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.
Objectives: The aim of the study was, to assess the nurse's role regarding cardiovascular drug
administration in Erbil city.
Methodology: A descriptive survey was conducted in Hawler teaching and Rizgari teaching Hospitals. The
number of samples is 50 nurses; the period of the study was started from 15th of November 2008 up to
the end of March 2009. A questionnaire was developed by investigators based on extensive review of
available studies and literatures. Data were collected through application of observational check list
consist of two part, part one was demographic sheet and part two about nurse’s responsibility regarding
medication administration which include (before, during, after drug administration). Data
Abstract:
The internal control is the tool through which it is possible to verify and ensure the implementation of tasks in accordance with the established plans and programs and to evaluate the level of performance that is implemented within the different companies.
A guarantee from the supplier with the absence of a specialized technical committee that follows up the stages of implementing the contract and disbursing all amounts of financial dues to the supplier before completing the implementation of the contract and overlooking the non-implementation of some clauses of the contract by the committee in charge of
... Show MoreWe have focused the research problem through an assessment of the applicability of the third pillar of the decisions of the Basel Committee 11 (market discipline) or not and its impact on both the adequacy of bank capital, supervisory oversight and banking risks and the statement weaknesses commitment banking institutions and which in turn lead to the stability of the financial system as a whole. .
The research is important statement on the importance of big capital in the banking business and the attributes of a role in the absorption of losses suffered by the bank, which reflects the willin
This research aims to numerous risks to the portfolio of the insurance company that arise from practicing the activity in general, and the risks arising from insurance contracts in particular, and what is the role of the company in the disclosure to help users (such as owners) to understand and concentration of risks in the financial reporting and identifying movable risks size to reinsurers that may affect the solvency of the portfolio and makes them at a given moment required to fulfill the obligations towards policyholders outweigh the financial capacity, which leads to stumble or bankruptcy.
So I sought this research is to identify the extent of the obligation to disclose the accounting for this risk and the extent of their i
... Show MoreThis research aims to Measurement provide the service from Two perspectives The first perspective Service Provider (doctors) and the second recipient of the service (patients) in Numan General Hospital, and represented the research problem in perceptions of medical staff in the hospital assigned to them responsibility by providing superior services satisfy customers, and how they maintained ready to assist customers and provide services that exceed their perceptions of these services through the use of the developer scale by (Frimpong and Wilson, 2012), includes orientation to provide the service scale four dimensions (Internal cooperative behaviors, service Competence, Service Responsiveness and Enhanced service) and includes do
... Show MorePlanning budgets are one of the methods used by the administration in controlling the elements of costs represented by (direct material costs, direct wage costs, and indirect manufacturing costs), and their importance lies in that they reflect what the activity of the economic unit should be in the future. In order to achieve the objectives of the economic unit and to solve this problem, the research was based on the following hypothesis (the role of planning budgets in controlling the elements of costs). , and thus the ability to reduce these costs and thus achieve profits by increasing sales and increasing market share, and the need to urge the state to support the company and the manufacturing sector, which helps and contributes
... Show MoreThe present paper attempts to find out the role of developmental loans in promoting strategic crops especially the basis stemming from the problem of non - defining economic feasibility study and the negative or positive revenues of developmental loans, directed to Iraqi Agricultural sector in general and Basic strategic crops in particular which resulted in the difficulty of planning and future prediction to grant loans agriculturally directed in terms of quality and quantity and the arbitrary of distributing these loans .the strategic crops have been selected as sample of population where the sample of Basic strategic crops include wheat and barley .The paper has come to several of conclusions mainly are as follows :- the increase in n
... Show MoreThe objective of this research to analyze the effectiveness of monetary policy in achieving economic stability and growth for the period 2004-2011 ،This period of time saw a fundamental shift in monetary policy after the issuing new law the Central Bank of the full independence of the monetary authority ،This is Prompt the monetary authority to bring about a change in the philosophy and objectives and the tools used to achieve the desired goals ،Which give them the ability to control the size of the money supply and to achieve price stability Indeed، Monetary policy has been able to achieve the golden triangle of economic stability ،Consisted of staff، exchange rate stability and low and stable general level of prices
... Show MoreThe issue of the research lies in the non-representation of the models developed for the communication process in the interaction and networking processes through social media, as the research sought to build a network model of communication according to the specific data and features of social media platforms in order to reach a special generalization to understand how the process of networking operates in cyberspace.
The researcher followed the analytical survey approach as she described the communication models outwardly in order to be able to build a networked communication model that represents the flow of post-reactive communication. Therefore, it has been named "Nebula - Sadeem" after the concept of post-space and cosmic g
... Show More