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.
It is a common Knowledge that adverbs in Turkish languages can modify verbs, adjectives, nouns or other adverbs. Moreover, adverbs can determine the meanings of nouns and verbs in a sentence as far as time, place, manner, quantity and interrogative are concerned. The present study debates adverbs’ functions in Namiq Kamal’s play Vatan yahut Silistre.
The study sheds light on the author’s use of the adverbs to describe the required theatrical actions of the play and to convey his reflections and thoughts easily to the auidence. One of the main hindrances encountered in conducting the study is the shortage of the upto date academic resources necessary for
... Show MoreThis research aims to know the reality of succession planning in the researched organization and how it occupies the important jobs in the organization and its readiness for sudden and urgent events that lead to the vacancy of these jobs, and the importance of this research is that it is one of the rare Arab and Iraqi studies and research in this field, as it is one of the first researches It deals with the reality of succession planning in light of the retirement law No. (26) of 2019, and the research problem was the absence of consecutive planning programs and the weak preparation of suitable candidates to face sudden and urgent conditions as replacements for current leaders who occupy the leading and key positions in the depar
... Show MoreThere is no doubt that each of the arts has a material from which the aesthetic achievement is built, so the researcher found that the art of theater, especially the show, whose artistic achievement is based on the body of the actor who emits the formal language (body language), is the focus of interest and active presence, because the body possesses its spiritual qualities that made him and the ability to The formation of things by (his body language), so the researcher studied this theatrical phenomenon and divided it into four chapters. In the first chapter, the research problem included the following question: (Is there a phenomenon of body language in the contemporary theatrical show "Imagine that" as a model) so It is of cognitive
... Show MoreA pure posteriorly posterior communicating artery (PCoA) aneurysm represents a surgical challenge. This is mainly when there is a need for good exposure of the aneurysmal neck, sac, PCoA, and anterior choroidal arteries. Ruptured pure posteriorly directed PCoA aneurysm imposes significantly extra challenge as the surgeon undergoes dissection through a tight brain. Even with measures commonly used to attain brain relaxation like the lumbar drain and cisternal fenestration. Here, we describe a technique for posterior temporal pole mobilization (TPM) as an integrated part of microsurgical clipping of ruptured pure posteriorly directed PCoA aneurysms. This technique is implicated in twenty-three successive cases of ruptured PCoA aneurys
... Show MoreThe sustainable competitive advantage for organizations is one of the requirements for value creation, which centered on the possession of scarce resources that achieve maximum flows to invest in intellectual capital, if what has been interest in them, measured and employed the way properly and style, so I figured the need for new technologies to enable organizations to measure the intellectual and physical assets and to assess its performance accordingly, so it sheds search light on the measurement of the added value of existing knowledge using the standard value-added factor is the intellectual (value added intellectual coefficient) (VAIC) and to develop a set of assumptions about the extent of the difference between the sample
... Show MoreBackground: Trauma is one of the most common
clinical problems that confront the maxillofacial
surgeon and radiologist alike. Middle third facial
fractures are diagnosed primarily on the bases of
clinical examination and plain radiographs than can
result in much preoperative speculation.
Objective: To assess the advantages of spiral
computerized tomography over conventional
radiography in the pre-surgical evaluation of middle
third facial fractures.
Methods: Thirty patients with thirty-eight facial
fractures were studied, all patients were examined
clinically, by plain radiography and then by spiral CT.
Results: Of the 38 middle-third fractures, 16
(42.1%) were zygomatic fractures, 8 (21.1%) were
The 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 total of 30 specimens of house sparrow Passer domesticus biblicus Hartert, 1904 (15 females and 15 males) were collected from gardens of some houses in Baghdad city; all birds were dissected to identify the parasites in vesicle, gizzard, intestine, gall bladder and caecum. One species of trematodes Brachydistomum microscelis (Yamaguti, 1933) was found in the gall bladder and two species of cestodes Anonchotaenia globata (von Linstow, 1879) and Raillietina tetragona (Molin, 1858) were found in the small intestine of house sparrow. Morphologic and morphometric measurements were considered.
The genus Brachydistomum Travassos, 1944 is being recorded for the first time in Iraq in the gall bladder of house sparr
... Show Moreobjective the research to diagnosis and interpretation of the nature of the correlation between the basic elements of knowledge management (tecgnology , structure , culture , process , human resource ) and the strategic performance of the Iraqi private banks, the research community and the level dimensions, and tested this research in the private banking sector represented by (7), especially in Baghdad city, Iraqi banks, and applied on sample consisting of 100 distributors in several administrative levels Director (Director, Director of the department, branch manager), and use questionnaire Head to collect data and information tool, and some private banks annual reports, has sought research to test a number of h
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