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 aims at diagnosing the importance of environmental analysis (external, industrial and internal) in the organization's strategy for the development of public organizations. The theoretical problem derived from the existence of a knowledge gap for studies and research that dealt with the variables of the study. Three public organizations were selected as the study society (the Civil Defense Directorate, the Directorate of Nationality, Passports and Residency, the General Traffic Directorate). The sample of the study was a sample of (215) managers (managers, department managers, Analysis of the data and hypothesis testing using the appropriate statistical tools, Pearson, the simple and multiple regression coefficient to te
... Show MoreA newly developed FIA-merging zones spectrophotometric system, the method is rapid, accurate and sensitive for metformin hydrochloride determination through the oxidation of 1- naphthol by sodium hypochlorite and coupling with metformin.HCl in the presence of sodium hydroxide to form a blue soluble ion pair and this product was determined using homemade CFIA-Merging zones techniques , at 580 nm. Data treatment shows that linear range is (0.5-35) µg/ ml. The optimization conditions for various chemical and physical conditions of [MTF- NaOCl-α-naphthol-NaOH] system were investigated. The LOD was 0.01µg / ml and LOQ 0.1µg/ml from the lowest concentration of the calibration graph with r2% 99.18 and RSD% did
... Show MoreMultiplicative inverse in GF (2 m ) is a complex step in some important application such as Elliptic Curve Cryptography (ECC) and other applications. It operates by multiplying and squaring operation depending on the number of bits (m) in the field GF (2 m ). In this paper, a fast method is suggested to find inversion in GF (2 m ) using FPGA by reducing the number of multiplication operations in the Fermat's Theorem and transferring the squaring into a fast method to find exponentiation to (2 k ). In the proposed algorithm, the multiplicative inverse in GF(2 m ) is achieved by number of multiplications depending on log 2 (m) and each exponentiation is operates in a single clock cycle by generating a reduction matrix for high power of two ex
... Show MoreThis study aimed to manufacture an innovative device that enables the player to walk after the operation and improves the functional efficiency through the improvement in the range of motion as well as the improvement in the size of the muscles working on the knee joint. The research, the study population consisted of players with severing the anterior cruciate ligament of the advanced soccer players, and the number of the research sample was (5) injured for the control sample and (5) for the experimental sample in Abu Ghraib Hospital and some rehabilitation centers for a period of six months, and the pre-tests were conducted after two weeks of The cruciate ligament surgery was performed, and the innovative device was used for the e
... Show MoreThe study aims to demonstrate the importance of instructional methods in teaching Arabic language as a second language or teaching the Arabic language to non-native speakers. The study is in line with the tremendous development in the field of knowledge, especially in the field of technology and communication, and the emergence of many electronic media in education in general and language teaching in particular. It employs an image in teaching vocabulary and presenting the experience of the Arabic Language Institute for Non-Speakers-King Abdul-Aziz University. The study follows the descriptive approach to solve the problem represented by the lack of interest in the educational methods when teaching Arabic as a second language. Accordingl
... Show MoreThe audit profession today gets an increasing interest by the financial , economic and legal contemporary societies , because of the importance of the technical & neutral auditor’s opinion to the financial reports beneficiaries in order to enable them making their investment decisions , but some of them whom suffered damage or loss when they made that decisions according to the mentioned financial statements which consolidated with auditor’s report , exposed the function to a responsibility and credibility crisis in addition to missing the trust especially at the latest years. They always ask why or what is the reason that cause the auditor didn’t giving us any warning signs about the economic mater for that companies.
Actual and effective organizational dynamic capabilities in the work environment contribute to a number of factors that contribute to the organization's ability to manage its human talents. Thus, the study sought to identify the level of contribution of organizational dynamic capabilities to human talent management based on their dimensions in the investigated organization by determining the level of relationship and impact between these variables. The presidency of Mosul University was chosen as a field for the current study, and data were collected by adopting the questionnaire form as the main tool for the study. The study used a deliberate sample of (42) administrative leaders in the investigated organization and adopte
... Show MoreNo country in the world has an ancient heritage of its own. It represents the product of the civilizations left behind by previous eras. It represents the development of urban life and its capital of the interest of its people in the field of construction and reconstruction. The urban heritage and its associated arts may seem to be a material heritage at first glance, but it is not free from the spiritual side. Therefore, the nations in different parts of the earth cherish it and care for it with all due diligence, because it mixes with its history, memories and emotions.
This research discusses the use of local environment materials in the production of urban fabric constituents. I
RESUMEN
Una joven cuenta cómo, en plena noche, aprovechando la tranquilidad de esa hora, sale a escondidas de su casa y va a reunirse con su enamorado. Envuelta en la oscuridad, se deja dirigir por la luz de su propio amor hasta el lugar de la cita, donde la pasión de los amantes culmina. A continuación, relajados por la brisa nocturna, los amantes se adormecen, primero, el amado velado por la amada, por último, ella misma.
Amor entre dos enamorados. Unión mística de alma y Dios , aunque , de hecho , podría servirnos de clara exposición temática el subtitulo con que el poema suele publicarse en la tradición , tanto manuscrita como impresa : Canciones del alma que se goza d
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