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.
Based 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
... Show MoreThe main aim of this study is to assess the performance and residual strength of post-fire non-prismatic reinforced concrete beams (NPRC) with and without openings. To do this, nine beams were cast and divided into three major groupings. These groups were classified based on the degrees of heating exposure temperature chosen (ambient, 400, and 700°C), with each group containing three non-prismatic beams (solid, 8 trapezoidal openings, and 8 circular openings). Experimentally, given the same beam geometry, increasing burning temperature caused degradation in NPRC beams, which was reflected in increased mid-span deflection throughout the fire exposure period and also residual deflectio
The 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
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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
... Show MoreThis study aimed to provide a conceptual model for the use and benefits of the e-Government as related to administrative fraud and financial corruption. The study also looked into their concepts, forms, dimensions and types and the role of e-Government on fraud reduction, corruption in administration and finance and its impact on the government performance. From the result, it is revealed that there is need for electronic government for implementation in order to curb the rate of fraud and administrative and financial corruption and improve the quality of service provision for better performance
Cultivation of the green seaweed Enteromorpha compressa was performed under natural laboratory spring environmental conditions of temperature, light intensity and photoperiod to study the salinity tolerance of this intertidal green macroalga. Cultivation was carried out under artificial seawater (ASW) of different concentrations (18, 35, 53 and 106 g/l sea salt) compared to the control using natural seawater (NSW). Growth rate and pigment content of the cultivated alga were recorded at regular intervals during the experimental duration. Antioxidant activity of the crude ethanolic extract and its fractions (petroleum ether, chloroform, ethyl acetate and acetone) was performed against DPPH radical scavenging assay and compared to
... Show MoreBackground: 37% phosphoric acid (PA) is the traditional enamel etching technique prior to bracket adhesion, yet it has been implicated in numerous enamel injuries. The purpose of the current study was to create a calcium phosphate (CaP) etching paste in a simplified capsule formula that can underpin clinically adequate bracket bond strength without jeopardizing the integrity of enamel upon the debracketing procedure. Materials and Methods: micro-sized hydroxyapatite (HA) powder was mixed with 40% PA solution to prepare experimental acidic CaP paste. Sixty human premolars were assigned into two groups of 30 each. Enamel conditioning was accomplished using 37% PA-gel for control group and CaP paste for e
... Show MoreBackground: The pandemic crisis prompted the world to adopt unexpected approaches to continue life as normally as possible. The education sector, including professors, students, and the overall teaching system, has been particularly affected. Objective: This study seeks to evaluate the benefits, challenges, and strategies related to COVID-19 from the perspectives of college students, particularly those in higher education in Iraq. Method: The online survey questionnaire was distributed via Google Forms and specifically aimed at undergraduate dental students. Results: A total of 348 students participated in the survey. There was a significant correlation (P > 0.01) between student satisfaction with hybrid learning and their experi
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