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 research aims to know the role of strategic flexibility in achieving organizational effectiveness by studying the dimensions of strategic flexibility (capacity flexibility, resource flexibility, information flexibility, and coordination flexibility) on the dimensions of organization effectiveness (environmental adaptation, productivity and achieving goals) through an analytical study conducted in six directorates in the office of the Iraqi Ministry of Education.
The research problem was represented in the form of questions, the most prominent of which was "What is the role of strategic flexibility in achieving organization effectiveness?" The descriptive analytical approach was relied on in applying
... Show MoreThis research amid to measure the impact of organizational flexibility (structural flexibility, operational flexibility, and strategic flexibility) in achieving organizational prosperity and its dimensions (strategic agility, intellectual capital, innovation and sustainable competitive advantage) in a number of Iraqi cellular communications companies. The research adopted descriptive analytical approach. A sample of (85) persons from the research community was selected, which included (Department managers, Directors administrative units, Communication engineers), to answer the questionnaire prepared for this purpose. And to analyze data and derive results. Statist
... Show MoreBackground Direct-acting antivirals (DAAs) combination therapies from various mechanisms of action and families have been revolutionized the management landscape of chronic hepatitis C virus (HCV). Ombitasvir, paritaprevir with ritonavir (OBV/PTV/r) ± ribavirin (RBV) is approved to treat HCV genotype 4 (GT4) infection. Here, our objective was to delineate the efficacy and safety of OBV/PTV/r plus RBV in treating of Egyptian naïve patients infected with HCV GT4.
Methods a cohort of 100 Egyptian patients infected with HCV GT4 was allocated and administered orally OBV/PTV/r with RBV. The primary endpoint of our study was a sustained virological response (HCV RNA < 12 IU/mL) 12 weeks after the c
... Show MoreIn this study the rate of infection in acute and chronic Toxoplasma gondii parasite that causes toxoplasmosis was determined. This study was Included 120 blood samples that collected from pregnant women revisions to some clinics and laboratories in Baghdad civil as well as 10 blood samples from non-infected women as a control group. All blood samples were collected in the first three months of the pregnancy period for detection toxoplasmosis by using serological tests of test kit ( Toxo , IgG.,Toxo , IgM ). To detect antibodies specialized type of IgG &IgM in acute and the chronic infection by Electro Clia manner using a Roche Cobas e411. The results showed that the total infection rate was (55.83)%, the rate of infection in acu
... Show MoreSchiff base derived from PVA and Erythroascorbic acid derivative (pentulosono-ɣ-lactone-2, 3-enedianisoate) was synthesized and characterized by Thin Layer Chromatography (TLC) and FTIR spectra, aldehyde was also characterized by (U.V-Vis), 1HNMR, 13CNMR and mass spectra. The inhibitory effect of prepared polymer on the activity of human serum Cholinesrerase has been studied in vitro. The polymer showed a remarkable activity at low concentration (4.5*10-3 – 4.5*10-8 M).
Pseudomonas aeruginosa is emerging opportunistic clinical pathogens. Clinical isolates of P. aeruginosaresist wide spectrum of antibiotics and form biofilm. The comparison study between clinical and environmental of P. aeruginosa in terms of biofilm formation and antibiotic resistance is very scanty. Thus, in current study microtiter plate technique was used to measure the biofilm formation by several clinical and environmental isolates. Moreover, the antibiotic susceptibility of these bacteria was evaluated by VITIK 2 techniques. The relationship between the antibiotic susceptibility and biofilm formation was evaluated for clinical and environmental isolates. Clinical and environm
... Show MoreBall and Plate (B&P) system is a benchmark system in the control engineering field that has been used to verify many control methods. In this paper the design of a sliding mode . controller has been investigated and verified in real-time via implementation on a real ball and plate system hardware. The mathematical model has been derived and the necessary parameters have been measured. The sliding mode controller has been designed based on the obtained mathematical model. The resulting controller has been implemented using the Arduino Mega 2560 and a ball and plate system built completely from scratch. The Arduino has been programmed by the Arduino support target for Simulink. Three test signals has been used for verification purposes
... Show MoreSkills learning is considered as an important factor in learning any subject as well as mathematics . Mathematical skills have a number of steps that should be learned and understood faster and with more accuracy . The practical or applied skills are type of learning which includes educational preparation and hand on skills is acquired which conducted by organized educational institutions. The sample included (120) students (males and females) first year / dept.of electrical technigues . The mathematical skills are implemented to wire up the electrical circuts. Test is implemented with questions concerned with the skills .statistical operations were conducted as well as the validity and standard deviation for the test .The results showed
... Show MoreIn this work, chemical oxidation was used to polymerize conjugated polymer "Polypyrrole" at room temperature Graphene nanoparticles were added by in situ-polymerization to get (PPY-GN) nano. Optical and Electrical properties were studied for the nanocomposites. optical properties of the nanocomposites were studied by UV-Vis spectroscopy at wavelength range (200 -800 nm). The result showed optical absorption spectra were normally determined and the result showed that the maximum absorbance wave length at 280nm and 590nm. The optical energy gap has been evaluated by direct transition and the value has decreased from (2.1 eV for pure PPy) to (1.3 eV for 5 %wt. of GN). The optical constants such as the band tail width ΔE was evaluated, the
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