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.
Background: Type 2 diabetes mellitus is a condition characterized by an elevation of oxidative stress, which has been implicated in diabetic progression and its vascular complications. Aim: Assessing the impact of gliclazide modified release (MR) versus glimepiride on oxidative stress markers, glycemic indices, lipid profile, and estimated glomerular filtration rate in uncontrolled type 2 diabetic patients on metformin monotherapy. Methods: This was an observational comparative study conducted in Thi-Qar specialized diabetic, endocrine, and metabolism center. Sixty-six patients were randomized into two groups based on the addition of the sulfonylureas (SUs). Group 1 (33 patients) was on gliclazide MR, whereas Group 2 (33 patients)
... Show MoreThe value of time out as a time not count of official time form the game like four periods and extra time also it considered a great interest if used well thru the game , the importance of this problem is not using well the time out and when the coach ask for time out and how to invest this time legally to make good results also there is no observing system as the researcher see gives the reality image that the coach is successful lead the game when he takes time out . The goals of research that knowing on numbers of time out for excellent teams in Iraq (first &second) stages and putting special inventory reverse reality of asking time out (positive &negative) on playing basketball , the hypothesis of research that tell the time out effect
... Show MoreArtificial neural networks usage, as a developed technique, increased in many fields such as Auditing business. Contemporary auditor should cope with the challenges of the technology evolution in the business environment by using computerized techniques such as Artificial neural networks, This research is the first work made in the field of modern techniques of the artificial neural networks in the field of auditing; it is made by using thesample of neural networks as a sample of the artificial multi-layer Back Propagation neural networks in the field of detecting fundamental mistakes of the financial statements when making auditing. The research objectives at offering a methodology for the application of theartificial neural networks wi
... Show MoreThe research aims to explain the role of huge data analyzes in measuring quality costs in the Iraqi company for the production of seed, and the research problem was diagnosed with the weakness of the approved method to measure quality costs, and the weak traditional systems of data analyzes, the researcher in the theoretical aspect relied on collecting sources and previous studies, as well as Adoption of the applied analytical approach in the practical aspect, as a set of financial analyzes were applied within the measurement of quality costs and a statement of the role of data analyzes in the practical side, the research concluded to a set of conc
... Show MoreAbstract:
The aim of this research is to highlight the importance of reducing the cost of a flight ticket by using information technology and the Internet, in the process of purchasing tickets for electronic flights, and to shift from the traditional method of purchasing and payment operations to the electronic method, to reduce the financial and non-financial risks associated with the traditional purchase process, as well as saving the cost Time, effort and money for the customer, and the researcher used the deductive approach in linking the variables (Internet of Things technology and reducing the costs of air tickets) wi
... Show MoreContemporary developments in various sciences and the impact of technological changes require an integrated vision of the activities and work of the organization in Iraq in light of the high costs of products and their low quality compared to imported products of high quality and low cost, and the need to use modern cost techniques based on a clear and specific philosophy that contributes to increasing the efficiency and effectiveness of management In the business environment and how it can contribute to reducing product costs and being environmentally friendly at the same time, it is no secret that the main goal of most organizations is to maximize profitability and reduce costs to the minimum, but this matter is not achieved autom
... Show MoreThe solution to the problems and challenges of the twenty-first century requires the absorption of many transformations, such as demographic change, poverty reduction, the expansion of safe and clean energy without affecting the environment, as well as reducing health risks and other transitions. It also requires greater cooperation than is possible in the current global system, because both of these constraints and challenges, even if addressed locally or nationally, are because of the potential for their transnational impact, that is, their impact on the lives of people at the global level, Which is necessary to be fully addressed unless it is guided by a comprehensive global vision. This is what environmental governance provides in te
... Show MoreGender has considered and become a new trend in women's studies, as it reflects the behaviors, roles and attitudes imposed by society on its members in accordance with their biological nature,with focusing on gender rather than on concentration on women, which is closely linked to the vision that concentrates on women's problems which are not primarily according to their biological differences But rather to a greater extent to social, cultural, historical and religious barriers and Obstacles.
Therefore, the qualitative division due to the concept of "gender" is not a rigid biological division, but is relied on the broad general context through which the social division of work is done. Thus, content in the pages of Facebook with high-
Our dear country faces many and varied challenges aimed at its history, civilization, its people, the scourge of drugs and psychotropic substances and their misuse. Therefore, we have a historical, ethical and professional responsibility to coordinate efforts and cooperation between all concerned to protect the Iraqi society from the threat of this scourge. Creative sources have varied in the variety of expressive means in politics, literature and the arts, in their style and technical treatment of various topics with innovative manifestations and intuitive interactive with visions as well as influences Psychological expressive descriptions of visual scene, it is one of the media and propaganda that contribute to the raising and developm
... Show MoreDescribed the Arabic language being of genius sets by top models of eloquence , rhetoric and clarity of sounds and developments Moreover , it is an important element of our existence and our identity and our survival . That my methods and best in teaching Arabic language what has pursued the easiest ways to learning and teaching and helped learners to be aware of the function linguistic information , and they need it and its impact on their lives , and contributed to unleashing the potential of activism and led them to make the effort to apply them in the form of examples and uses of new life , as well as fits are the capabilities and tendencies of different learners , so the goal of current research into the importance of the curriculum
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