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.
Osteoblast and osteoclast activity is disrupted in post-menopausal osteoporosis. Thus, to fully address this imbalance, therapies should reduce bone resorption and promote bone formation. Dietary factors such as phyto-oestrogens and Zn have beneficial effects on osteoblast and osteoclast activity. However, the effect of combinations of these factors has not been widely studied. We therefore examined the effect of coumestrol, daidzein and genistein in the presence or absence of zinc sulphate (Zn) on osteoclast and osteoblast activity. Osteoclast differentiation and bone resorption were significantly reduced by coumestrol (10- 7 m), daidzein (10- 5 m) and genistein (10- 7 m); and this direct anti-osteoclastic action was unaffected by Zn (10-
... Show MoreIn this paper, we investigate the connection between the hierarchical models and the power prior distribution in quantile regression (QReg). Under specific quantile, we develop an expression for the power parameter ( ) to calibrate the power prior distribution for quantile regression to a corresponding hierarchical model. In addition, we estimate the relation between the and the quantile level via hierarchical model. Our proposed methodology is illustrated with real data example.
This work examines numerically the effects of particle size, particle thermal conductivity and inlet velocity of forced convection heat transfer in uniformly heated packed duct. Four packing material (Aluminum, Alumina, Glass and Nylon) with range of thermal conductivity (from200 W/m.K for Aluminum to 0.23 W/m.K for Nylon), four particle diameters (1, 3, 5 and 7 cm), inlet velocity ( 0.07, 0.19 and 0.32 m/s) and constant heat flux ( 1000, 2000 and 3000 W/ m 2) were investigated. Results showed that heat transfer (average Nusselt number Nuav) increased with increasing packing conductivity; inlet velocity and heat flux, but decreased with increasing particle size.Also, Aluminum average Nusselt number is about (0.85,2.
... Show MoreIn current research Copper was employed for preparing a ternary system of Al–Si alloy in different (0.2–2.5 wt. %) the best was taken is (1.5%wt) of copper that circumstances of solidification for improving the mechanical performance of the available in aluminium alloy. Cast iron molds were prepared to obtain tensile strength testing specimens. Alloys were prepared by employing gas furnaces. The molten metal was poured into a preheated cast-iron mold. The obtained alloy structures were studied using an X-ray diffractometer and optical microscopy. The mechanical performance of the prepared alloys was examined under the influence of different hardening conditions in both heat and non-heat-treated conditions. The outcomes showed at the
... Show MoreForeign direct investment (FDI) is one of the most practical types of foreign investment. FDI contributes to job creation, foreign exchange earnings and national income escalation, improving semi-skill and skilled labor. Based on our knowledge, this paper is the first study attempting to investigate the effect of political stability on the FDI in Turkey using an econometric approach. Achieving this objective, a co-integration analysis was conducted between the FDI and its determinants in the short-run and long-run including “macroeconomic indicators” and “Political Stability (PS)” in Turkey. Using annual data from 1974 to 2017 via Auto-Regressive Distributed Lag (ARDL) model. The results confirm the positive correlation betwe
... Show MoreThis study introduces a series of single and pile group model tests subjected to lateral loads in . multilayered sand from Karbala, Iraq. The aim of this study is to investigate: the performance of the pile groups subjected to lateral loads; in which the pile batter inclination angle is changed; the effect of pile spacing (s/d) ratio, the influence of using different number of piles and pile group configuration. Results revealed that the performance of single negative (Reverse) Battered piles with inclination of 10° and 20° show a gain of 32% and 76 % in the ultimate lateral capacity over the regular ones. For pile groups, the use of a combination of regular, negative and positive battered piles in
... Show MoreInternal control is system,defined and implemented under its responsibility , which aims to ensure that; laws and regulations are complied with; the instructions and directional guidelines fixed by Executive Management or the Management Borad are applied; the company internal processes are functioning correctlly , particularly those implicating the security of its assets; Financial Information is reliable; and generally contributes to the control over its activities , to the efficiency of its operation and to the efficient utilisation of its Resources. By helping to anticipate and control the risks involved in not meeting the objectives the company has set for itself, the internal control system plays akey role in conducting & monito
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The aim of the research is to verify the role of organizational trust as an “administrative” dimension of objective importance in the relationships adopted by the Iraqi General Insurance Company with customers, as it is one of the basic pillars in building and succeeding companies, which allows the provision of services with high confidence through the customer relationship management system in order to achieve The company's goal is to gain new customers, retain current customers, increase work in insurance companies, and develop the national economy by increasing the company's sales and profitability. The research
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The research stems from the problem that focuses on a number of questions. They are as follows: What is the extent of interest in the topic of efficiency by the banks and their role in raising the efficiency of the banking business and its development? Is the banking efficiency used in Iraqi banks clear and specific for the Iraqi banking sector? How the banking sector efficiency is measured and what are the approaches adopted in determining the banking inputs and outputs? What is the level of efficiency in the research sample of the banks and what are the causes of its decline or rise in private banks individually and in the Iraqi banking sector in general?
The re
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