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 importance of this research has been to rationalize the cost of producing maize seeds through the followers of modern techniques and methods in agricultural activities such as genetic engineering for increasing production efficiency of maize seeds as well as the importance of calculating seed cost rationalization through the ABC system and thus rationalizing government spending. The research is based on one hypothesis in two ways that the use of genetic engineering on maize seeds works to: one - increase production efficiency of seeds and savings in agricultural inputs. 2. Rationalize the costs of examining and planting maize seeds. In order to calculate the costs will be based on the cost system based on activities ABC. The research
... Show MoreThe continuous technical development in the means of communication and information technologies has led to an increase in competition in the provision of service and product on the part of the organizations, as this competition does not know silence and stability on specific methods, but rather it is a world that is constantly moving and renewed in approaches, methods and approaches, and the focus of attention of integrated marketing communications practitioners are Customers, for them, organizations sell their goods, products, services, and ideas, and with them, they become stronger in competition.
This scientific study aimed to identify the trends of the initiators towards the integrated marketing communications of (the Emirates Tel
Аннотация
В данном исследовании рассматривается символичность (( Джикора )) в лирике иракского поэта ас-Саййаба и перевода лирики o деревне и городе с арабского на русский. Русский читатель пока не имеет возможности познакомиться с стихотворениями Бадра Шакера.
Abstract
The paper aims at making the Russian reader acquainted with the Iraqi Poet Badr Shakir as-Sayyab, and showing the effect of the village an
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Metaphor is a linguistic phenomenon related to people's cultures. It is an integral part of cultural heritage. This paper tackles the use of animal-based metaphors in the field of football club titles so as to draw comparisons between those in Russian with their counterparts in Arabic. Names of animals are used to refer to some clubs and teams, where these names or titles reflect animal features such as strength, preying on victims; or animal figures are employed in the club symbols, or due to the similarity of the club shirt to the animal outer shapes in colours. For instance, "an-Nawaris", which means gulls in English, is used to refer to az-Zawraa club du
... Show MoreBackground: The isthmus is a difficult area in the root canal complex to manage. The research aimed to evaluate the efficiency of three different obturation techniques (lateral condensation, EandQ (thermoplasticized gutta percha system) and Soft Core (thermoplasticized core carrier gutta percha system)) to obturate the isthmus area of roots prepared by two different instrumentation techniques (rotary ProTaper universal and ProTaper Next systems). Material and method: Sixty freshly extracted teeth were randomly divided into two main groups (A and B) of 30 teeth each. Group A was prepared by rotary ProTaper Universal whereas group B was prepared by ProTaper Next system. Each main group was then randomly subdivided into three subgroups of 10 t
... Show MoreThe Islamic architectural heritage constitutes a civilized fortune that has to be preserved and protected and work should be done to maintain its development to be more convenient for the circumstances of the age and the civilization transformations. Due to the fact that architecture represents the civilization pot and cultural identity, its originality has to be preserved and work has to be done to prevent the strange architectural invasion that changes its character and make it lose the identity and the character and detached from its roots and environment.
Decoration, in the interior design, as a concept is connected to ornamentation process of interior spaces, which is a process of adding certain items
... Show MoreThe implicit is the narrative technique used to give indirect hidden messages. To read between the lines means to understand the implicit meaning that is not directly indicated. This technique is expressed in two forms: the hypothesis and the implications of linguistic and non-linguistic rules. Nathalie Sarraute’s "Pour un oui ou pour un non" states this narrative method through her character’s verbal and non-verbal dialogue. The present paper discusses the implicit method and shows the reason behind which the author uses it in her play "Pour un oui ou pour un non".
Résumé
... Show MoreThis study aims to identify the degree of students of Princess Rahma University College owning e-learning skills related to MOODLE as they perceived in the of light Corona crisis. The researchers' questionnaire consisted of (37) items, distributed in three areas of e-learning skills related to the MOODLE on (147) students were chosen randomly. The results of the study showed that the degree of students 'possession of e-learning skills related to the MOODLE was significant. The results also revealed that there were statistically significant differences in the degree of students' possession of electronic learning skills related to the MOODLE due to sex in favor of females. Finally, there were no statistically significant differences in the
... Show MoreAcademic writing is a key skill for success in academic life, particularly for graduate students of a foreign language. The importance of writing to academic culture, practice, and knowledge building has led to a great deal of research in many fields, including rhetoric and composition, linguistics, applied linguistics, and English for Academic Purposes (EAP). Often, studies and research investigating academic writing are motivated by the need to inform the learning of writing to native and non-native English-speaking students, through both descriptions of professional academic writing as well as through comparisons of novice writer (native and non-native Englishspeaking) and expert production. However, while learning about academic writing
... Show MoreBackground: Ultrasound provides a powerful tool for assessing early pregnancy and detecting pregnancy failure at first trimester and promoting rapid effective management. Several criteria have been established to predict the pregnancy outcome particularly in symptomatic women .
Aim: To evaluate asymptomatic women at the first trimester of pregnancy , to assess the efficacy of certain ratios as mid sac diameter (MSD) / yolk sac ratio & crown rump length (CRL)/mid sac diameter (as indicator of early first trimester oligohydramnios) in predicting poor 1st trimester outcome
Type of the study: A cross-s
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