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 impact of the auditor's personal judgment starts from the beginning of the audit process to the formation of the final opinion and the issuance of the report, and because of the possibility of bias in the auditor's judgment for various reasons that may relate to the auditor himself or the circumstances surrounding it, which requires assessing the current reality of the auditor's personal judgments In the local environment and determining their determinations. To clarify the concept and determinants of the auditor's personal judgments when implementing the audit work, prepare the report and determine the role of the international auditing standards in rationalizing the auditor's personal judgment when conducti
... Show MoreSmart cities are using innovative technological solutions to improve the quality of life and service that citizens and visitors receive. Defined as a digital or ecological city, its services depend on information and communication technology infrastructure, such as intelligent automated traffic systems, advanced security management Services, building systems, and the use of automation in offices and homes. The global trend now towards smart cities, sustainable and green cities and other cities, with different nomenclature, the common denominator is the comfort of the individual and the preservation of natural resources. Adopting smart, sustainable, green, or healthy cities is either t
Methotrexate (MTX) is one of the most effective medications to treat rheumatoid arthritis (RA).Aserum of 60 Iraqi male patients suffering from RA as (G1) was newly diagnosis and the same patient in G1 after taking MTX as G2 and 40 Iraqi male healthy control as G3. Nesfatin-1 (Nf-1) is belong to the adipokine family withpleiotropic effect. Nf-1 has been found in different tissues, including stomach, pancreas, bone cells, cartilage and heart. Retinol binding protein (RBP4) was known as transpoter of retinol from its storage sites in the liver to the extrahepatic tissues. Moreover, RBP4 acts as adipokine and contributes in the pathophsyology of prototypic inflammatory disease, rheumatoid arthritis (RA). The results showed a significant increas
... Show MoreThe research aims at conducting a follow-up evaluation of a number of strategic projects implemented by the Directorate of Public Municipalities, one of the Ministry of Construction, Housing and Municipalities and Public Works. The sample included (35) varied strategic projects implemented in most Iraqi governorates. Buildings, municipal buildings, minarets, massacres, multi-story parking, paving and rehabilitation of streets and residential neighborhoods. The difference between the actual and planned times and costs of these projects was then measured and analyzed. These projects were used as a tool for collecting data and information. The questionnaire included four axes, each representing one of the parties to the project, whi
... Show MoreThe study presents the performance of flexural strengthening of concrete members exposed to partially unbonded prestressing with a particular emphasis on the amount (0, 14.2, and 28.5%) of cut strands-symmetrical and asymmetrical damage. In addition to examining the influence of cut strands on the remaining capacity of post-tensioned unbonded members and the effectiveness of carbon fiber reinforced polymer laminates restoration, The investigated results on rectangular members subjected to a four-point static bending load based on the composition of the laminate affected the stress of the CFRP, the failure mode, and flexural strength and deflection are covered in this study. The experimental results revealed that the usage of CFRP la
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Purpose\The researcher paper aims to determine the impact of information technology on the job performance, for Iraq private ban as through the use of technology dimensions of job performance.
The aim of this research: this study aims to discuss the importance of information technology and its role in achieving job performance and its impact on the Iraq banking sector design/ methodology/ approach used entrance design/methodology/approach- pilot, the questionnaire was used to collect data in order to develop a model to measure reliably and correctly to the variables of information technology and job performance, and hypotheses were tested through the use of some statisti
... Show MoreBased economic units to technology to add innovations that lead to contribute to customer satisfaction, under intense competition and rapid development in customer taste, the economic units tend to apply the concepts that contribute to customer satisfaction led by the introduction of artificial intelligence techniques. In the production prominent role in the contributing and responding to the rapid changes in customer tastes, and consequent impact this in achieving customer satisfaction. Search gained importance of relying on artificial intelligence techniques to achieve customer satisfaction through speed of response to changes in the tastes of customers and thus be able to increase its market share، and sales growth، and to achieve a
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The Aims of this research is to describe the concept of risk, its type and method of measurement, and to clarify the impact of these risks on the expected cash flow statement and the preparation of the target cash flow statement that takes these risks into consideration. Because the local economic environment is exposed to many risks, Therefore, this list will be predictive, which will help the economic unit to make administrative decisions, especially decisions related to operational, investment and financing activities. Therefore, the research problem is based on the fact that most of the local economic units are the list of flows According to the actual basis and not according to the discretionary basis (bud
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