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 role of filamentous bacteria represented by Streptomycessp was studied as biological treatment for activated sludge AL- Restomia treatment unit in Baghdad city. The result shows reducing in phosphate concentration where apprise in started entrance the treatment unit 12.083 mg/L fast the unit stages reached to 8.426 mg /L where nitrate concentration apprises 3.59 mg/l and ending in 2.43 mg/L The concentration of ammonia apprises 1358 mg/L and reached to 140 mg/L. also the TDS concentration reduced from 1426 to 1203 mg/L where nutrient which represented (SO4, Mg, Ca, Na, K) reduced by range 30.883- 23.337 , 194- 121 , 440- 321 , 109.03- 101.53 and 16.85- 15.4mg/L respectively COD reduce from427.263- 82mg/L with absorbance0.018- 0.027
... Show MoreThe banking sector is a cornerstone of the national economy because of its large role of economic development of a country, which requires the advancement of this vital sector and interest in all the accompanying changes to him in order to survive and grow and continue Accordingly dealt Find reversal (organizational culture, on the quality of banking service ) sought search to achieve a number of cognitive and practical goals by selecting (10), especially among the working banks in Iraq Iraqi banks and the period is the surveyed period (2005-2014) embodied the research problem in the dialectical relationship between the (organizational culture) and its impacts on banking service quality.
Through a set of
... Show MoreThe banking sector of all kinds is the backbone of the economy in all countries, as it is the main financier of most economic projects in order to achieve economic development and achieve stability, which contributes to providing the necessary resources in return for obtaining a profit margin in exchange for giving up his money and bearing credit risks. Among the aforementioned banking sectors are: Islamic banks that invest their capital in several forms in order to obtain profits that enable them to continue and grow, and the most important of these formulas is the Murabaha formula, which is summarized by the bank selling a commodity after owning it and then selling it to the applicant for this commodity based on a prior request
... Show MoreThis research is based on monitoring the local and environmental technologies in the design of the temporary hotel units (nomadic tents) in the desert in the south of Jordan in order to air condition them in summer and winter, maintaining the Jordanian identity, that they are presented with the form and technologies of the age in order to get to the universality.
The research adopted the descriptive analytical method and the researcher conducted the analysis of SWOT specified for the analysis of the positive and negative aspects in the design of the temporary hotel units and comparing them with the case studies available in the chosen research area "the Jordanian golden triangle", through the elements of the case under study. The res
Abstract
quality issue is the only issue the interesting in recent years of the last century, but also came out of sync with the other issue is the issue of environment, Where they have become represent two sides of one currency, challenges faced by the world and raised by the environmental problems have made industrial organizations pay great attention to the environment by improving their environmental performance, and that's where the oil industry is one of the most dangerous industries, influential and damaging to the environment due to the organizations move away from oil for adoption The application of EMS then a tool to improve environmental performance has been chosen sam
... Show MoreThis research aims to know and the role of the marketing recovery dimensions in improving the organization's reputation through an exploratory study of private banks in the city of Baghdad. The aim of the research is to define the role of the marketing recovery through its dimensions (compensation, apology, speed of response, assistance and problem solving), in improving the organization's reputation, as the research will attempt to provide a theoretical framework for the dimensions studied through the most important of what researchers presented and then conduct the applied aspect of the research. Data were collected using a questionnaire-based survey consisting of 35 questions and distributed to 110 managers of private banks in
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To identify the importance of the role of succession planning in developing human capital in organizations in light of the accelerating and dynamic events and changes in the work environment, and the research problem indicated the seriousness of employees retiring or leaving their positions for any reason and the extent of its impact on the organization in creating gaps in leadership and problems In managing the talent injection because there will be a shortage of talent, which in turn will affect the general performance of the business in the researched institute, so the importance of research appears in trying to present a set of solutions through which some of the problems facing the organization in quest
... Show MoreCryptosporidiosis is mainly cause a persistent diarrhea in immune compromised patients, BALB/c mice have been suppressed by dexamethasone, tissue Th1, Th2 and Th17 cytokines concentrations in the ileum were significantly diminished in both infected and immunosuppressed mice. Level of IFN-g, TNF-a, IL-12, IL-6, IL-17A was increased in level, IL-4 didn’t increases, in both ileal and spleen tissue. Levels of above cytokines were examined in spleen in order to follow the proliferation of CD4+ T-cell during C. parvum infection.