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 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
... Show MoreThis study explores the role of nanomaterials in the performance of asphalt binders and mixtures. Two commonly available nanomaterials, i.e., nanosilica (NS) and nanoalumina (NA), were used at contents of 0%, 2%, 4%, 6%, and 8% by weight of asphalt binder. A set of experiments was carried out at the binder level to investigate properties such as penetration, softening point, aging-related mass loss, nanomaterial dispersion (storage stability), and workability (rotational viscosity). In addition, the suitability of NS and NS was also assessed through the testing of nanomodified asphalt mixtures, which focused on Marshall properties, the resilient modulus, moisture susceptibility, permanent deformation, and fatigue resistance. The findings in
... Show MoreField experiment was conducted by using two fertilization systems (i.e.) biofertilizers (inoculation with Pseudomonas putida and with Azotobacter chroococcum and non - inoculation) and chemical fertilization (100%, 50% and 25% of recommended by Ministry of Agriculture) to study the influence of these system and interaction on water and grain yield productivity, some growth phytohorones and number of bacterial cells in soil rizosphere of root of wheat crop under water scarcity. The result showed that the integrate fertilization (inoculation with Pseudomonas putida and Azotobacter chroococcum bacterial + 50% of the recommended chemical fertilizer) recorded 5.70 and 5.55 t ha-1, respectively with reducing the chemical fertilizer app
... Show MoreABSTRACT The importance and objectives of the study were an attempt to understand the methodology of disseminating radical thought and the reasons of social acceptability that make young people embrace this thought. It also sheds light on the impact of this phenomenon on the regional role of Egypt and examines the strategic means and standards that the Egyptian state focuses on in immunization and prevention of extremism.
Abstract
The study seeks to use one of the techniques (Data mining) a (Logic regression) on the inherited risk through the use of style financial ratios technical analysis and then apply for financial fraud indicators,Since higher scandals exposed companies and the failure of the audit process has shocked the community and affected the integrity of the auditor and the reason is financial fraud practiced by the companies and not to the discovery of the fraud by the auditor, and this fraud involves intentional act aimed to achieve personal and harm the interests of to others, and doing (administration, staff) we can say that all frauds carried out through the presence of the motives and factors that help th
... Show MoreBackground: The menopause is physiological changes in women that give rise to adaptive changes at both systemic and oral level. During menopause, ovarian function declines and the production of sex steroid hormones reduces significantly affecting the oral tissues and periodontal structures leading to chronic inflammation of the gingiva, increased risk of tooth loss. Aim of study: The present study was designed to estimate the oral hygiene status in relation to salivary estradiol level among pre and post-menopausal women. Materials and Methods: Ninety women aged 48-52 years old, the control group consisted of 45 pre-menopausal women and the study group consisted of 45 post-menopause were examined for gingival index, plaque index and calcu
... Show MoreThe tourism activity is one of the pillars on which the economy of any country is based , the importance of the tourism sector is reflected in its potential to become an effective development alternative in many countries, especially Iraq ,this has a direct impact on the national economy as an important source in attracting hard currency and eliminating unemployment. Adding the Iraqi Marshlands to the list of effects makes it contribute to diversification of sources of income and stimulating rest of the economic sectors, the potentials and qualifications possessed by Iraq in the field of tourism and monuments have a significant impact on the state budget if they were exploited optimally. The research aims at identifying the contr
... Show MoreDocumentary Credit passes through many practical phases starting from Opening credit and matching documents and payment of the amount of credit……etc. It is worthy to mention that there are several aspects that are varied and differed from Bank to another one which can offer Competitive Advantage for the bank …This will be shown in this research.
For the purpose of achieving the objective of this research within the theoretical aspect, the researcher had seen and briefed several books and researches which are mainly related to the subject of the research.
As for the practical aspect, has included Questionnaire which included many questions that are fit and suitable to the hypotheses.
Research sample has
... Show MoreBackground :Alkaline phosphatase (ALP) was a widely used marker for skeletal and hepatobiliary disorders, but its activity was also increased in atherosclerosis and peripheral vascular disease. Several study has showed that ALP activity was increased in the sera of diabetic patients. The current study was conducted to evaluate ALP activity in type 2 diabetic patients and optimum conditions for enzyme activity in their sera.Methods: This study was carried out at in AL-Yarmok hospital(diabetic center) between February /2009 and April /2009. Fifty two patients with type 2 diabetes have been enrolled. Besides BMI, WHR, serum fasting blood glucose, ALP, HbA1C,uric acid and lipid profile levels have been performed .The relationship bet
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