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.
The research aims to enrich the subject of marketing deception, which is still in the concept stage at the level of the research sample and to allow future researchers to contribute to addressing the concept of marketing deception and linking it with other variables. The research problem is that is there a correlation between marketing deception and organizational reputation in Baghdad assets. What is the reflection of marketing deception on the organizational reputation in the assets of Baghdad? The research is concerned with shedding light on the reputation of the organization in terms of frequency of purchase, place of purchase, brand loyalty, and knowing the impact of marketing deception on these fact
... Show MoreUsing watermarking techniques and digital signatures can better solve the problems of digital images transmitted on the Internet like forgery, tampering, altering, etc. In this paper we proposed invisible fragile watermark and MD-5 based algorithm for digital image authenticating and tampers detecting in the Discrete Wavelet Transform DWT domain. The digital image is decomposed using 2-level DWT and the middle and high frequency sub-bands are used for watermark and digital signature embedding. The authentication data are embedded in number of the coefficients of these sub-bands according to the adaptive threshold based on the watermark length and the coefficients of each DWT level. These sub-bands are used because they a
... Show MoreThe aim of this study was to evaluate in-vitro activity of Cefamandol and Ceftazidime, in combination with potassium clavulanate against 10 uropathogenic E.coli isolated from patients with chronic complicated urinary tract infections (UTIs), these isolates were identified by the Api identification systems.The antimicrobial susceptibility tests were determined by Kirby-Bauer method and the minimum inhibitory concentrations of Cefamandol and Ceftazidime, were determined, by tube method. These isolates were resistant to Ampicillin (Amp), Amoxicillin (Amo), Carbenicillin (Cb), Ticarcillin (Tic), Amoxicillin\ Potassium Clavulanate {Augmentin}, (Amo\CA), Ticarcillin\ Potassium Clavulanate {Timentin} (Tic\CA), Cefamandol (Cfm) and Ceftazidime (
... Show MoreThe current study was conducted on 504(Ros-308) broiler chicks during the period 28/9/2017-9/11/2018to determine the effect of heat shock in early age and additives such as ginseng in three levels on birds weight and feedconsumption. Results showed that the exposure to high temperature (38-400C) lead to significant decrease (p≤≤≤≤≤0.05 (inaverage body weight at7 day of age and significant decrease in body weight in birds expousured to high temperature inthe periods 2, 4 and 6 hours compared with control (Table 1). Significant decrease in live body weight when exposure to2hr compared with 6hr namely (138.54) and (144.21), respectively while no significant difference between 2 and 4h.Results showed no significant effect in body we
... Show MoreWhen sites of new communication occurs which represents the merit of the development of communication technology which is characterized by the services of ( facebook-twiter-corapora-youtube-mass space-friendster-flicker-willnecked in addition to the direct services for viber-whatsup-telgram-and chat on) play important role in changing the infrastructure of Arabic societies which are consideredas closed and not changeable societies during near period and the significance of this study comes from the importounce of this subject which is considered as anew trend of the age on the field of media and public response and acceptance inspite of what is known about Arabic society-it doesn’t accept change-this occurance is associated with terms
... Show MoreThe objective of the research is to determine the nature of the strategic direction of the institution and its impact on enhancing the indicators of institutional performance. The strategic direction is the main purpose for which it was found. Therefore, it is the main engine for all activities and tasks that the institution can carry out to achieve its objectives within the environment in which it operates. The promotion of corporate performance indicators is one of the major challenges that senior management must address in order to help the organization invest its human resources in the best possible way.
The research problem was determined by means of the intentional sample, consisting of (33) members
... Show MoreIn this numerical study a detailed evaluation of the heat transfer characteristics and flow structure in a laminar and turbulent flow through a rectangular channel containing built-in of different type vortex generator has been a accomplished in a range of Reynolds number between 500 and 100,000.A modified version of ESCEAT code has been used to solve Navier-Stokes and energy equations. The purpose of this paper is to present numerical comparisons in terms of temperature, Nusselt number and flow patterns on several configurations of longitudinal vortex generator including new five cases. The structures of heat and flow were studied, using iso-contours of velocity components, vortices, temperature and Nusselt n
... Show MoreBackground: The relation between insulin resistance ,leptin levels and other hormones in women with polycystic ovary syndrome(PCOS) is still controversial.Metformin therapy is proved effective in reducing insulin resistance and also in some studies it was seen to be effective in reducing leptin levels.
Al- Kindy Col Med J 2012 ; Vol .8 No. (2) p: 65
Objective: to study the effect of metformin on reducing leptin levels and enhancing ovulation in PCOS women.
Methods:metformin 500mg 3 times daily for 3 months was was given to 36 women
with proved PCOS, in addition to that, other parameters were included.
Results:28 women out of 36(77.78%) showed an evidence of ovulation ovulation after 3 months of metformin therapy(p<0.01)
The literature shows conflicting outcomes, making it difficult to determine how e-learning affects the performance of students in higher education. The effect of e-learning was studied and data has been gathered with the utilization of a variety of qualitative and quantitative methods, especially in relation to students' academic achievements and perceptions in higher education, according to literature review that has been drawn from articles published in the past two decades (2000-2020). The development of a sense of community in the on-line environment has been identified to be one of the main difficulties in e-learning education across this whole review. In order to create an efficient online learning community, it could be claim
... Show MoreThe current research aims to identify the risk management and its impact on the quality of service in the Salahalddin Sewerage Directorate, This is due to the great impact that the service provided by this institution plays in preserving health and the environment in the community, which has faced many administrative challenges, problems and issues as a result of the rapid and continuous environmental changes, and therefore, the adoption of administrative concepts such as risk management and knowledge of their impact on the quality of the municipal service is necessary to reach this service To the required levels. To achieve the research objectives, two main hypotheses have been formulated, the first of which is to find the extent of the li
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