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.
A study has been performed to compare the beddings in which ductile iron pipes are buried. In water transmission systems, bends are usually used in the pipes. According to the prescribed layout, at these bends, unbalanced thrust forces are generated that must be confronted to prevent the separation of the bend from the pipe. The bed condition is a critical and important factor in providing the opposite force to the thrust forces in the restraint joint system. Due to the interaction between the native soil and the bedding layers in which the pipe is buried and the different characteristics between them. Also, the interaction with the pipe material makes it difficult to calculate the real forces opposite to the thrust forces and the way they
... Show MoreThe purpose of this research is to demonstrate the effectiveness of a program to address the problem of mixing similar letters in the Arabic language for students in the second grade of primary and to achieve the goal of the research. The researcher followed the experimental method to suit the nature of this research and found that there are statistically significant differences between the tribal and remote tests, The effectiveness of the proposed educational program. At the end of the research, the researcher recommends several recommendations, the most important of which are: 1 - Training students to correct pronunciation of the outlets, especially in the first three stages of primary education (primary) and the use of direct training
... Show MoreThe importance of this research is due to its importance goals, Which are about the attempt of researchers to investigate the probability of depending on businesses, environments to transform organizations, performance in away that enhance the leading role of organizations in their environments , and through views of a number of the staff working in the foundation of technical institutes in Mosul. .
After deciding the methodology of the study that ,in one hand ,performs the goals of the study , and achieving a suitable theoretical framework to present the concepts of businesses, environments and the leadin
... Show MoreThe study aims to measure the level of academic stress in the e-learning environment in three areas, students and their dealing with classmates, dealing with the professor and technical skills, and the nature and content of the curriculum among graduate students in the College of Education at King Khalid University during COVID-19 pandemic. This study was descriptive in nature (survey, comparative). The sample consisted of (512) male and female graduate students in the master's and doctoral programs. The Academic Stress Scale in the E-learning Environment designed by Amer (2021) was used. The results indicated a high level of academic stress among graduate students in the e-learning environment. The study also found that there were stati
... Show MoreThis study examines the analysis of the contents of the international public relations campaign in confronting the Covid-19 virus, which was taken from the (Your Health is a Trust) campaign for the World Health Organization, Iraq office.The research problem revolves around a main question that is, what are the axes of the campaign (Your Health is a Trust) established by the World Health Organization (Iraq office) in the prevention of Covid 19 virus?From this main question, several sub-questions emerged that this study answered on their Facebook page, and the communication activities of the Covid-19 awareness campaign. In the content analysis form, as this form included a number of main themes and main categoriesthat were adopted in analyzin
... Show MoreThe objective of the study was to identify the effect of the use of the Colb model for the students of the third stage in the College of Physical Education and Sports Sciences, University of Baghdad,As well as to identify the differences between the research groups in the remote tests in learning skills using the model Colb.The researcher used the experimental method and included the sample of the research on the students of the third stage in the College of Physical Education and Sports Science / University of Baghdad by drawing lots, the third division (j) was chosen to represent the experimental group,And the third division (c) to represent the control groupafter the distribution of the sample splitting measure according to the Colb mode
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המשבר הוא מצב מצוי רב בחברת המדינות אחרי המלחמות והשינויים הגדולים במאה העשרים, ומשבר הזהות הוא ממשברי המאה העשרים שזכה בהתעניינות רבה בכל תחומי המדעים האנושיים, ומהם תחום הספרות. ובספרות העברית היה הסופר א. ב. יהושע מהסופרים החשובים שהתעניין בנושא הזהות בישות הציונית, הוא התווכח בנושא ביצירותיו, ראיוניו ורוב הכנסים התרבותיים והפוליטיים שנכח אותם, הוא השתמש באסכולה ספרותית מאו
... Show MoreThe present paper focuses on studying a rhetorical form often used in Spanish linguistic discourse .It also examines the study two sides (theoretical and practical), the concept of metaphor, the most important modern school that deals with this issue, the development of this technique and its relationship with other intellectual ideologies, and the role metaphor plays in interpreting the meaning of the linguistic discourse especially in conveying political message. The study allows the formulation and the creation of a conceptual picture for the purposes of metaphor in the linguistic discourse used in Spanish press. It investigates discursive models from the Spanish press,
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