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.
This study seeks to address the impact of marketing knowledge dimensions (product, price, promotion, distribution) on the organizational performance in relation to a number of variables which are (efficiency, effectiveness, market share, customer satisfaction), and seeks to reveal the role of marketing knowledge in organizational performance.
In order to achieve the objective of the study the researcher has adopted a hypothetical model that reflects the logical relationships between the variables of the study. In order to reveal the nature of these relationships, several hypotheses have been presented as tentative solutions and this study seeks to verify the validity of these hypotheses.
... Show MoreThe problem of steady, laminar, natural convective flow in an square enclosure with and without partitions is considered for Rayleigh number (103-106) and Prandtl number (0.7). Vertical walls were maintained isothermal at different temperatures while horizontal walls and the partitions were insulated. The length of partition was taken constant. The number of partitions were placed on horizontal surface in staggered arrangement from (1– 3) and ratio of partition thickness (H/L= 0.033, 0.083, 0.124). The problem is formulated in terms of the vorticity-stream function procedure. A numerical solution based on a program in Fortran 90 with the finite difference method is obtained. Representative results illustrating the effects of the thickn
... Show MoreInvestment drives the wheel of the development of different developed and developing countries. Sudan is a model for a developing country facing a lot of difficulties in the field of both local and foreign investment. The present study was focused on the problem of poor diversification and efficiency of both local and foreign investment in Sudan. Also, it clarified the important role of administrative supervision to strengthen the efficiency of investment, taking the experience of the Sudan as a model. The researchers used the well-known descriptive and analytical tools (questionnaire, interview, observation) to complete this study. A well designed questionnaire was used. It included all questions that could cover all aspects of
... Show MoreVehicular ad hoc network (VANET) is a distinctive form of Mobile Ad hoc Network (MANET) that has attracted increasing research attention recently. The purpose of this study is to comprehensively investigate the elements constituting a VANET system and to address several challenges that have to be overcome to enable a reliable wireless communications within a vehicular environment. Furthermore, the study undertakes a survey of the taxonomy of existing VANET routing protocols, with particular emphasis on the strengths and limitations of these protocols in order to help solve VANET routing issues. Moreover, as mobile users demand constant network access regardless of their location, this study seeks to evaluate various mobility models for vehi
... Show MoreIn this paper, we introduce the concepts of Large-lifting and Large-supplemented modules as a generalization of lifting and supplemented modules. We also give some results and properties of this new kind of modules.
The research talks about the interest and its impact on polygamy as a legitimate social psychological issue, where she talked about the concept of polygamy, and evidence of the legitimacy of polygamy, and clarify the conditions, and then touched on the great interests for which the law allowed polygamy, and mentioned some practical models in polygamy, including What is in the interest of men in pluralism, including in the interest of women in pluralism, including in the interests of both sexes in pluralism .
The pilgrimage takes place in several countries around the world. The pilgrimage includes the simultaneous movement of a huge crowd of pilgrims which leads to many challenges for the pilgrimage authorities to track, monitor, and manage the crowd to minimize the chance of overcrowding’s accidents. Therefore, there is a need for an efficient monitoring and tracking system for pilgrims. This paper proposes powerful pilgrims tracking and monitoring system based on three Internet of Things (IoT) technologies; namely: Radio Frequency Identification (RFID), ZigBee, and Internet Protocol version 6 (IPv6). In addition, it requires low-cost, low-power-consumption implementation. The proposed
In this paper we show that if ? Xi is monotonically T2-space then each Xi is monotonically T2-space, too. Moreover, we show that if ? Xi is monotonically normal space then each Xi is monotonically normal space, too. Among these results we give a new proof to show that the monotonically T2-space property and monotonically normal space property are hereditary property and topologically property and give an example of T2-space but not monotonically T2-space.
A disagreement has arisen among scholars regarding the ruling on historical statues and monuments in Muslim countries, especially after the Taliban blew up some huge historical statues, and we have witnessed different positions that reach the point of contradiction, each claiming to be right, and now that the crisis has passed and the intensity of the dispute has subsided, I see It is appropriate to discuss this issue calmly, without drifting behind this or that party, to find out the legal position on these statues and monuments.
I presented the most prominent modern opinions related to the subject and discussed them in this research, which I called (Sharia’s position on historical statues and monuments), in which I tried to reach