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.
Urban wetlands are one of the complex systems that provide many economic, social and environmental services to the city. In this research, the most important services provided by urban wetlands from the point of view of the urban planner were reviewed, and the types of these lands and their divisions according to the type of services provided by each type were presented. Environmental is represented in its ability to reduce the dangers of floods, mitigate the climate and reduce its negative impacts, purify water and deplete a lot of suspended impurities and pollutants, and social services such as recreational areas and beautiful landscapes that inspire joy and reassurance in the soul, as well as cultural areas and sports activities for m
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We report a method of converting non-conductive plastic surfaces into conductive by plating either copper electroless or copper electroplating -carbon black containing bending Agent onto Perspex plastics . Various approaches have been studied in order to comparing properties of the plated copper for two methods such as scanning electron microscopy (SEM),thickness, roughness, porosity, tensile Strength and elongation. The results show that the surface of electroplating was uniform, compact, and continuous and it had an obvious metallic sheen, while the surface of plated copper for electroless for it had many pores. Also observed that the coating was composed of small cells. Thes
... Show Moreكان لنهاية الحرب الباردة وعولمة العالم على وفق رؤية كونية تتجاوز حدود ومفاهيم السيادة الوطنية والقومية الاثر الواضح في ترتيب العلاقات الدولية , واصبحت تلك العلاقات تدور حول محورين الاول .. هو الاعتماد المتبادل بين الدول من اجل الوصول الى خطوط مشتركة للمصالح المختلفة بين هذه الدول . والآخر.. هو تبعية الدول الضعيفة للدول القوية لافتقار الاولى توفير الحاجيات الى مواطنيها . هذا يشير الى نشأة علا
... Show More. The concepts of structural flexibility became one of the important goals in the design phases to reach high performance in architecture. The pioneering projects and ideas that linked architecture with technologies and scientific innovations appeared, with the aim of reaching projects that mix the concepts of flexibility with the development of machine thought and modern technology to meet the functional, environmental, and aesthetic requirements for human wellbeing. The aim of this paper is to identify the mechanisms used in order to reach flexible structural systems capable of accommodating technological changes and developments. The research hypothesizes that the structural design according to the concepts of flexibility achieves high s
... Show MoreMercury is a heavy metal that is extremely toxic. There are three types of it: inorganic, organic, and elemental. Mercury in all its forms has been shown to have harmful effects on living things. It can multiply its concentration from lower to higher trophic levels and accumulate in the body's various tissues. Aquatic organisms bodies have been exposed to mercury mostly through various human activities. The largest source of mercury pollution in the air is thermal power plants that mostly use coal as fuel. It is carried to a body of water after being deposited on the ground surface from the air. The way it enters the food chain is through aquatic plants and animals. Mercury accumulations in the kidney, liver, gills, or gonadal tissues of sp
... Show MoreDoxycycline hyclate is an antibiotic drug with a broad‐spectrum activity against a variety of gram‐positive and gram‐negative bacteria and is frequently used as a pharmacological agent and as an effector molecule in an inducible gene expression system. A sensitive, reliable and fast spectrophotometric method for the determination of doxycycline hyclate in pure and pharmaceutical formulations has been developed using flow injection analysis (FIA) and batch procedures. The proposed method is based on the reaction between the chromogenic reagent (V4+) and doxycycline hyclate in a neutral medium, resulting in the formation of a yellow compound that shows maximum absorbance at 3
This study aims to study some morphological and reproductional characteristics in eleven species of two genera belonging to the family of Asparagaceae, which are Bellevalia Lapeyrouse, 1808 and Ornithogalum Linnaeus, 1753 and the species are: Bellevalia chrisii Yildirim and Sahin, 2014; Bellevalia flexuosa Boissier, 1854; Bellevalia kurdistanica Feinbrun, 1940; Bellevalia longipes Post, 1895; Bellevalia macrobotrys Boissier, 1853; Bellevalia paradoxa Boissier, 1882; Bellevalia parva Wendelbo, 1973; Bellevalia saviczii Woronow, 1927; Ornithogalum brachystachys C. Koch, 1849; Ornithogalum neurostegium Boissier, 1882 and Ornithogalum pyrenaicum Linnaeus, 1753. These species were identified and compared with each other; the results showed th
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The curriculum is the major effective tool in achieving the goals of
education and society.
Many countries that want to reach the forefront of developed countries
through their curriculum have realized this fact. School text book, the
application assessment for knowing the rang of success or fail of this text
book in achieving the general aims. therefore this study aims at assessing the
principals and techniques of geography text book for fourth secondary class of
literary studying from the teachers point of view according to the fields of the
book, style of material, technical arrangement of the material, ethnical
arrangement the language of the book, style of the material, technical
arrang