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 figure of personality modes determines its privileged style in the use of modern and advanced technological tools in the process of changing and developing in order to keep up with that. The proses of selection and choosing administrators in the appropriate places are the most important functions of senior management because it is easy to adopt factory buildings or establishments But this is a human world as that of machines world. So it is required to have people in the process of changing those who have a time, Knowledge, skill, ability and strong administrative personal skills, those people (leaders) should to put a clear vision for the selection and application of the change efforts and to create the necessary climate and
... Show MoreThe current research attempts to examine the relationship between social-psychological conflict and their relation to family upbringing approaches among the adolescents of intermediate stage according to sex and economical level. To do this, the researcher prepared a questionnaire to measure social-psychological conflict that consisted of (32) item divided on four dimensions, and also she prepared a questionnaire to measure family upbringing approaches which composed of (28) item divided on four dimensions. The sample was (260) male and female student from intermediate stage chosen randomly. The results revealed that there were significant differences between social-psychological conflict which went to male, there was a negative correlat
... Show MoreAbstract\
preparation process of performance evaluation in organizations is of extreme importance, and under development in organizations and the opening of markets and technological developments in the industry and heightened competition among industrial organizations imposed systems are built for performance give a clear picture about performance and competition, And centered research problem in answering the following questions: Is performance evaluation system is available in Wasit State Company for Textile Industries(Research sample ), This research aims to assess the performance of policies and programs in the company, according to guide performance evaluation of programs and policies prepared by the Dutch Cou
... Show MoreThis study examines the vibrations produced by hydropower operations to improve embankment dam safety. This study consists of two parts: In the first part, ANSYS-CFX was used to generate a three-dimensional (3-D) finite volume (FV) model to simulate a vertical Francis turbine unit in the Mosul hydropower plant. The pressure pattern result of the turbine model was transformed into the dam body to show how the turbine unit's operation affects the dam's stability. The upstream reservoir conditions, various flow rates, and fully open inlet gates were considered. In the second part of this study, a 3-D FE Mosul dam model was simulated using an ANSYS program. The operational turbine model's water pressure pattern is conveyed t
... Show MoreResearch Hypothesis from the fact that kicks off the effect that agricultural production in Iraq plays an important role in overcoming the food problem and achieving food security, but he became far far away from the provision of sufficient quantities of food products and then securing the Iraqi consumer food basket by the challenges faced by the agricultural sector.
To prove the hypothesis research in its structure in three axes came, the first axis eating historical significance to the subject of food over time periods as well as to clarify the concept of food security, and the second axis touched on the most important challenges facing the agricultural sector in Iraq and prevent the achievement of food requirements for members of
The research revolves around the views of Al-Amadi and Al-Jurjani in the metaphors in their books, balancing Abu Tammam and Al-Bohtari, and mediation between Mutanabi and his opponents. And others whose poems were cited. One of the most important things we have reached is: the critics release the term metaphor to take sometimes and mean to take the meaning or steal it, and analyzed the evidence of metaphor as a rhetorical art in the light of what he heard about the former Arab poets, rejected the unusual metaphor out of use, and reclaimed the familiar metaphor. The research after submitted to the topics are: the first: Al-Amadi and his budget book, the second: Al-Jurjani and his book of mediation, and the third is divided into three dema
... Show MoreA new results for fusion reactivity and slowing-down energy distribution functions for controlled thermonuclear fusion reactions of the hydrogen isotopes are achieved to reach promising results in calculating the factors that covered the design and construction of a given fusion system or reactor. They are strongly depending upon their operating fuels, the reaction rate, which in turn, reflects the physical behavior of all other parameters characterization of the system design
The emerge of capitalism beside appearing modern and contemporary political systems which had become hold out it is semi-domination on more vital space of human community life, it is through some vital apparatus, which the free market apparatus had make important one which depend on achieve the privileges of the capitalism elite whom standing on it, especially the finance elite. Thus the achievement of the profit had become the main podcasted of those elite which whom the really advancer of the Globalization system, this is which incarnated by the appears and extend of the (COVID-19) fatality pandemic in the end of last year, whereas reveals widespread of it in more than one states in the world, especially the developed coun
... Show More