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.
Construction 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 MoreCorruption, in all its categories and forms, is regarded as the nowadays virus which has greatly spread in most institutes and society, a matter that cause a great waste of resources.
According to the reports of international transparency Institute, Iraq is regarded as one of the greatest countries in corruption.
Regardless of the reasons and forms of corruption, the retreat in work – values and ethics are the main reasons behind that.
Being the main source of providing qualified staff "educators" for the working market, the high education institutes face great challenges in standing against corruption inside and outside
... Show MoreThe first chapter includes introduce the research and the problem of the research that there are negligence of some educational institutions and schools management , some parents and supervisors .Also there are some educators who believes that school activities are obstacles means to learning and prevent pupils from studying and understanding the subjects. That may due to social , psychological and educational reasons
The purposes of the researches come from the reports of supervision visits which indicate a lot of difficulties faced by pupils and teachers related to education activities and its influence on in education and the necessity of indentify these difficulties and remedy them
... Show MoreThe conducted research was done in Grda rasha field (Salahaddin University) for one month to compare the impacts of Alcea kurdica powder, Rifaxmine, and Ranitidine as anti-lesion and immune-strengthening agents on stress-induced quails which are affecting their growth rate and in severe cases causing gizzard erosion and deep intestinal lesions. To do that, 75 quails (12 weeks old) were grouped into six treatments with different additives. (T0-) = Negative control (Stress-induced Without treatment), (T0+) = Positive control (No stress inducing or treatment). T1= (treated with Rifaximine 200mg/L water mixed), T2= (treated with Ranitidine 200mg/L), T3= (treated with A.kurdica extract 100mg/L). The tested groups,
... 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
... Show MoreThe principal objective of this study is to demonstrate how green quality management and product life cycle costing may help an organization gain a competitive advantage. Green quality management's influence on increasing product quality and meeting environmental criteria, as well as tracking the activities of product life cycle before, during, and after production, is demonstrated. Orienting these activities toward the production of eco-friendly products that fulfill the needs of customers, hence increasing organization's market share. We found from our study that proposed framework can help organizations improve their competitiveness. Green quality management contributes to environmental protection and the provision of high-qualit
... Show MoreBackground: The role of prophylactic antibiotics remains controversial. It is clear that actively facial fractures are considered as clean contaminated and should be treated with therapeutic antibiotics; however, there is widespread variability in the use, type, timing, and duration of prophylactic antibiotic administrated in practice today. There is an adverse effect of increased antibiotic resistance, as well as costs, it is important to review the current evidence for the role of prophylactic antibiotics in compound facial fractures. The purpose of this study is to evaluate the role and significance of preoperative, perioperative and postoperative antibiotic prophylaxis for patients when there is already an infective focus, such as co
... Show MoreFacing the receiver (critic) problematic understanding of modern art done, which turned positive professional image to symbolic language, which gave it authenticity previous Arts advantage, and this latest progress in critical reading contemporary and several mechanisms for analyzing literary texts and plastic, including textural fabric. And we suffer from the absence of cash the recipient culture (learner), so the current search goal focused on detecting structural mechanisms formative (Goldman) reading done modern art and its role in raising criticism knowledge (learner). Defining the theoretical framework of chapter II by discussing it; the first episode dealt with the textural fabric, while the latter was accomplished Studio talk, an
... Show MoreThe study seeks to analyze the perceptions of audience in UAE towards the performance of Emirates Satellite TV Channels. It analyzed the exposure motivations of audience to satellite TV channels, its positive and negative aspects and to what extent they abide by media ethics. A survey is conducted with a sample of four hundred. The study shows significant differences between male and female towards the characteristics of TV channels, its positive and negative aspects and its commitments to media ethics.
The study also shows that the expectancy value model and third person effect model are applicable in studying the perceptions of audience and media people in UAE t
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