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