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 study aimed to know the degree to which Islamic education teachers employ the strategy of directed discovery in teaching to develop higher thinking skills (analysis, synthesis, and evaluation) among sixth-grade students at the basic stage in East Nile Province, Khartoum State - Sudan. The researcher used the descriptive-analytical method, and adopted a questionnaire that consisted of (15) indicators representing the skills of analysis, synthesis, and evaluation as a tool of the study. A random sample of (175) Islamic education teachers was selected, from the Department of Basic Education. The data were analyzed according to the Statistical Packages for Social Sciences (SPSS) program, and the results of the study have shown that the u
... 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.
The 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 MoreBackground: University dental students perceived a higher level of stress prior to the final exam associated with raised salivary alpha-amylase levels which could be considered as a useful noninvasive biomarker for measuring acute stress. Using a Helkimo anamnestic and clinical dysfunction scoring for temporomandibular disorders can give a better insight about the association of this marker and temporomandibular disorders. The aim of this study was to evaluation level of salivary alpha-amylase in stressor students with temporomandibular disorders and the relation between the marker in relation to temporomandibular disorders severity. This might give a better understanding to the role of psychological stress as an etiological factor for deve
... Show MoreBackground: The apical seal is the single most important factor in determining the success of surgical endodontics, the aim of this study was to compare the sealing ability of Mineral Trioxide Aggregate in three different cavity designs. Materials and Methods: Thirty extracted human single-rooted teeth were divided into three groups of ten teeth per group, a retrograde cavity preparation was carried out using a low speed handpiece and round bur with parallel walls in the first group, ultrasonic retrotip and unit in the second group and a low speed handpiece with a carbide inverted cone bur with undercuts in the third group, all the cavities were filled with MTA. microleakage was measured by dye penetration technique using methylene blue. Re
... Show MoreThe use of the Iraqi song in the symphony orchestra is one of the pioneering and important works, which carries with it an artistic value of aesthetic specificity in how to use the Iraqi singing heritage. The research aimed to identify the employment of the song (Foug Al-Nakhl) and its works within the Iraqi national symphony orchestra music by the author Hans Count Momer whose works still have a great influence on the authors of the Iraqi orchestra. The researcher presented a brief introduction to the Iraqi Symphony Orchestra, a brief introduction about the author, and the trends of world music towards heritage. He also talked about musical composition, research procedures and tools, and applying the tool to the selected sample (F
... Show MoreFootball has progressed from being a ritual and a celebration to become an amateur sport, a professional sport, and now, increasingly, a commercial sport. In the analysis of football business model, the systemic approach should be adopted. If sport is regarded as one of the business sectors, then the application of business system methodology can be fully justified. The interest to create strong football business system calls for the search of the ways of popularizing football business model and boosting the economic potential of its participants. In the research literature tend to ignore the business processes within the sports business. Besides, the systemic approach in football business is usually limited to p
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The current research discusses the jurisprudence of the argumentative meaning in the Qur’an, and it is one of the general methods of responses in the Qur’an, as well as the argumentative approach to the recitations of the readers and directing their meanings. I have chosen a model for three verses from Surat Al-An’am, in which there are seven frequent recitations and seven odd ones, on a topic related to theology and faith; It forms the centerpiece of the argument verses in Surat Al-An'am; It contains the jurisprudence of dealing with infidels and dissenters, turning away and forbidding insulting what they claim besides God in the event of corruption, and God Almighty’s decree and wisdom in the occurrence of unbeli
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