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.
This 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
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 MoreThe aim of this research is to identify the role of strategic agility achieving organizational excellence in one of the formations of the Ministry of Municipalities (Dhi Qar Sewage Directorate), as important service organizations that have a key role in serving and developing the society which faced many administrative challenges and issues and as a result of the changes in the environment is continuing and accelerating, so the adoption of modern administrative concepts such as strategic Agility and knowledge of their role in achieving organizational excellence can help them in facing these changes and achieve what they aspire to. In order to achieve research objectives, two main hypotheses have been formulated. The first hypothe
... Show MoreThis paper suggesting a new modern method to evaluate the performance of hotel industry at Jordan instead of the classical method used by the industry and that is Bench Marking , this method can be done by comparing the performance of hotel industry at two serial years which helps in calculating a standard performance .
The industry can use this standard to identify the variance, which make the evaluation of performance easier and support the efforts to develop the hotel industry at all levels and enable to give high quality services to customers.
The study believed that this situation would not be achieved unless the hotel industry will app
... Show MoreEpithelial mesenchymal transition (EMT) is a process comprising cellular and molecular events which result in cells shifting from an epithelial to a mesenchymal phenotype. Periodontitis is a destructive chronic disease of the periodontium initiated in response to a dysbiotic microbiome, and dominated by Gram-negative bacteria in the subgingival niches accompanied by an aberrant immune response in susceptible subjects. Both EMT and periodontitis share common risk factors and drivers, including Gram-negative bacteria, excess inflammatory cytokine production, smoking, oxidative stress and diabetes mellitus. In addition, periodontitis is characterized by down-regulation of key epithelial markers such as E-cadherin together with up-regulation of
... Show MoreThe effects of postmodernism on theatrical form was managed by the director (Anas Abdul Samad) to be employed in the Iraqi play (Dream in Baghdad) and the researcher sought to study this problem and divided it into four chapters dealt with in the first chapter the problem of research and its need, the importance of research, As well as the definition of terminology, either Chapter II theoretical framework divided by the researcher to the first two is the postmodernism in the theater is the most prominent reference references and the second most important postmodern applications in the world play and then the researcher concluded the second chapter of the most important indicators. In the third chapter, the researcher identified th
... Show MoreAir pollution is considered one of the major environmental problems that contain many challenges and difficulties facing most countries of the world, including Iraq. The problem has emerged widely with the emergence of the industrial revolution in the world and the tremendous increase in the population and the increase in the number of transportation and its development in addition to excavation, maintenance and work Construction and weather fluctuations, such as dust and sandstorms, pollution resulting from oil refining, extraction, diversion and other processes that cause pollution, and the start of the world using methods that limit the volume of environmental pollution. The most prominent of these methods is the imposition of
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