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 e-commerce is one of the best achievements of the twentieth century, since the conduct commercial transactions via the Internet may be the consumer easy selection process and purchase convenient manner different from traditional methods, and with the beginnings of the new millennium impose the emergence of e-commerce term significant challenges to the insurance industry as an important economic sectors Generally, and insurance companies in particular as a result of scientific development, which has led to a reduction in costs and innovation in the production, which led to intense competition on both levels local or global. The insurance industry is a vital part of the economy and it has a varied impact to the community and individual
... Show MoreBackground: Cardiovascular disease (CVD) is the number one cause of death worldwide. Objective: To determine of coronary care unit nurses' knowledge regarding patient rehabilitation after myocardial infarction. Methodology: A cross- sectional study was designed in the Cardiac Care Unit of Al-Diwaniyah Teaching Hospital and the Specialized Center for Cardiac Surgery and Catheterization for the period from (November 7, 2022) to (May 12, 2023). A non-probability (purposive) sample consisting of (75 nurses) working in the above-mentioned study site. To determination of coronary care unit Nurses' knowledge regarding patient rehabilitation after myocardial infarction, the researcher used a tool that consists of two parts: The first part:
... Show MoreExamining and comparing the image quality of degenerative cervical spine diseases through the application of three MRI sequences; the Two-Dimension T2 Weighed Turbo Spin Echo (2D T2W TSE), the Three-Dimension T2 Weighted Turbo Spin Echo (3D T2W TSE), and the T2 Turbo Field Echo (T2_TFE). Thirty-three patients who were diagnosed as having degenerative cervical spine diseases were involved in this study. Their age range was 40-60 years old. The images were produced via a 1.5 Tesla MRI device using (2D T2W TSE, 3D T2W TSE, and T2_TFE) sequences in the sagittal plane. The image quality was examined by objective and subjective assessments. The MRI image characteristics of the cervical spines (C4-C5, C5-C6, C6-C7) showed significant difference
... Show MoreThis study showed the basic features of corporate tax in Iraq by showing what was in the Income Tax Law in force .The study aims of this to indicate the role of tax corprates in tax revenue and then the possibility of strengthening the revenue of this tax as an important source of local funding sources in the form that is with him reduce dependence on oil revenues to finance the general budget in Iraq, the risks and the study found a number of conclusions from the most important: that the corporate tax comes in the introduction to the components of the income tax structure in terms of relative importance and formed a revenue source of prime The gross proceeds of the income tax in Iraq, where it contributed to more than a quarter of that
... Show MoreThe article is devoted to the issue of word-formation motivation, which does not lose its relevance and plays a role not only in disclosing formal-semantic relations between words of one language and has not only theoretical, but also applied significance. The authors consider word-formation motivation consistently in its varieties in a comparative way on the materials of so different languages as Russian and Arabic and approach the mechanism of achieving semantic equivalence of translation. To the greatest extent, word-formation activity today, due to objective reasons, affects some special branch (technical, medical, etc.) vocabulary, which is increasing from year to year in national dictionaries. This extensive material, selected
... Show MoreThe current research deals with the study of aesthetic relations in the field of interior design and the extent to which its mechanisms achieve sensory stimulation between the internal and external spaces, to generate a continuous visual connection that is an extension of it, achieving in turn sensory stimulation for the users of those spaces. The internal and external spaces meet the desired purpose of feeling pleasure and beauty.” The current research aims to “discover the nature of aesthetic relations between the internal and external spaces and the extent to which mechanisms can achieve sensory stimulation in residential spaces.” The first topic included the concept of aesthetic relations, sensory excitement, and perception at
... Show MoreThe current paper highlights an important character represented by the American president John Tyler 1841 – 1845, who is considered the tenth American president. The importance of this paper lies in identifying his personality in terms of his upbringing and the political activities he practiced before assuming the presidency and his most significant internal achievements, which showed his decisions as a president. He was fully prepared to support national policies since they do not exceed the authorities of the states. With his achievements in the foreign policy, he was capable to draw and define the features of the American foreign relations that were in harmony with the general situation in the United States of America at that time.
... Show Moreالزكاة فريضة من فرائض الإسلام وعبادة من العبادات التي اقرها الشرع الإسلامي هذه الفريضة المالية التعبدية بالإضافة الى دورها المعنوي الذي يهدف الى إرساء قواعد العدالة الاجتماعية والقضاء على مشكلة الفقر في المجتمع الاسلامي وكما ينص عليها الدين الإسلامي فان لها ابعادها ووظائفها الكثيرة التي تخدم اليات العمل الاقتصادي في مجتمع يعمل وفق نظام اقتصادي أسلامي .
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... Show MoreThe present paper investigates the role of fear and predator dependent refuge in the prey-predator system. The system describes the interaction between prey and a stage structure of predator that incorporates Holling II functional response. The predator splits into two compartments immature (juvenile) and mature (adult). The mature predators can hunt and reproduce but this capability is not found in the immature predators, the immature depend on their parents. The growth rate of prey decreases due to the existence of mature predators. The existence, uniqueness, and boundedness of the solution of the system are investigated. Three equilibrium points of the system are determined. The local stability of the system is studied. The global stabil
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