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 aim of this research is to adopt a close range photogrammetric approach to evaluate the pavement surface condition, and compare the results with visual measurements. This research is carried out on the road of Baghdad University campus in AL-Jaderiyiah for evaluating the scaling, surface texture for Portland cement concrete and rutting, surface texture for asphalt concrete pavement. Eighty five stereo images of pavement distresses were captured perpendicular to the surface using a DSLR camera. Photogrammetric process was carried out by using ERDAS IMAGINE V.8.4. The results were modeled by using a relationship between the photogrammetric and visual techniques and selected the highest coefficient of determinatio
... Show MoreThat internal control is particularly important in improvingperformance and tax reform، they play an important role in the regularity ofwork and development and the anti corruption and activating the decisionsand tax legislation، as contained in the organizational plan and the means،procedures and components designed from which to ensure a policy andimplementation plans The research aims to review the reality of the internalcontrol in the General Commission for Taxes and stand on the deficiencies init, with the strengthening of the role of internal control in the GeneralAuthority for taxes based on the laws and regulations and by using modernmeans to work as well as developing the performance of employees in thebody، including helpin
... Show MoreBackground: This in vitro study compares a self-etch primer (SEP) to an etch-and-rinse (EaR) for bonding sapphire brackets by evaluation of the enamel etch-pattern, shear bond strength, amount of remnant adhesive and enamel surface damage following thermal and fatigue cyclic loading. Material and Methods: Ceramic (sapphire) brackets were bonded to 80 extracted human premolars using two enamel etching protocols: conventional EaR using 37% phosphoric acid (PA) gel (control), and a SEP (Transbond Plus). Each group was subdivided into two subgroups (n=20 teeth) according to the time of bracket debonding: after 24 h water storage or following 5000 thermo-cycles plus 5000 cycles fatigue loading, to determine the shear bond strength (SBS), adhesiv
... Show MoreBackground: Menopause can bring oral health problems and also associated with significant adverse changes in the orofacial complex. After menopause, women become more susceptible to periodontal disease due to deficiency of estrogen hormone. Current study aimed to evaluate the periodontal health status in relation to salivary constituent including pH, flow rate and some elements (Magnesium, Calcium and inorganic phosphorus) of pre and post-menopause women. Materials and Methods: Periodontal health status of 52 women aged 48-50 years old (26 pre-menopause and 26 post-menopause) were examined including (gingival index, plaque index, calculus index, probing pocket depth and clinical attachment level). Salivary sample was collected for two women
... Show MoreThe research aims at identifying the importance of scientific research for researchers and in creating new knowledge، development and utilization of mental and cognitive energies and developed them with the ability to research، extrapolation، meditation and then conclusion. The information was collected by interviewing the Secretary-General of the Central Library and by distributing questionnaire forms to the (33) teaching staff of the College of Higher Education. The responses of the society were analyzed the result and the recommendations were the most important 1. Information specialist and all employees of the administrators and technicians in the centers of information sources (libraries) and in the field are considered scientific r
... Show MoreCovalent modification of protein by drugs may disrupt self-tolerance, leading to lymphocyte activation. Until now, determination of the threshold required for this process has not been possible. Therefore, we performed quantitative mass spectrometric analyses to define the epitopes formed in tolerant and hypersensitive patients taking the β-lactam antibiotic piperacillin and the threshold required for T cell activation. A hydrolyzed piperacillin hapten was detected on four lysine residues of human serum albumin (HSA) isolated from tolerant patients. The level of modified Lys541 ranged from 2.6 to 4.8%. Analysis of plasma from hypersensitive patients revealed the same pattern and leve
الاستثمار الاجنبي المباشر في العراق ودوره في تحقيق التنمية الاقتصادية
This study aimed to clarify the importance of ecological taxation in achieving sustainable development, by analyzing a set of economic measures such as taxes, taxes levied by the legislation in the field of ecology, to fight against pollution. And we tried to evaluate this initiative in Algeria. The results of the study showed that economic measures of ecological taxation contribute to achieving sustainable development, and Although Algeria has adopted a series of ecological tax mechanisms, it is far from keeping pace with developments in this area.
The Study aims to show the role of Flexible Budget in planning and control The Factory over head.
The study consists four reaserchs the First introduction for the role of Budget in planning and control The second definition Flexible Badget the Third Factory overhed cost variances Analysis The four conclusions and recommendations.
The factory overhead cost represents great ratio from product cost so the management must planning and control on cost Through the year by the Budget of factory over head in the beginning of the year and determind overhead rater.