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.
Increased downscaling of CMOS circuits with respect to feature size and threshold voltage has a result of dramatically increasing in leakage current. So, leakage power reduction is an important design issue for active and standby modes as long as the technology scaling increased. In this paper, a simultaneous active and standby energy optimization methodology is proposed for 22 nm sub-threshold CMOS circuits. In the first phase, we investigate the dual threshold voltage design for active energy per cycle minimization. A slack based genetic algorithm is proposed to find the optimal reverse body bias assignment to set of noncritical paths gates to ensure low active energy per cycle with the maximum allowable frequency at the optimal supply vo
... Show MoreA new data for Fusion power density has been obtained for T-3He and T-T fusion reactions, power density is a substantial term in the researches related to the fusion energy generation and ignition calculations of magnetic confined systems. In the current work, thermal nuclear reactivities, power densities of a fusion reactors and the ignition condition inquiry are achieved by using a new and accurate formula of cross section, the maximum values of fusion power density for T-3He and TT reaction are 1.1×107 W/m3 at T=700 KeV and 4.7×106 W/m3 at T=500 KeV respectively, While Zeff suggested to be 1.44 for the two reactions. Bremsstrahlung radiation has also been determined to reaching self- sustaining reactors, Bremsstrahlung values are 4.5×
... Show MoreThis current study aims to:
1st: The recognizing of Alexithymia level for 6th grade students (Study Specimen) through the next Zero Hypothesis:1. There are no statistically significant differences at (0.05) level between the arithmetic mean of the specimen degrees as a whole and the central assumption for the scale of the lack in emotions expression
2. There are no statistically significant differences at (0.05) level between the arithmetic mean of the male students specimen and the arithmetic meanc of the female students specimen for the scale of Alexithymia.
2nd: ldentification the level of the emotional intelligence among 6th grade students (Study Specimen) through the next Zero Hypothesis:
1) There are no statistically si
Introduction to Medical Physics for Pharmacy Students and Medical Groups - ISBNiraq.org
In this modern Internet era and the transition to IPv6, routing protocols must adjust to assist this transformation. RIPng, EIGRPv6 and OSPFv3 are the dominant IPv6 IGRP (Interior Gateway Routing Protocols). Selecting the best routing protocol among the available is a critical task, which depends upon the network requirement and performance parameters of different real time applications. The primary motivation of this paper is to estimate the performance of these protocols in real time applications. The evaluation is based on a number of criteria including: network convergence duration, Http Page Response Time, DB Query Response Time, IPv6 traffic dropped, video packet delay variation and video packet end to end de
... Show MoreIn this research, the preparation of a chemically activated carbon from date stones by using electric and microwave assisted K2CO3 activation was studied. The effect of radiation power, radiation time, and impregnation ratio on the yield and Iodine number on the activated carbons was investigated. The activated carbon characterizations were examined by its surface area, pore structure analysis, bulk density, moisture content, ash content, iodine number, FTIR, and scanning electron microscopy (SEM). The adsorption capacity was also studied by adsorption of fluoroquinolones antibiotics, CIP, NOR, and LEVO, by the prepared activated carbon.
... Show MoreThe spectrum of clinical efficacy of Methotrexate (MTX) is broad in that MTX is used in the treatment of certain cancers, severe psoriasis and rheumatoid arthritis.Various mechanisms by which cancer cells grown in tissue culture become resistant to anticancer drugs. The use of multiple drugs with different mechanisms of entry into cells and different cellular targets allows for effective chemotherapy and high cure rates. In an efforts to develop effective strategies that increase the therapeutic potential of anticancer drugs with less systemic toxicity ,are being directed towards the investigation of dietary supplements and other phytotherapeutic agents for their synergistic efficacy in combination with anticancer drugs. A promi
... Show MoreIn this study, we design narrow band pass filter for window (3_5) ?m dependent on the needle optimization method , and a comparison with global designs published -Also, the effect of change parameter design on the optical performance of filter was studded and being able to overcome the difficulties of the design.In this study, the adoption of homogeneous optical properties materials as thin film depositing on a substrate of germanium at wavelength design (? = 4 ?m). For design this kind of filters we used advanced computer program (Matlab )to build a model design dependent both matrix characteristic and Needle technique. In this paper we refer to the type of Mert function , which is used for correct optical performance acces
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Find interested in the harmonization of variables and determinants of supply chain planning needs of the material, leading to the results start effective supply chain management, and end up quickly modify the sizes to suit the demand and turnover in the market. As well as identifying relationships between variables, and type of relationship used by the company with the processors and their feasibility, and indicate the level of interest and willingness to redesign the supply chain Company for Electrical Industries and build an integrated model for supply chain with the MRP system can be applied in the company.
Research depend on quantitative and descriptive method, It
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