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.
يسعى البحث إلى الاهتمام بإحدى الوظائف المهمة في إدارة الموارد البشرية وهي تقويم الأداء التي تواجه مجموعة من الانتقادات والآراء السلبية، اذ ظهر في الأّونة الأخيرة أنموذج جديد يمكن إن يتجاوز تلك السلبيات وهو أنموذج التغذية العكسية المتعدد المصادر درجة .وقد حاول الباحثان توظيف هذا المفهوم في اثنتين من المنظمات العامة العراقية هما (دائرة كهرباء الوسط) التابعة لوزارة الكهرباء
و (دائرة الماء والمجاري) ال
The UV−VIS absorption spectroscopy technique was used to study the formation of a new complex of charge transfer (CT) between bioactive organic molecules as (Nystatin) containing both a π-electrons from a conjugated system and lone-pair of electrons (amine) with Tetrachloro-1,4 benzoquinone (TCBQ) as a π-acceptor in which the transferred electron goes into its vacant anti-bonding molecular orbitals. The Tyrian purple-colored complex formed was quantitatively measured at 544 nm. This complex shows obeying Beer's law within the concentration range of (10-90) μg.ml-1The stoichiometry of the formed complex between the (Nys.) and (TCBQ) was found 1:2 as evaluated by continuous variation (Job's method) and mole ratio method The value of mola
... Show MoreDBN Rashid, JOURNAL OF XI'AN UNIVERSITY OF ARCHITECTURE & TECHNOLOGY, 2020
Background: Insulin resistance is associated with metabolic syndrome , type 2 diabetes and representing a risk factor for cardiovascular disease . This relationship may be modulated to some extent by age related changes in sex hormone status.. In particular, reduced total testosterone (TT) levels have been associated with insulin resistance and subsequent risk for developing type 2 diabetes. Aim of study: we examined whether low total testosterone level were associated with insulin resistance in young adult men. Methods: a total of 83 men (young adult men) divided into 2 group : (group1 ) 49 men with a risk factor for insu
... Show MoreRepresent a topic occupational safety and health management is one of the priorities of the loading organization in the business environment ,and one of the requirement for the success and its impact on the productivity of workers and their performance in an appropriate working environment .The international responses to the problems that accompany the technological and industrial development of the business environment are the issuance of ISO 45001:2018 aimed at providing an appropriate framework for controlling risks , reducing injuries and work accidents and improving work performance ,after realizing the environmental relationship between safe and sound work with competition .The search’s issue is represented with the exist
... Show MoreThe dislocation and gifts at special is the aspect of social life they reflect us how rich and influential class of society, a special category of the ruling category of the caliph and his family and his ministers and his generals and senior statesmen, a powerful and wealth and power and study here dealing with the effect the media for the distribution of dislocations and gifts to the special category both internally and for employers the state and its men or externally represented foreign relations with princes in the state and the regions and include the definition of the concepts above with surrounding contents and events distributed as the some of which were distributed in certain occasions fixed times while others did not have a spe
... Show MoreThe current research aims to identify the degree to which a sample of managers in public organizations appreciated the level of application of the service leadership style from their point of view, and its relationship to the customer satisfaction index in light of the (Covid-19) pandemic, to achieve this, the researcher followed the experimental approach by applying a questionnaire that included two axes, The first: to measure the level of service leadership according to the scale (D. Van Dierendonck and I. Nuijten, 2011), which includes (8) dimensions (empowerment, stand back, accountability, courage, forgiveness, Authenticity, humility, stewardship). The second axis: to measure the level of customer satisfaction according to (Askim, 2004
... Show MoreGroundwater is an important resource that can be used for various purposes. Various factors can change the chemistry of the GW, such as the chemical composition of an aquifer as well as the leaching of human waste into groundwater. The study area is a barren land covered by some sabkhas, in addition to some agricultural fields. The study aims to assess groundwater quality for drinking purposes using the Water Quality Index. The groundwater is chemically heterogeneous and has a wide quality range from very poor to excellent. Evaporation appears to be the controlling factor among the other shallow waters, while relatively deep water is related to rock-soil dominance. Rocks, land use and land cover have helped control the groundwater q
... Show MoreObjectives: The study aims to evaluate the application of monitoring indicators for maternal, newborn and
child health through the evaluation of impact and coverage health indicators and to evaluate the usefulness of the
application of these indicators at sub primary health care centers in Baghdad City.
Methodology: A descriptive comparative design, which is using the evaluation approach, has been steered at
Sub Primary Health Centers of Baghdad City in order to evaluate the application; impact and coverage, and the
usefulness of monitoring indicators for maternal, newborn and child health from December 4th 2017 to April 29th
2018. A multistage, "non-probability" convenient, sample is selected for the present study. A t
The absorption spectrum for three types of metal ions in different concentrations has been studying experimentally and theoretically. The examination model is by Gaius model in order to find the best fitting curve and the equation controlled with this behavior. The three metal ions are (Copper chloride Cu+2, Iron chloride Fe+3, and Cobalt chloride Co+2) with different concentrations (10-4, 10-5, 10-6, 10-7) gm/m3. The spectroscopic study included UV-visible and fluorescence spectrum for all different concentrations sample. The results refer to several peaks that appear from the absorption spectrum in the high concentration of all metal ions solution.
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