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 promotion by its means lead a vital and important role at the level of all organizations, whether (industrial or service) in general, and financial markets in particular. The promotion is earns delved to be as one of the main operations which market uses it through various means of financial markets and companies which its shares listed in the aim of (finance or investment), with a view to the implementation and financing of public and private projects the one hand, or with a view to achieving profits through investment of speculative or... For other purposes, on the other hand.Accordingly, we find that the set of public and private goals joint between the financial markets and listed companies respectively, will serve the stra
... Show MoreOne male specimen of the species Metapenaeus stebbingi Nobili, 1904 was first recorded in November 2021 from the Iraqi territorial waters, Northwest of the Arabian Gulf. Therefore, the investigated shrimp species nominally corresponds to the original description of M. stebbing through the main diagnostic features. It must be adopted in the spread and expansion of species, a new record of the area, and a distinctive addition to the species of commercial shrimp within the Iraqi marine waters.
Diarrhea is one of the most commonly encountered minor ailments in the community pharmacies. It is associated with significant morbidity and mortality. However, the majority of pharmacists in Iraq did not manage diarrheal cases in a proper way. Therefore, the current study aimed to evaluate the benefit of a new mobile application (diarrhea management step by step) to improve the pharmacist's role in the management of diarrhea. The study was conducted from 21th September to 21th October 2021 using a pre-post design via a simulated patient (SP) technique. A validated diarrhea scenario was presented to each pharmacist by the SP twice, once before and the other after giving the mobile application to the pharmacist. Furthermore, pharmaci
... Show MoreThe regular job of a reservoir engineer is to put a development plan to increase hydrocarbon production as possible and within economic and technical considerations. The development strategy for the giant reservoir is a complex and challenging task through the decision-making analysis process. Due to the limited surface water treatment facility, the reservoir management team focuses on minimizing water cut as low as possible by check the flow of formation and injected water movement through the Mishrif reservoir. In this research, a representative sector was used to make the review of water injection configuration, which is considered an efficient tool to make study in a particular area of the entire field when compared with the ful
... Show MoreHate speech (henceforth HS) has recently spread and become an important issue. This type of speech in children's writings has a particular formulation and specific objectives that the authors intend to convey. Thus, the study aims at examining qualitatively and quantitatively the classism HS and its pragmatic functions via identifying the speech acts used to express classism HS, the implicature instigated as well as impoliteness. Since pragmatics is the study of language in context, which is greatly related to the situations and speaker’s intention, this study depends on pragmatic theoriespeech acts, impoliteness and conversational implicature) to analyze the data which are taken from Katherine Mansfield's short story (The D
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This study aims to identify the reality of using electronic applications in teaching language skills to people with mild intellectual disabilities from the mothers’ perspective. A descriptive approach was used. The electronic questionnaires were administered to the study sample, 122 responses were received from mothers of the students with mild intellectual disability in Hafer Al-Baten schools. The response average rate was 94%. The results showed that there are statistically significant differences that are related to the variant of monthly income as for the barriers to using electronic applications in such schools, whereas there were no differences regarding the variant of monthly income regarding t
... Show MoreThis research deals with and which was entitled: relationship between psychological time and elements of filming expression (one-day event filmsas an example). It is about the relationship of psychological time (internal) with the elements of filming expression and how the time affected when using these elements in terms of its deceleration or acceleration. In particular, this research focus on elements that slow down time or stops it when using these elements. As one day time is short and heavy at the time of spectators in terms of the large number of film events which makes the viewer runs out of breath to understand the nature of those events and then identify the causes and consequences, as they occur in a short time (one day time) a
... Show MorePurpose: The research aims to build an integrated knowledge framework for the basic research topic. The spirituality of the workplace is through access to the most important scientific proposals on these topics. In management thought framing, the knowledge within them in a serious attempt is to provide the appropriate answers about the intellectual dilemma of research by diagnosing the nature of the relationship with the influential elements and its historical development . Methodology: The study is relied on the analytical survey method. The research sample targeted (88) managers in the center of the Iraqi Ministry of Health exclusively from the researched senior leaders (general manager, assistant general manager, and head of department),
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