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 physical and morphological characteristics of porous silicon (PS) synthesized via gas sensor was assessed by electrochemical etching for a Si wafer in diluted HF acid in water (1:4) at different etching times and different currents. The morphology for PS wafers by AFM show that the average pore diameter varies from 48.63 to 72.54 nm with increasing etching time from 5 to 15min and from 72.54 to 51.37nm with increasing current from 10 to 30 mA. From the study, it was found that the gas sensitivity of In2O3: CdO semiconductor, against NO2 gas, directly correlated to the nanoparticles size, and its sensitivity increases with increasing operating temperature.
One of the important goals in the learning process is to be effective learning through the self-direction of the learner , because it has an impact on the effort of learners , it is better to be a learner responsible for learning and independent of the acquisition of knowledge ,
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... Show MoreThis study Ajert to modify the chemical composition of milk fat cows and make it similar to the installation of milk fat mother through the addition of protein and soybean oil to be given Alkhltatnsp sensory protein that the best plan is the ratio of 1:1
The current research aims at detecting Brain Dominance Learning Styles distinguished
and ordinary secondary school students (males and females).The researcher adopted Torrance
measure, known as ‘the style of your learning and thinking to measure Brain Dominance
Learning Styles’, the codified version of Joseph Qitami (1986); picture (a). The researcher
verified the standard properties of tool. The final application sample was 352 distinguished
and ordinary students; 176 distinguished male and female students and 176 ordinary male and
female students at the scientific fifth level of secondary school from schools in the province of
Baghdad, AL- KarKh Education Directorates in the First and Second . and who have been
Sliding Mode Controller (SMC) is a simple method and powerful technique to design a robust controller for nonlinear systems. It is an effective tool with acceptable performance. The major drawback is a classical Sliding Mode controller suffers from the chattering phenomenon which causes undesirable zigzag motion along the sliding surface. To overcome the snag of this classical approach, many methods were proposed and implemented. In this work, a Fuzzy controller was added to classical Sliding Mode controller in order to reduce the impact chattering problem. The new structure is called Sliding Mode Fuzzy controller (SMFC) which will also improve the properties and performance of the classical Sliding Mode control
... Show MoreObiovisly that the holy thresholds are directly related to Islam and Muslims and related to the general culture of the Islamic peoples. In terms of architecture, it is considered a distinctive architectural scene that reviews the history of this origin and its architectural styles. Recently, with the increase in the number of pilgrims and visitors to the holy shrines, there is a need to develop and expand the buildings and provide them with services and introduce modern technology. The building of the holy thresholds consists of a number of functional design indicators: The general problem of research is that there is no clear theoretical framework for the design indicators for the development of the holy shrines according to the functio
... Show MoreThe research aimed to identify the causal relationship between forgiveness and psychological hardness for university students, by answering the following questions: Does forgiveness cause psychological hardiness? Does psychological hardiness cause forgiveness? Is the relationship between the two variables a reciprocal relationship? The research sample consisted of (300) male and female students from the universities of Baghdad and Al-Mustansiriya University. To extract the psychometric properties of the two scales: forgiveness and psychological hardiness, a sample of (50) male and female students employed to repeat the test, making the six connections between the two research variables. To determine the causal relationship, The Pearson c
... Show MorePurpose: The research seeks to develop the implications of intellectual human capital, and social capital in business organizations, and will be accomplished on three levels, the first level (the level of description) to identify, diagnose and display content philosophical Strategic Human Resource Management at the thought of modern administrative represented by human capital and Ras social capital. The second level (level of analysis) and the analysis of the extent of the impact of alignment between human capital, and social capital in the organizational strength of the organizations. The third level (Level predict) the formulation of a plan to strengthen the organizational strength in business organizations and to develop speci
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