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.
Patients with renal failure in the final stages undergo the treatment by hemodialysis. Hemodialysis is used to reinstate the intracellular and extracellular fluid environment, by propagation of molecules in solution through a semipermeable membrane along an electrochemical concentration gradient. Blood catching in the dialysis machine and the recurrent phlebotomy may lead to losing about 1-3 g of iron per year. Prohepcidin hormone is an acute phase protein (type II) that plays a major role in the systemic iron irregularities as it is a mediator of anemia in inflammation and regulator of iron metabolism. This study aims to evaluate the effect of hemodialysis on iron hemostasis and its relationship with prohepcidin as an inflammatory mark
... Show MoreBanks face many of the various risks: which are of dangerous phenomena that cause the state achieved a waste of money and a threat to future development plans to be applied to reach the goals set by: prompting banks and departments to find appropriate solutions and fast: and it was within these solutions rely on Banking risk management and effective role in defining and identifying: measuring and monitoring risk and trying to control and take risks is expected to occur in order to encircle and make it in within acceptable limits: and try to avoid them in the future to reduce the losses that are likely to be exposed to the bank: and it began to emerge and dominate a lot of legislation that seeks to structure the year risk management and t
... Show MoreThe research aimed to achieve many objectives represented in two variables, which are the impacted factors and the aggregate planning alternatives of workforce in Educational Al- yarmouk Hospital , This research started from a problem focused on finding solutions to the demand’s fluctuation or the energy limitation while the study importance is emerged from diagnosis the suitable strategy and adopt the suitable alternatives due to their importance in meeting the demand for the health service submitted by the hospital .This study based on choosing assumptions of connection relationship and the impact among the mentioned variables in the(surgery and internal diseases) departments. The research is dependent on ch
... Show MoreThe study tries to answer several questions posed by the subject, one of the important: How the Internet promotes rumor? And what are the most Internet applications that promote rumor? And the practical ways to reduce these negative? Using the process of in vestige and reading theoretical heritage available in this field, and inferred the numbers and statistics marked the uses of the Internet and its applications over recent years, and the characteristics of each these tools in the field of collection, processing, and dissemination of information
As the child is growing up, he goes through different phases which will be accompanied by physical and psychological changes. These changes set the basis for processes of designing and making children's clothes which in turn give its required benefits and meet the physiological, psychological and community needs. That will help provide the child with healthy physical and psychological growth.
The aim of this research is to recognize the decoration of clothes by colors and drawings and its role in clothes' richness and children's education. The research limits are objective, The limits are for female (3-5) years old. The research was done in teaching kindergarten in the college of education for women in 2016. The researchers found many
The current research aims to highlight the role of social networking sites in the dissemination of scientific knowledge and the importance of their use by researchers, and the researcher relied on the descriptive approach and the survey method. Among the data collection tools are the questionnaire and paper and electronic sources. Among the most important results that the research came out with: The number of the subscribers’ sites was (14) sites, and the most used social sites for receiving and Disseminating Scientific knowledge are: Facebook, Telegram, WhatsApp, Viber, Messenger and YouTube. All respondents receive tacit knowledge (Exchange of Messages and News) through social networking sites, and few of them do not receive explicit kn
... Show MoreRefuse derived fuel (RDF) is considered one of the most important types of low cost thermal energy which can be tapped in the industry, especially the cement industry in particular being the need of high thermal energy during the production processes, and in this paper we have implemented the use of a derivative of the fuel RDF as a substitute for gasoline , to reduce production costs and thereby achieve production efficiency, and the methodology used in this research statistical analysis as well as the use of the cost of kaizen target for the purpose of reducing costs and achieve production efficiency, and this has reduced the cost total cement production by which led to reduce total costs of cement production by 8.4% and an incre
... Show Moreتتبلور فكرة البحث حول التوصل لنوع العلاقة التي تربط التعليم الالكتروني خلال جائحة كورونا برفع المهارات التكنولوجية للأساتذة والطلاب، وتبرز أهمية البحث في ان نجاح الوصول لهذه العلاقة يمكن الإفادة منها في تغيير منهجية تطوير المهارات التكنولوجية مستقبلا وذلك باعتماد الجوانب التطبيقية الفعلية بدلا من الدورات وورش العمل والتي قد لا تضاهي الطريقة العملية في رفع مستوى المهارات المختلفة سواء التدريسية او التكنو
... Show MoreThe current research aims through its chapters to verify the relationship and impact of strategic leadership as an independent variable in the marketing performance as a respondent variable, in a leap cement plant, and try to come up with a set of recommendations that contribute to enhancing the practice and adoption of the two variables in the organization under discussion. And based on the importance of the research topic to the community, and to the researched organization and its members, the analytical and analytical approach was adopted in the completion of this research, and the research community included a leap cement plant in Anbar Governorate, while the research sample was represented by (department heads, and people o
... Show MoreThe problem of the study crystallized in the following main question: What is the role of media awareness in building the student’s personality according to the opinions of a sample of middle school students? The importance of the research derives from the importance of media awareness being an important variable in building the student’s personality. The sample size was (50) students at Al-Kadhimiya Al-Sabahiya Preparatory School for Boys. In this research, a scale was used to measure the role of media awareness in building personality through (16) items on three axes (cognitive, skill, emotional), and the validity and reliability of this scale were extracted, and the results showed the following: