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.
Air 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
... Show MoreThe 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 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 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 MoreThis study has taken into consideration two vital variables (leadership, leadership styles and intellectual capital). The research aim through the relations between the leadership styles and intellectual capital, to building conceptual frame for the variables of study and exploring the nature of correlation relations between these variables and their effects in enhancing intellectual capital.
The research was conducted at the Ministry of foreign in Iraq, and included a sample of leaders and subordinates amounted to (186), has been using the questionnaire as a key tool to collect data on the sample.
For the dealing with
... 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
This 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
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