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.
In this study, the energy charging mechanism is mathematically modeled to determine the impact of design modifications on the thermofluidic behavior of a phase change material (PCM) filled in a triplex tube containment geometry. The surface area of the middle tube, where the PCM is placed, is supported by single or multi-internal frustum tubes in vertical triplex tubes to increase the performance of the heating and cooling of the system. In addition to the ordinary straight triplex tubes, three more scenarios are considered: (1) changing the middle tube to the frustum tube, (2) changing the inner tube to the frustum tube, and (3) changing both the internal and central tubes to the frustum tubes. The impact of adopting the tube desig
... Show MoreThe chemical composition of wastes of pressed grapes and found that the main components of wastes of pressed grapes, represented by the percentage of moisture was 6.47%, and the proportions are 3.71%. Either carbohydrates amounted to 85.77 %, either in fat models using petroleum ether Petroleum ether) was the increase of 0.27%. estimated the percentage of ash in the sampls was 3.78%, either fiber reached 69.47 %,, in addition to the test extracts towards the growth of seven types of bacteria, which included Bacillus subtilis, Bacillus cereus, Bacillus stearothermophilus, Escherishia coli, Staphylococcus aureus, Salmonella typhimurium and Pseudomonas fluorescens and yeast Candida albicans and Kluyveromyces marxianus, ( diffusion method ).
... Show MoreThe aim of this research is to identify the level of mental mindfulness among female students of the College of Education at Umm Al-Qura University, as well as to identify the statistically significant differences in the level of mental mindfulness according to academic level, specialization, and academic achievement. A mental mindfulness scale was designed to cover five dimensions. The study employed the analytic descriptive approach applied to a random sample of (217) female students from various academic specializations. The findings indicated that the level of mental mindfulness was average among female students. Statistically significant differences were attributable to the academic level, academic specializations, and academic achi
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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 MoreThrough research and research in the creative composition in the poetry of Zafer-Alhaddad it turned out to be superior in its systems, especially that he chose a linguistic and verbal texture accompanied by a cultural dictionary full of creativity and beauty helped this culture arrangement reflects the poetically wonderful and beautiful custom led to the harmony of colors and bodies painted by the poet brush the creative artist evaluates the metaphorical and metaphorical relations that would explain the poets idea, most of which were inspired by the wonderful spirit of nature, its beautiful landscapes and bright colors, especially that we do not forget the beautiful colors and the aesthetic touch that created a fascinating musical intera
... Show MoreThe aim of this research is to construct an educational program in light of the theory of behavioral cognitive and its impact on the development of the efficient response to students affected by crises (centers of your right to education). To achieve the objectives of the research, two scales were developed by the researcher in addition to two equivalent hypotheses were formulated. The scale contains (26) items divided into five fields; for its validity and reliability were derived based on the measure of efficient response, an educational program based on the theory of behavioral cognition. The test and the educational program were applied to a sample of (60) students from the centers of your right to education, divided into experimenta
... Show MoreBackground: The present study was carried out to compare shear bond strength of sapphire bracket bonded to zirconium surface after using different methods of surface conditioning and assessment of the adhesive remnant index. Materials and methods: The sample composed of 40 zirconium specimens divided into four groups; the first group was the control, the second group was conditioned by sandblast with aluminum oxide particle 50 μm, the third and fourth group was treated by (Nd: YAG) laser (1064nm)(0.888 Watt for 5 seconds) for the 1st laser group and (0.444 Watt for 10 seconds) for the 2nd laser group. All samples were coated by z-prime plus primer. A central incisor sapphire bracket was bonded to all samples with light cure adhesive res
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