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.
Samuel Beckett’s Happy Days (1961) clearly portrays a lack of communication among the characters of the play which refers to the condition of modern man. This failure of communication led Samuel Beckett to use a lot of pauses and silences in all plays written instead of using words. To express the bewilderment of the modern man during the 20th century, Beckett adopts the use of no language strategy in the dramatic works. After World War II, people were without hope, religion, food, jobs, homes, or even countries. Beckett gave them a voice. He used a dramatic language out of everyday things, in which silence was part of the syntax as a poetic repetition. Language is no more important to the modern man; instead, he us
... Show MoreBackground: The use of Miswak, chewing sticks (salvadorapersica) can be traced back to Babylonians some 7000 years ago. It is commonly used throughout the world especially for the purpose of oral hygiene. Muslims are using as the religious view. Current study aimed to test the ability of aqueous siwak extract to increase the resistance of enamel surface against acid dissolution compared to sodium fluoride. Materials and Method: Twenty maxillary first premolars were treated with the selected solutions included two aqueous siwak extract concentration(5%,10%) and sodium fluoride(0.05%)as control positive for 2 minutes once daily for 20days interval, de ionized water was used as control negative. The concentration of the dissolved phosphorus i
... Show MoreThe current research aims to find out ( the effectiveness of the structural model of learning in the acquisition of geographical concepts at the first grade average students ) , and achieving the goals of research has been formulating the null hypothesis of the following :
" There is no difference statistically significant when Mistoi (0.5 ) between the mean scores of the collection of students in the experimental group that is studying the general geographical principles " Bonmozj constructivist learning " and the mean scores of the control group , which is considering the same article ," the traditional way " to acquire concepts.
The researcher adopted th
... Show More
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
... Show MoreIn this paper solar radiation was studied over the Iraqi countary land. The best sun duration hours regions (maximum hours) in Iraq were estimated detected by using Geographic information system (GIS Ver. 9.2) program to apply the (Inverse distance weighting) IDW exact interpolation technique depending on the measured data of metrological stations were distributed on the land areas of Iraq. The total area of the best regions was calculated .Excel 2007 program is used in calculation, graphics and comparison the results.
Background: Beta thalassemia major is an inherited disorder that may affect general and oral health.The purpose of this study was toassess the severity of dental caries in relation to oral cleanliness, mutans streptococciamong a group of boys with beta thalassemia majorin comparison with a control group. Materials and Methods: The study involved 30 boys with BTM aged 10-12 years compared to 30 healthy boys with the same age group. d1-4mfs and D1-4 MFS indices were applied (Muhlemann, 1976), the viable counts of mutans streptococci in stimulated saliva were also determined. Results: The entire thalassemic group was caries-active. For both dentitions, a higher dmfs/DMFS values were recorded for study compared to control group, difference was
... Show MoreAbstract
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 MoreThe utilization of artificial intelligence techniques has garnered significant interest in recent research due to their pivotal role in enhancing the quality of educational offerings. This study investigated the impact of employing artificial intelligence techniques on improving the quality of educational services, as perceived by students enrolled in the College of Pharmacy at the University of Baghdad. The study sample comprised 379 male and female students. A descriptive-analytical approach was used, with a questionnaire as the primary tool for data collection. The findings indicated that the application of artificial intelligence methods was highly effective, and the educational services provided to students were of exceptional quality.
... Show MoreIn the period after the collapse of the Soviet Union in 1991, the Federal Republic of Russia witnessed a setback in the overall strategic performance of the country, as it went through a stage of performance flop between the orientation towards Europe in the era of President Boris Yelsen (1991-1999), or the change of direction towards Eurasia, as the Russian Federation managed After President Vladimir Putin assumed power in 2000, from rebuilding the same state and preserving national unity and social cohesion, as well as building a phased military doctrine that made clear moves in Russian strategic thought and future directions towards regions of eternal importance in Russian strategic perception Lack of a set of motivations based on it:
... Show More