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.
Because of the new political stage that Iraq is living in, which called on researchers to choose the subject of political marketing and increase its effectiveness through strategic intuition. The problem of research was reflected in the following question: How can strategic intuition be used to achieve efficiency in marketing marketing to achieve voter acceptance and achieve political success later on? ).
The research derives its importance from the fact that it is related to the developments in the concepts and areas of marketing in various fields, and it has a role in identifying the gain of new markets, where it is specialized to provide a political product and identify the mechanism of marketing the p
... Show MoreThis research aims to clarify the concept of doctrinal rules and adjust its basic terminologies. It further aims to lay down a map for the method of rooting this science by mentioning its rooted sources, in addition to drawing a miniature picture of its history, origin, formation and development. The paper ends with practical models to highlight its importance in rooting the science of nodal rules and facilitating the mentioning of its scattered discussions in a short and comprehensive phrase. The study further illustrates the pioneering role of doctrinal rules science in managing the doctrinal disputes, combining multiple sayings, and in bringing together opposing opinions. The study follows the inductive, descriptive and analytical app
... Show MoreThe aim of the study is to examine the challenges of financing small and medium enterprises in Iraq and subsequently to proffer solutions to mitigate problems. These solutions are achieved by focusing on the role of accounting information on the financial projects in for example, hotel construction, and by providing the necessary accounting information for the concerned parties to finance these projects. In order to highlight the challenges associated with the funding of small and medium enterprises and the role of accounting information in reducing those challenges, a questionnaire was prepared. As the government authorities are the ones responsible for the accomplishment of these projects, a questionnaire form was distributed in the proje
... Show MoreThis research aims at identifying the nature of addressing the Middle East issues in the talk shows in the foreign channels speaking in Arabic "France 24, a model", and identifying the extent of interest of the channel in addressing middle east issues in the talk shows, the nature of the guests and the hosts, methods of addressing the issues, and the technical features that characterize the presenter of the research sample program. This research is considered an analytical descriptive study. It depends on the analysis of the content of the series of the weekly talk show "a week from the world" on the French channel (France 24) during the period (August 1/July 31 2018).
The most important results indicated that the foreign channels sp
The insurance companies are one of the organizations that rely mainly on human capital to underwriting to insurable risks because most of risks have many variables, so the aim of the research is to show the level of interest of the researched company in human capital, the reality of the underwriting policy in it, and the relationships of correlation and effect between them, and the approach has been used Analytical descriptive, as books, research and other related sources were used for the purpose of completing the theoretical side, on the practical side, a questionnaire was prepared, which represents the main tool for collecting data and distributed to a random sample of 64 people from underwriting managers and employees in spec
... Show MoreResearching performance audits according to the dimensions of financial sustainability in light of the scarcity of resources and economic and social transformations in the business environment is of utmost importance in the non-profit non-governmental organizations in achieving the goals and correct the path and address deviations, and help them in improving the outputs of processes and associated procedures and capacity The research was based on the hypothesis that the existence of a performance audit program in accordance with the dimensions of financial sustainability leads to the measurement of the commitment of the Olympic Committee. National Iraqi indicators of financial sustainability of the dimension of revenue in order to improv
... Show MoreObjective: The evaluation of serum osteocalcin (OSN) for Iraqi infertile patients to see the effect of osteocalcin insufficiency, which may lead to a decreased level of testosterone production in males that may cause infertility. Methods: Forty two newly diagnosed infertile males age range (24–47) years and thirty two apparently healthy males as controls age range (25–58) years. Serum levels of testosterone (TEST), stimulating follicle hormone (FSH) and luteinizing hormone (LH), prolactin (PROL), osteocalcin OSN, and fasting blood sugar (FBS) were performed in both patients and controls. Estimation of serum OSN by Immulite1000 auto-analyzer, TEST, FSH, LH, PROL, and FBS by Immulite2000 auto-analyzer. Results: Infertile patients
... Show MoreConstruction is the opening of the important pillars of the construction of the film as a whole for this, we find that the first of any narrative of my film begin at the borders of this construction is the window that we look through the contents tale and puzzle narrative is of significance that degrade traveler when reservoirs expression later in reasoning and find justifications ills that came by those initiation, this initiation may be the window that lead us to the core, understanding the story through signals received to the recipient to sail because of the paths of pickling what is which is encoded, but this initiation may serve as keys that understanding the be puppies and signals that beset and surrounded to what He holds inevita
... Show MoreSince the emergence of the science of international relations as an independent academic scientific field, various theories and trends have appeared and have tried to understand and explain the international reality and give a clear picture of what is happening within the international system of interactions and influences and the search for tools for stability and peace in international relations. Among these theories is the feminist theory, which is a new intellectual trend on the level of international relations theories, which tried to give an explanation of what is happening in world politics and in international relations in particular. The main issue that feminist theory is concerned with is the lack of women’s subordination
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