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 research tried to show the importance of Administrative Control being one of the important means in administrative work; they work on the review and audit work done and error handling explored in the work and prevent the occurrence and ascertain the extent of implementation of the planned targets, and therefore this is reflected in raising the efficiency of the performance of the tax examiner and complete the work as soon as possible and the highest efficiency and reduce the gaps that may occur between the parties of the tax settling accounts and dealt with in the theoretical side of the search to the research problem, namely with whether operating management oversight to improve the performance and increase the efficiency of t
... Show MoreAbstract
This paper discusses the essence of the developmental process in auditing firms and offices at the world today. This process is focused on how to adopt the audit concepts which is based on Information and Communication Technology (ICT), including the Continuous Auditing (CA) in particular. The purpose of this paper is to design a practical model for the adoption of CA and its requirements according to the Technology Acceptance Model (TAM). This model will serve as a road map for manage the change and development in the Iraqi auditing firms and offices. The paper uses the analytical approach in reaching to the target results. We design the logical and systematic relations between the nine variable
... Show MoreThe purpose of this research is to identify
the effect of the translation of poetic poem into an artistic picture in the achievement of retention among fifth grade students.
In order to verify the research goal, the first two hypotheses were determined. There are no statistically significant differences between the average scores of the experimental group who study (according to the technical picture) ) And the control group (according to the traditional method of art education) at the level of significance (0,05). The second is that there are no statistically significant differences between the average of the experimental group who study (according to the technical picture) and the control group who study (On According to the trad
This study was prepared to investigate the performance and behavior of concrete thrust blocks supporting pipe fittings. In the water distribution networks, it is always necessary to change the path of the pipes at different degrees or to create new branches. In these regions, an unbalanced force called the thrust force is generated. In order to counter this force, these regions are supported with concrete blocks. In this article, the system components (soil, pipe with its bend and thrust blocks) have been numerically modeled and simulated by the ABAQUS CAE/2019 software program in order to study the behavior and stability of the thrust block with different burial conditions (several b
Abstract Lanɡauaɡes, like humans, need communication and interaction to prosper. One of the ways for a language to flourish is to borrow words from other languages. The southern regions of Iran and the coastal countries of Persian Gulf have had strong cultural relations since old times, with language being a dimension of these relations. With their land being geographically located in the realm of Islamic civilization and being Muslims, Baloch people have had strong connections with the Arab world and the Arabic language.Thus, many Arabic words have made their ways into Balochi language either directly or indirectly through persian language. Since each language has its own unique sound structure, these loanwords have undergone ph
... Show MoreBackground: The use of Miswak, chewing sticks (salvadorapersica) can be traced back to Babylonians some 7000 years ago. It is commonly used throughout the world especially for the purpose of oral hygiene. Muslims are using as the religious view. Current study aimed to test the ability of aqueous siwak extract to increase the resistance of enamel surface against acid dissolution compared to sodium fluoride. Materials and Method: Twenty maxillary first premolars were treated with the selected solutions included two aqueous siwak extract concentration(5%,10%) and sodium fluoride(0.05%)as control positive for 2 minutes once daily for 20days interval, de ionized water was used as control negative. The concentration of the dissolved phosphorus i
... Show MoreThis paper deals with an analytical study of the flow of an incompressible generalized Burgers’ fluid (GBF) in an annular pipe. We discussed in this problem the flow induced by an impulsive pressure gradient and compare the results with flow due to a constant pressure gradient. Analytic solutions for velocity is earned by using discrete Laplace transform (DLT) of the sequential fractional derivatives (FD) and finite Hankel transform (FHT). The influences of different parameters are analyzed on a velocity distribution characteristics and a comparison between two cases is also presented, and discussed in details. Eventually, the figures are plotted to exhibit these effects.
Samuel Beckett’s Happy Days (1961) clearly portrays a lack of communication among the characters of the play which refers to the condition of modern man. This failure of communication led Samuel Beckett to use a lot of pauses and silences in all plays written instead of using words. To express the bewilderment of the modern man during the 20th century, Beckett adopts the use of no language strategy in the dramatic works. After World War II, people were without hope, religion, food, jobs, homes, or even countries. Beckett gave them a voice. He used a dramatic language out of everyday things, in which silence was part of the syntax as a poetic repetition. Language is no more important to the modern man; instead, he us
... Show MoreThe research included four topics: the definition of Imam al-Bazzazi, his scientific life, his sheikhs, his students, his writings, his death, and selected issues of his weight in the book of prayer. The Imam al-Bazazi is the son of Muhammad ibnShihabibn Yusuf. He is known as al-Khardizi al-Khawarizmi. The author did not adopt the definitions of language and terminology, and rarely mention the legal evidence adopted by the scholars in their opinions, and only to mention the views only, and the author, may God have mercy on him in his book on the sources of m The Prophet (peace and blessings of Allaah be upon him) said: "The Prophet (peace and blessings of Allaah be upon him) And fall down the order, the third issue, which is to leave the
... Show More