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 researcher seeks to know the extent of applying the concept of design by Iraqi electronic press sites to provide media product with the acceptance of their browsers and ensure their repeated visits to such sites in the framework of the guiding rules for laser browsing. The researcher uses analytical study on a sample of six Iraqi electronic newspaper sites to identify the general features of their design and the methods of distribution of the structural elements of the pages. The researcher also conducts a field study on a sample of the surfers of electronic newspaper sites to see the extent of their evaluation to their design and the degree of their satisfaction.
The skill of management educational activities gradually grow with the experience, but they differ from personal skill educator to another, because each style nanny personally and the way to work. There educator and active movement and vitality that look like happiness and clear during the implementation of the activity, and the other runs educational activities quietly, efficiently and without emotion and clear (dry, 2001: p. 274). And the stage of childhood is one of the most important stages that are based upon the future life as a whole because the man also confirmed by the School of analysis psychological is the son of his childhood and the best example to us what the Holy Prophet Muhammad (peace be upon him): (Every child i
... Show MoreBackground: Characterization of the ovarian masses preoperatively is important to inform the surgeon about the possible management strategies. MRI may be of great help in identifying malignant lesion before surgery. Diffusion Weighted Imaging (DWI) is a sensitive method for changes in proton of water mobility caused by pathological alteration of tissue cellularity, cellular membrane integrity, extracellular space perfusion, and fluid viscosity.
Objective: to study the diagnostic accuracy of DWI in differentiation between benign and malignant ovarian masses.
Type of the study:Cross-sectional study.
Methods: this study included 53with complex
... Show MoreThe provision of electric power is necessary for the advancement of the country's economy. It is the main engine of the economy and its various activities. It is an indicator of social welfare and it is considered as the basic pillars for achieving sustainable development (economic, social, environmental and institutional) by raising the levels of performance and meeting local needs. The problem of research was the absence of a program to audit the performance of the electricity sector contributes to ensure the application of sustainable development. The research was based on the hypothesis that the preparation of a proposed program to audit the performance of the electricity sector contributes to the achievement of The researchers sough
... Show MoreThe current research dealt with a vital subject contributing In success Iraqi Industrial Companies general and Iraqi Cement state company A market knowledge, It is one of the most important industrial companies that Which serve to fill the local market need Of cement without resorting to import, The problem of research was limited understanding of the importance of the role played market knowledge of the tendencies and desires of competitors, This in turn affects the company's ability to achieve competitive advantages,The research aims to know the extent of adoption Iraqi Cement state company Concept market knowledge And employment achieving Competitive advantage By removing them (Cost, and quality, and del
... Show MoreAs population growth increases the demand for crops increases and their quality improves, and it becomes necessary to find innovative and modern solutions to enhance production. In this context, artificial intelligence plays a pivotal role in developing new technologies to improve crop sorting and increase agricultural yields. The present review discusses the main differences between manual and mechanical potato harvesting, explaining the advantages and disadvantages of each method. Manual harvesting is highlighted as a traditional method that allows for greater precision in handling the crop, but it requires more time and effort. In contrast, mechanical harvesting provides greater efficiency and speed in the process, but it may damage some
... Show MoreThe research aimed to identify the level of job security, the level of sports institutional performance, and the relationship, contribution and impact of job security to sports institutional performance from the point of view of workers in the Iraqi Ministry of Youth and Sports. The descriptive approach was adopted in the manner of correlational relationships on a sample of (400) individuals who were randomly selected by (33.333%) of the employees working in the institutions at the headquarters of the Ministry of Youth and Sports, amounting to a total of (2293) individuals for the sports season (2022-2023), and they are naturally distributed among (13) main institutions in the formations of the headquarters of this ministry, and after adopt
... Show MoreDue to the developments taking place in the field of communications, informatics systems and knowledge management in the current century, and the obligations and burdens imposed on the business organization to keep pace with these developments, the traditional methods of administrative decision-making are no longer feasible, as recent trends have emerged in management that focus on the need to rely on quantitative methods such as operations research.. The latter is one of the results of World War II, which appeared for the first time in Britain to manage war operations. The first method used in this field is the linear programming method. The use of operations research has developed greatly in the past years, and the methods of analysis in
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