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.
Successive waves and generations of terrorists attacked the Iraqis in the years following the fall of the regime in Iraq in 2003, after the US invasion of the country under the pretext of weapons of mass destruction. Hence, the Iraqi people enrolled in ongoing war with these armed groups which led to massive casualties due to blasts and missile injuries.
Mechanism of blasts injury can be classified into primary, secondary, tertiary, and quaternary. While bullet injuries can be classified into low and high-energy injuries, the type and severity of the injury will influence the type of management, together with facilities available in
The aim of this study is to shed light on the importance of biofuels as an alternative to conventional energy, in addition to the importance of preserving agricultural crops, which are the main source of this fuel, to maintain food security, especially in developing countries. The increase in global oil prices, in addition to the fear of global warming, are among the main factors that draw the world’s attention to searching for alternative sources of traditional energy, which are sustainable on the one hand, and on the other hand reduce carbon emissions. Therefore, the volume of global investment in renewable energy in general, and in liquid biofuels and biomass in particular, has increased. Global fears emerged that the excessive convers
... Show MoreThis paper deals with the subjective reflections of consumer values on fashion design. The consumer self is determined by the consumer's idea of himself, according to the intellectual, spiritual and social values, and these values take their intellectual reflection in the form of material values that the consumer finds in fashion design. These values are based on considerations between what is intellectual represented by the values of the consumer, and what is material determined by the fashion design, which also proceed from values that are visible or implied in costume design, such as the function, beauty and symbol. The consumer self gets its material image represented in the
... Show MoreDuring the last quarter century, many changes have taken place in the tanks industry and also in the materials that used in its production، while concrete is the most suitable material where concrete tanks has the benefits of strength, long service life and cost effectiveness. So, it is necessary improvement the
conventional concrete in order to adapt the severe environment requirements and as a result high
performance concrete (HPC) was used. It is not fundamentally different from the concrete used in the past, although it usually contains fly ash, ground granulated blast furnace slag and silica fume, as well as
superplasticizer. So, the content of cementitious material is high and the water/cement ratio is low. In this
stu
A high settlement may take place in shallow footing when resting on liquefiable soil if subjected to earthquake loading. In this study, a series of shaking table tests were carried out for shallow footing resting on sand soil. The input motion is three earthquake loadings (0.05g, 0.1g, and 0.2g). The study includes a reviewing of theoretical equations (available in literatures), which estimating settlement of footings due to earthquake loading, calibration, and verification of these equations with data from the shaking table test for improved soil by grouting and unimproved soil. It is worthy to note that the grouting materials considered in this study are the Bentonite and CKD slurries. A modification to the seismic set
... Show MoreThe aim of this paper is to present a weak form of -light functions by using -open set which is -light function, and to offer new concepts of disconnected spaces and totally disconnected spaces. The relation between them have been studied. Also, a new form of -totally disconnected and inversely -totally disconnected function have been defined, some examples and facts was submitted.
The reliability of optical sources is strongly dependent on the degradation and device characteristics are critically dependent on temperature. The degradation behaviours and reliability test results for the laser diode device (Sony-DL3148-025) will be presented .These devices are usually highly reliable. The degradation behaviour was exhibited in several aging tests, and device lifetimes were then estimated. The temperature dependence of 0.63?m lasers was studied. An aging test with constant light power operation of 5mW was carried out at 10, 25, 50 and 70°C for 100hours. Lifetimes of the optical sources have greatly improved, and these optical sources can be applied to various types of transmission systems. Within this degradation range,
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