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 set to indicate the role of the opportunity cost in the overall economic development (human and social development) by selecting the most appropriate alternative for the growth of the country in exchange for sacrificing profit limits to achieve this growth and development of the country, especially in the present circumstances of the country and after studying the reality of the economic case for him, as the problem lies with don't selecting the best alternative that enhances the gross domestic product, which extends to promote overall economic development and revive the industrial and agricultural sectors, productivity is more like Impotent, versus sacrifice alternative consumption may bring more financially lucrative than
... Show MoreThroughput accounting is concerned with a throughput measurement process to determine the efficiency of the company, to know the problems and obstacles it suffers from, to determine their causes and ways to address them.The research problem is represented by the following question: does the application of a throughput accounting lead to maximizing the company's profits? The aim of the research is to demonstrate the importance of throughput accounting, which is one of the tools of management accounting in providing an efficient information system that provides the company’s management with the information it needs to improve its production processes, increase a throughput, and thus maxi
... Show MoreThe people lived under Mamluk rule, distress, poverty, famines, oppression of princes, rulers, And their domination and he always wished for a just ruler to relieve his misery, and remove the injustice
from him, so they found in Al-Nasser Mohammed tend to establish justice.
When Al-Nasser ascended the throne of the Sultanate, there was a rise or fall in prices, so he pursued Prices will end and punish those
who come out for it. And you talk about this search for a relationship
Sultan Al-Nasser with the poor classes in society and his keenness to pursue their affairs was compassionate On them, mer
... Show MoreIs hardly day expire without hearing the news either Abuse Managementthe accounting standards or the existence of serious misstatements by someauditors.Which caused the demanding of many companies in the recent republication of the financial statements and the re-announcement of its financialresults. Such acts raise questioning about the role that should be played by theauditors, prompting agencies responsible for setting auditing standards to takeTo throw increasingly responsibility on the auditors in order to interest risksfraud The Risks of Fraud in their review of the financial statements.also The Public Company Accounting Oversight Board in the U.S.called about the need of owning the Certified Public Accountants those whoaudits for
... Show MoreMH Hamzah, AF Abbas, International Journal of Early Childhood Special Education, 2022
Progression in Computer networks and emerging of new technologies in this field helps to find out new protocols and frameworks that provides new computer network-based services. E-government services, a modernized version of conventional government, are created through the steady evolution of technology in addition to the growing need of societies for numerous services. Government services are deeply related to citizens’ daily lives; therefore, it is important to evolve with technological developments—it is necessary to move from the traditional methods of managing government work to cutting-edge technical approaches that improve the effectiveness of government systems for providing services to citizens. Blockchain technology is amon
... Show MoreThe research aimed at finding out the effect of functional rotation on the tax performance of the employees of the General Authority for Taxes through the five-meter questionnaire prepared according to the required data. The data obtained from the research sample were analyzed. The results showed a significant effect of recycling In the tax performance, and this is evident from the proportion of his contribution to the interpretation of the total variation, which is a good indicator of the impact of functional rotation in the performance of the body sample research.
In this research, the kinetic studies of four isoenzymes of Asprtate aminotransferase, which partially purified from the urine of chronic renal failure patients were carried out .The four isoenzymes were obeyed Michaelis-Menton's equation and the optimum concentration of their substrate (Aspartic acid) was (166.5x10-3) mole/liter,and their Km values were determined. Four isoenzymesI,II,III,IV have shown an optimum pH at 7.4.The four isoenzymes obeyed Arrhenius equation up to 37º C and their Ea and Q10 constants were determined .
Adyertising sponsorship is one of the most prominent public activities, hich drives many public relations relations practitioners in companies to rely heavily on it in order to achieve positive results that contribute to the marketing of the brands of these sponsoring companies. The problem of Our research can be identified by the main question: What is the role of advertising sponsorship in brand marketing "The research aims to identify the role of sponsorship in brand marketing, and its role in attracting the public's attention to the products of the sponsors. As well as clarifying the role of the care method in the popularity of the products of the Sponsorship companies.