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.
Organizations must interact with the environment around them, so the environment must be suitable for that interaction. These companies are now trying to become Learning Organizations because it try to face that challenges may rise from its environments. The Learning Organization is a concept that is becoming an increasingly widespread philosophy in modern companies, from the largest multinationals to the smallest ventures. What is achieved by this philosophy depends considerably on one's interpretation of it and commitment to it. This study gives a definition that we felt was the true ideology behind the Learning Organization and Group Working. A Learning Organization is one in which people at all levels
... Show MoreBack ground: This in vitro study was carried out to investigate the effect of post space regions (coronal, middle and apical), Time and the mode of polymerization (dual, self-cured) of the cements used on the bond strength between translucent fiber post and root dentin by using push-out test. Materials and Methods: Forty eight extracted mandibular first premolars (single root) were instrumented with ProTaper Universal system files (for hand use) and obturated with gutta percha for ProTaper and AH26® root canal sealer following the manufacturer instructions, after 24 hours post space was prepared using FRC postec® plus drills no.3 creating 8 mm depth post space. The prepared samples were randomly divided into two main groups (24 samples ea
... Show MoreBackground:The most common pattern of dyslipidemia in diabetic patients is increased triglyceride (TG) and decreased HDL cholesterol level, The concentration of LDL cholesterol in diabetic patients is usually not significantly different from non diabetic individuals, Diabetic patients may have elevated levels of non-HDL cholesterol [ LDL+VLDL]. However type 2 diabetic patients typically have apreponderance of smaller ,denser LDL particles which possibly increases atherogenicity even if the absolute concentration of LDL cholesterol is not significantly increased. The Third Adult Treatment Panel of the National Cholesterol Education Program (NCEP III) and the American Heart Association (AHA ) have designate diabetes as a coronary heart dis
... Show MoreBackground: Many structural or functional abnormalities can impair the production of thyroid hormones and cause hypothyroidism.Objectives: to identify the main etiological causes of hypothyroidism among patients visiting Specialized Center for Diabetes and Endocrinology.Methods: This study was conducted in the Specialized Center for Diabetes and Endocrinology on 217 patients with proved hypothyroidism, from 2006 to 2008. Every patient was tested with thyroid function tests, Ultrasound examination, thyroid autoantibodies, fine needle aspiration, radiology of skull, isotopes scan, also checking adrenal and gonadal function. Results: Out of these 217 patients 120 patients have thyroiditis 33 patients had been undergone thyroidectomy. 39 pat
... Show Morethe reality of small and medium enterprises analysis reflects weaknesses plaguing these enterprises and strengths that are characterized by, and thus the formulation of appropriate solutions to the obstacles faced by these enterprises to enhance its contribution to the achievement of economic and social development. Iraqi small and medium enterprises suffer from several obstacles stand in front of development and support their competitiveness, the finance one of the main obstacles which impede growth and development of these enterprises, noting the banking system in Iraq reluctance to lend to small and medium-sized enterprises, as a result of the high cost of lending these enterprises compared to large projects, as well as
... Show MoreThis review examines how artificial intelligence (AI) including machine learning (ML), deep learning (DL), and the Internet of Things (IoT) is transforming operations across exploration, production, and refining in the Middle Eastern oil and gas sector. Using a systematic literature review approach, the study analyzes AI adoption in upstream, midstream, and downstream activities, with a focus on predictive maintenance, emission monitoring, and digital transformation. It identifies both opportunities and challenges in applying AI to achieve environmental and economic goals. Although adoption levels vary across the region, countries such as Saudi Arabia, the UAE, and Qatar are leading initiatives that align with global sustainability targets.
... Show MoreThe research aims to verify the role of the Human Resources Strategic Management (HRSM) in enhancing the strategic success factors for talent (SSFT) in the General Tourism Authority by distributing a questionnaire consisting of (36) paragraphs on an intentional sample represented by the higher departments as it reached (50) and the sample valid for testing was (44) Person and to test the relationships between the two research variables, the researchers used statistical methods represented by (Bartlett test / mean / simple regression coefficient / difference coefficient, alpha- cronbachAch, confirmatory factor Analysis ) through the statistical program (SPSS v.23 & AMOS v.23). In enhancing the factors of success for talent management in the
... Show MoreThe rapid development of information technology and its use in all areas has had a positive impact on all areas, and financial markets have had a share of this development through the use of an electronic trading system to settle transactions, enhance transparency and disclosure in all activities of these markets and revitalize their performance.
The reason for choosing this topic is that it is a very important topic for what modern technology addresses in trading operations in financial markets. It is worth noting that these innovations have eliminated the need for direct contact with people, but through the Internet and telephone networks, and the new technology has reduced the costs of building systems
... Show MoreMarketing information system (KMIS) is an essential factor of developing business’ performance and getting sustainable success. The main goal of the research is to measure effect of MIS on customer orientation and product innovation. Also, another goal is to analyze the mediation role of product innovation in relationship MIS and customer orientation. This study sought to analyze the marketing information system and measure its effect on the customer orientation and product innovation. The data of the study were collected using questionnaire. The data were analyzed using statistical tools and SPSS programming. The results of the study showed that the KMIS can positively and significantly effect product innovation. Also, t
... Show More