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 paper aims at measuring and analyzing the influence of the stock exchange on the economic development in the Kingdom. This is done through comparing the Gross Domestic Product (GDP) as a changeable factor affiliated with some independent variables in the KSA stock exchange. These variables are (All Share Index {TASI}, Market Value, Trade Volume Index, number of companies and number of shares). The study covers the period from 2003 to 2017 and adapts the measuring method in analyzing this relation using the Multiple Linear Regression (Stepwise) and (SPSS). The study affirmed the validity of the
... Show MoreThe problem of divorce from the phenomena that characterized the nature of privacy,
although their impact beyond the individual to include the community as a whole, the parties
to the relationship affected by divorce caused them harm moral and material for a long time,
resulting imbalance in the personal relationship and family and social relations because of the
high divorce rates, particularly in Iraq high rates of 28690 thousand cases in 2004 to 59 515
thousand cases in 2011 and an increase of more than (100%) during the period above, and this
rise caused by aggravation of many of the problems led the reasons for social, economic and
incompatibility spouses, health and lack of reproduction, not spending The wife a
The advancements in horizontal drilling combined with hydraulic fracturing have been historically proven as the most viable technologies in the exploitation of unconventional resources (e.g., shale and tight gas reservoirs). However, the number of fractures, well timing, and arrangement pattern can have a significant impact on the project economy. Therefore, such design and operating parameters need to be efficiently optimized for obtaining the best production performance from unconventional gas reservoirs. In this study, the process of selecting the optimal number of fractures was conducted on a section of a tight gas reservoir model (based on data from the Whicher Range (WR) tight gas field in Western Australia). Then, the optimal number
... Show MoreThe research aims to a statement of specificity of the Controller of (academic achievement, specialty, job title, length of service, Gender) and its impact on performance, Through a proposed appraisal form includes three main axes and each axis including several specialized elements in the supervisory work in form (check list). as is the importance of research to enable officials of oversight bodies financial identify and diagnose performance Controller through what has this observer of the process of scientific properties when performing supervisory work. Be summarized problem of the research that the lack of regulatory institution with the Controller interesting in terms of the necessary characteristics and requirements and inv
... Show MorePesticide poisoning is a serious global public health issue and is responsible for a sizable number of annual fatalities. This study was designed to examine the potentially harmful effects of adult rats being exposed to imidacloprid (IMD) as a nanoparticle by determining the chronic effect of inhalation of (5,10 and 20) mg/kg/b.w. of nano-imidacloprid for a duration of 60 days. The most important biochemical parameters of the serum liver function parameters were aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase ALP, kidney function [blood urea, creatinine, and urea], and oxidative stress parameters (MDA, GSH, and CAT) in all treated groups when
represent websites link support of human communicate and cohesion of cultures different depending on their languages and their environments around, it was the evolution of one of the most important means of communication of services for electronic networks, the Internet active role in containing the world Bbodqh science and knowledge to Taatlaqah cultures from which derives its intellectual and cognitive cupboards continuity and as a link language for each those environmental Altdadat, linguistic, religious, political, economic . We all know that these electronic means difficult promise ring intellectual and mental connectivity for the masses polarized without being of the image as an element Kravekaa supporter of the electronic media an
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