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 present paper focuses on examining the style of both the civilized dialogue of Prophet Hud (PBUH) in the Glorious Qur'an, and the debated dialogue of Aad’s people. The study consists of an introduction which shows the importance of the civilized dialogue and its significant impact on containing, accepting, and persuading the other in peaceful ways without intolerance and violence. Then, the conditions and techniques of the civilized dialogue and its types have been mentioned. This is followed by the practical side of the study, which involves examining stylistically the techniques used in Hud’s (PBUH) civilized dialogue to be invested later in people’s future conversations. It is also concerned with investigating stylistically
... Show MoreThe research aimed to identify the effectiveness of instructional design according to whole brain theory of Herman in the achievement of chemistry at the fifth scientific students at a secondary school of the General Directorate for Educational in Diyala / Baladruz in Iraq. The research sample Consisted of (57 student, (29) students as experimental group studied according to instructional design strategies for whole brain theory of Herrmann and (28) a student as a control group studied by the usual way for two semesters, a prepared achievement test as article and objective type of multiple choice, the coefficient stability of alpha-Cronbach equation reached (0.86). The research Results showed the presence of a statistically significant d
... Show MoreObjective (s): To assess the QoL of children age from (8- lessthan13) years with acute lymphocytic leukemia undergoing chemotherapy and to find out the relationship between the QoL of children with acute lymphocytic leukemia and their illness history.
Methodology: A descriptive study included (40) children with acute lymphocytic leukemia who were ranged between (8 - less than 13 years) at the Hematology Center in Medical City for the period from 4th March 2021 to 1st September 2021. The sample was non-probability (purposive) sample of children (male and female). A questionnaire designed with 2 main parts was used. The first part focused on sociodemographic characterist
... Show MoreThe subject of research entitled "The Mechanisms of build up the dramatic construction in the films of the world of nature - National Geographic's films as a model" emerges from the importance of the subject of the dramatic construction and its departure from its classic style due to the evolution of the visual presentation and its instruments and the specificity and emergence of a form of television production represented by the films of the world of nature which began to occupy an important space in the map of television and television channels specialized in this subject, which drove the researcher to study the mechanisms of producing the dramatic construction in this kind of film s. This research came in three chapt
... Show MoreThe study aims at analyzing the inconsistent structural and semantic aspects found in the plays of N.A Ostrovsky. The analysis, that includes all the linguistics schools of thoughts in modern Russian language, is performed chronologically to clarify all the ambiguities that the Russian language learners may face. Such difficulties lie in the use of inconsistent aspects with complete declarative sentences and adverbial clauses. Hence, it constructs a new sentence category that consists of secondary clause and its syncretism semantic.
The study illustrates the wide scope of both studying the sentence inconsistent
... Show MoreFor poets to pay a great attention to the Islamic figures and their symbolism in Islam come as a prominent phenomenon in our literature . As there is an impact of them on the brilliant history commemorated by littérateurs . As a matter of fact ، the chronicle of Imam Ali Ibin Abi Talib (peace be upon him) falls in the orbit of the focus Ibn Abi Al-Hadid Al-Mu'tazili steers to in his poems . The current research study is to trace the portrayal of Imam Ali (peace be upon them) in the poetry of Ibn Abi Al-Hadid Al-Mu'tazili ، Seventh Alwiite Poems ، as there is no a study tacking such a conjecture before. In the article there are two axes : the introduction comes as first axis portraying Imam Ali Ibn Abi Talib (peace be upon him) in the wa
... Show MoreIn this study, from a total of 856 mastitis cases in lactating ewes, only 34 Streptococcus agalactiae isolates showed various types of resistance to three types of antibiotics (Penicillin, Erythromycin and Tetracycline). St. agalactiae isolates were identified according to the standard methods, including a new suggested technique called specific Chromogenic agar. It was found that antibiotic bacterial resistance was clearly identified by using MIC-microplate assay (dilution method). Also, by real-time PCR technique, it was determined that there were three antibiotics genes resistance ( pbp2b, tetO and mefA ). The high percentage of isolate carried of a single gene which was the Tetracycline (20.59%) followed by percentage Penicillin was
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Focused research aims to provide a framework cognitive analytical nature of real estate investments and how they evaluated in the light of the assessment tools of modern theory of real options, and the possibility to rely on that theory in the detection of the true value of projects, real estate investments that would maximize the value of the investment decision taken, and the analysis of those projects that arise in the real estate markets and environments is the organization, which she was to make sure cases and high-risk, compared with entrances techniques, discounted cash flow (net present value). Based on the assumption lies in the possibility of the application of the implic
... Show MoreThe research aims to improve operational performance through the application of the Holonic Manufacturing System (HMS) in the rubber products factory in Najaf. The problem was diagnosed with the weakness of the manufacturing system in the factory to meet customers' demands on time within the available resources of machines and workers, which led to time delays of Processing and delivery, increased costs, and reduced flexibility in the factory, A case study methodology used to identify the reality of the manufacturing system and the actual operational performance in the factory. The simulation was used to represent the proposed (HMS) by using (Excel 2010) based on the actual data and calculate the operational performance measures
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From 50 stool samples collected from children with diarrhea of both sexes who visited various hospitals in Baghdad, 26 isolates of E.coli were found to belong to the phylogenetic group E. The findings revealed that the percentage of E.coli for thephylogenetic group E is (52%) , making it the dominant group among the other phylogenetic groups. The findings demonstrated that 100% of the E.coli isolates from phylogenetic group E are resistant to penicillin, and only 15% are resistant to imipenem. Multi-drug resistance (MDR) was found to be 15%, while XDR reached 85%. The results of thephylogenetic group for the remaining species of isolates in this study were group A (2/50 and by 4%), gr
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