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.
Faintly continuous (FC) functions, entitled faintly S-continuous and faintly δS-continuous functions have been introduced and investigated via a -open and -open sets. Several characterizations and properties of faintly S-continuous and faintly -Continuous functions were obtained. In addition, relationships between faintly s- Continuous and faintly S-continuous function and other forms of FC function were investigated. Also, it is shown that every faintly S-continuous is weakly S-continuous. The Convers is shown to be satisfied only if the co-domain of the function is almost regular.
An intelligent software defined network (ISDN) based on an intelligent controller can manage and control the network in a remarkable way. In this article, a methodology is proposed to estimate the packet flow at the sensing plane in the software defined network-Internet of Things based on a partial recurrent spike neural network (PRSNN) congestion controller, to predict the next step ahead of packet flow and thus, reduce the congestion that may occur. That is, the proposed model (spike ISDN-IoT) is enhanced with a congestion controller. This controller works as a proactive controller in the proposed model. In addition, we propose another intelligent clustering controller based on an artificial neural network, which operates as a reactive co
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Mobile-based human emotion recognition is very challenging subject, most of the approaches suggested and built in this field utilized various contexts that can be derived from the external sensors and the smartphone, but these approaches suffer from different obstacles and challenges. The proposed system integrated human speech signal and heart rate, in one system, to leverage the accuracy of the human emotion recognition. The proposed system is designed to recognize four human emotions; angry, happy, sad and normal. In this system, the smartphone is used to record user speech and send it to a server. The smartwatch, fixed on user wrist, is used to measure user heart rate while the user is speaking and send it, via Bluetooth,
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To achieve the goals, the researcher followed the design of equal and independent groups of partial control and post-test . The research has chosen the Institute of Fine Arts in the area Almansour area as deliberate sample where three sections of students have been chosen and the number of students is (69) students. The researcher conducted equivalence in the variables (age, and IQ , and the overall rate for grade III). in diagnostic phase, (21) concepts of alternative image out of (46) concepts have been identified in addition to the goals of formulation of acquisition concepts according to the three processes (definition, discrimination and application). Achievement test has been
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The current research problem includes a variety of research motivations to serve the private health sector, which is witnessing a great competition from internal and external environments. In this regard, private medical clinics are increasingly seeking to attract and retain customers through the quality of their service offerings represented by health services. Innovative and effective marketing methods to improve performance and stay in competition, by relying on the physical evidence of the product as a component of the marketing mix of services and its role in particular in packaging and supporting the health service with concrete evidence that affects the customer an
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