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 Voluntary Obedience has great importance for the modern taxes systems and its management and this is meant the taxpayer whom in charge to pay of his taxes obligations voluntarily , he is very known of himself whereas he prepared his finishing accountings and present them as samples prepared by taxes management and settle the tax sum directly according to specified income , which has an impact to find end to tax evasion as result lead to increase the tax income and achieve the justice for the taxpayer and the state treasury
This research aims to present a proposed model for disclosure and documentation when performing the audit according to the joint audit method by using the questions and principles of the collective intelligence system, which leads to improving and enhancing the efficiency of the joint audit, and thus enhancing the confidence of the parties concerned in the outputs of the audit process. As the research problem can be formulated through the following question: “Does the proposed model for disclosure of the role of the collective intelligence system contribute to improving joint auditing?”
The proposed model is designed for the disclosure of joint auditing and the role
... Show MoreThis research aims to learn about public relations programs and their role to enhance the morale of the State land Transport Company employees.The researcher relied on the survey method and use a questionnaire and scale tools to collect information from workers in the Department of Relations and Media and employees in all departments.
The research reached several conclusions, including:
1- Public relations seek to increase workers’ confidence in senior management and motivate them to improve their production, as well as their relentless endeavor to bring workers closer by following multiple and varied forms of communication with them.
2- The results of the study showed that there was a negative i
Most of the world is seeking attention to the agricultural sector, which occupies a distinguished economic center, including Iraq, it is no wonder that the focus is on this sector, especially in developing countries. Descriptive analysis of the sample tables of wheat and barley crops in Iraq showed that adherence to the principles and rules of total quality, including modern irrigation methods (irrigated) has a significant impact in increasing productivity, reducing costs and improving quality compared to traditional irrigation methods, so it became necessary to take agricultural economic units All procedures and means that will help in the application of the rules of total quality to promote the reality of wheat and barley cultivation in I
... Show MoreThe current research aims to focus on strategic vigilance dimensions and contained (environmental vigilance, technological vigilance, competitive vigilance, vigilance marketing) to improve nursing services, which include a) the quality, timeliness, problem-solving and decision-making, relationships with others, leadership skills) and measure the degree link and influence between strategic vigilance in the hospital respondent and improve nursing service that the problem of the research lies in the weakness of strategic plans and health organizations in general and the hospital surveyed (martyr Ghazi al-Hariri), in particular, the lack of awareness of the hospital researched strategy vigilant management to improve nursing services,
... Show MoreFinance is an essential element when developing any housing policy because of its role in providing funds to institutions concerned with housing lending. Therefore, the research aims to evaluate the financial aid provided by the Central Bank of Iraq in solving the housing crisis through the adoption of the Central Bank of Iraq initiatives to support the financing of the housing sector, and here The importance of the research is highlighted to determine the role of the initiative by drawing an effective strategy aimed at providing the housing sector with the necessary funding. By providing financing to financial institutions directed towards providing real estate credit, and that the percentage of the contribution of the implement
... Show MoreThe tax exemption, whether wholly or partially, and for an unlimited duration of the investment or for a limited period of few years, is one of the encouraging things to the flow of foreign capital. And if necessary, impose tax on the profits of the invested capital, the promotion requires that not be discriminatory taxes or payments in the amount of money with the need to avoid double taxation. The tax exemption is granted by the government and the feature according to the law of a natural person or legal entity seeking from the government purports to achieve a set of political goals, economic and social development. The reduction of taxes or grants partial exemption is one of the factors that encourage attract of direct foreign i
... Show MoreThe research aims to shed light on the ethics of information systems and their role in achieving banking excellence for a sample of private banks in the province of Baghdad. It is important to focus on studying the ethics of banking information systems, which has become one of the most important basic and strategic resources that banks rely on to achieve outstanding performance. Achieving banking leadership in the Iraqi banking market. The researchers adopted the descriptive analytical approach to the research, and the questionnaire was considered as a main tool for collecting information in addition to personal interviews. The research reached the most important results that there is an acceptable correlation relationship between the ethic
... Show MoreThe research aims to identify the administrative skills and their role in institutional performance, and used the descriptive approach in a survey style and correlational relations to suit the nature of the problem to be studied.The research community was identified with the directors of sports activity in the Iraqi universities in a deliberate manner, and their number is (134) directors, where two scales (administrative skills and institutional performance) were used and the two scales were distributed to the above-mentioned sample in order to obtain answers that meet the required and representative sample of the community on the day 3/12/2021. The answers to all the statements were completed and after processing the results statistically
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