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.
It is well known that monotherapy does not provide therapeutic response in all hypertensive. Somepatients show an excellent response, while in others there is a poor response. Combinationantihypertensive therapy is administered when blood pressure is inadequately controlled bymonotherapy to achieve a balanced and additive antihypertensive effect with minimum adverse effects.Both angiotensin converting enzyme (ACE) inhibitors and dihydropyridine type of calcium antagonistsare well established and widely used in monotherapy. An understanding of differences in themechanism of action of these agents allows a logical approach for the use of these agents as acombination therapy. This study was designed to evaluate the possible beneficial
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Objectives: The study aims to know the effectiveness of the educational program in the patient’s adherence to medication and diet and to know the relationship between the effectiveness of the education program and their demographic data related to the patient’s age, gender, marital status, education level, occupation, monthly income and residence.
Methodology: A quasi -experimental design study was performed on patient who attended to Gastroenterology and Hepatology Teaching Hospital, from March 2021 to September 2021. The non-probability sampling including 50 patients for case study and 30 patients for control group. The questionnaire consists of 3 parts, part one the socio
... Show MoreSand production in unconsolidated reservoirs has become a cause of concern for production engineers. Issues with sand production include increased wellbore instability and surface subsidence, plugging of production liners, and potential damage to surface facilities. A field case in southeast Iraq was conducted to predict the critical drawdown pressures (CDDP) at which the well can produce without sanding. A stress and sanding onset models were developed for Zubair reservoir. The results show that sanding risk occurs when rock strength is less than 7,250 psi, and the ratio of shear modulus to the bulk compressibility is less than 0.8 1012 psi2. As the rock strength is increased, the sand free drawdown and depletion becomes larger. The CDDP
... Show MorePhraseological or phraseological turn - unchanged in structure and composition, integral in meaning and lexically indivisible phrase or sentence, performing the function of a separate dictionary unit - lexemes. Idioms are found in any language of the world. But such a number of winged phrases, as in Russian, is nowhere else. Idioms play a role in displaying the national-cultural characteristics of any language. They very clearly and accurately reflect the characteristics of the perception of the world, the characteristic features of the material and spiritual life of native speakers, his mentality.
Abstract
The research aims at achieving a set of objectives, which is to study a vital variable in the organizations which is the talent management and its impact on encouraging and empowering employees to take part in making appropriate decisions with their heads in the Iraqi Cement State Company. The problem of this research is in finding solutions to the weaknesses that face the managers in attracting talented employees and keep them in the company, and this leads to a weak capacity of the company on authorizing talented employees and giving them the needed confidence to participate in decision making process. The research sample was included (45) managers in the researched company. Th
... Show MoreUsing the traditional methods in teaching Islamic subject have neglected student's role and focus mainly toward teacher. Thus, the role of student in teaching process would take a negative side: following these methods cannot achieve the educational objectives of Islamic subject. Teachers who give Islamic subject do not have a full knowledge of the appropriate techniques in teaching. They lack the scientific background that qualify them for teaching. The weakness of knowledge that face Islamic teachers have arisen over different stages of education which showed their lacking in the provision of intonation and interpretation of the Quran as well as the utterance of Prophet Mohammed Hadiths. It takes time to train teachers to do a
... Show MoreThe current research aims to diagnose the extent of interest in knowledge sharing and its role in achieving organizational excellence at the level of the Iraqi environment Primary data through descriptive statistics (arithmetic mean, standard deviation, coefficient of variation, percentages, frequencies) and hypothesis testing using appropriate statistical methods for inferential statistical analysis (Pearson correlation coefficient, simple linear regression, multiple regression, path analysis) and checking the quality of the data from During (normal distribution, confirmatory factor analysis, structural modeling method, and exploratory factor analysis), after collecting data from (358) observations from the company’s leaders, as
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The Islamic religion approach Rabbani urges and seeks to bring happiness to people, as Allah says: ((We sent thee not all people glad tidings and a warner, but most people do not know)) Spa: State 28
Islam looks at the concept of educational values through positive behavior derived emerging through formal and informal education. The Islamic approach works on the basis of a systematic and clear rule in the form of an integrated system includes multiple areas. As the lead actor role as the desired position.
Although
This study aimed to clarify the legal provisions concerning the senses and their role in financial transactions, in the light of the definition of all the vocabulary presented by this study (senses - the definition of senses apparent: they are hearing - sight - smell - taste - touch) in the first section. The study deals with the second topic of the reference and writing denominator phrase and includes two requirements, the first requirement: the establishment of the denominator of the phrase, which has two branches: Section I: signal Akhras. Section II: Signal of the Spokesman.
The second requirement is that writing takes the place of the phrase in financial transactions. The owners argue that the sale of the blind is correct a