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 study aimed to find out the relationship between the dimensions of internal control systems and the availability of an effective governance framework in the Sudanese banks. The study used descriptive and analytical method for collecting and analyzing the study data using SPSS program. The questionnaire was used as an analysis tool. The target sample of Sudanese bank employees, the study found several results, including that the bank avoids methods that lead to the rational use of available resources, and identifies and separation of tasks among employees, in addition to rapid response to reports The study found several recommendations, including the need for a list of banks that are sufficiently flexible and comp
... Show MoreThis research seeks to identify the dimensions of the development of staff performance (training ', incentives, management skills) and its impact on the settlement of compensatory claims adopted in the current research in the Iraqi insurance company،This research aims to highlight the role of developing insurance company’s workers’ performance in settling insurance compensation, and to check this process, the research was applied in the general Iraqi insurance company as it considered as the research community, and a sample was taken from this community that represented by company’s insurance department workers or by collecting actual data that is related to the research’s sample, in addition to the financial compensation data.<
... Show MoreThe internal observing system is considered a cornerstone for the high management in all the systems. It aims at defending the things for waste and increasing efficient and application the rules and regulations and constrictions. To easier for the high management activity in the internal observing system which in presented and practiced and to what extent can depend on it. Thus it goes to evaluate the internal observing system periodically to check the weak points in that system so as the find out the mistake, in the construction of the system or mistake, by indication of the workers. The importance of this study is represented in the need of increasing the coactivity in the internal observing system so as to be in touch with the new tre
... Show MoreThe research seeks to highlight the importance of digital finance in banking by providing financial and banking services and its role in improving the access of financial services to customers at the farthest possible point by using modern technology to finance their needs by granting them cash credits through electronic payment tools to facilitate them and shorten time and effort as well as Low cost, and this cannot be achieved without concerted efforts and the provision of basic infrastructure that includes connecting the Internet to all targeted areas, whether cities or rural areas, as well as distributing the largest possible number of ATMs and sending specialized teams to those areas that develop in customers the culture of digital
... Show MoreAs a result of creative accounting, many firms in the Iraqi stock market are able to achieve two very significant goals: first, to boost the market value of their shares and thus gain the biggest trading volume in shares, and second, to lower their earnings in order to decrease the tax burden. First by growing its profits, then by evading taxes and denying the state its right to its money. Using this research, we hope to demonstrate how financial institutions that use innovative accounting tools in the preparation of their financial statements impact trade activity. Trading volume is critical to accurately forecasting stock price patterns, allowing investors to maximize their wealth. So, without accounting information, the financial
... Show MoreThis study tries to examine a model involving human resources management practices, employees’ outcomes, governmental support, and organizational performance of small businesses in Malaysia. It was hypothesized that HRM practices will be positively related to the organizational performance (financial and operational), and that employees’ outcomes would serve as a mediator in the relationship between HRM practices and performance. Also it was hypothesized that the governmental support will be positively related to organizational performance. The statistical results on data gathered from a sample of 265 small manufacturing businesses will demonstrate the nature of relationships among the study variables. Theoretical and practical
... Show MoreBackground: with the advent of new postmaterial in dentistry, it has become important to measure fitness of post restoration along the horizontal plane of the root space.This study aimed to measure and compare, the cement film thickness of conventional zinc phosphate cement in micrometer between the post and root dentin along horizontal plane at different post space regions (coronal, middle and apical) of four types of posts, by using stereomicroscopy. Material and methods: Thirty-two extracted human maxillary canines, mandibular canines and maxillary central incisors (n=32) were instrumented with ProTaper system files (hand use) and obturated with gutta-percha for ProTaper and AH26® root canal sealer. After 24hrs of incubation at 37ºC, p
... Show MoreThe performance of composite prestressed concrete beam topped with reinforced concrete flange structures in fire depends upon several factors, including the change in properties of the two different materials due to fire exposure and temperature distribution within the composition of the composite members of the structure. The present experimental work included casting of 12 identical simply supported prestressed concrete beams grouped into 3 categories, depending on the strength of the top reinforced concrete deck slab (20, 30, and 40 MPa). They were connected together by using shear connector reinforcements. To simulate the real practical fire disasters, 3 composite prestressed concrete beams from each group were exposed to high t
... Show MoreIn this study, a Hydroxyapatite (HA) coating was prepared on a titanium implant by an electrochemical deposition process. The titanium pre-treatment by anodizing in 1.65 mol/L sulfuric acid with (10V) at room temperature. The deposition was all conducted at a constant voltage of 6.0 V, for 1 h at room temperature. The coatings thus prepared were characterized with Fourier transform infrared spectroscopy (FTIR) and thickness of the coated layer.The electrochemical deposition of HA occurred on the titanium as a cathode. Coated titanium by HA after anodizing revealed a good corrosion protection efficiency even at a temperature ranged (293-323) K in artificial saliva. Activation energy and pre-exponential factor (kinetic parameters) were calcul
... Show MoreThe main objective of this paper is to study the behavior of Non-Prismatic Reinforced Concrete (NPRC) beams with and without rectangular openings either when exposed to fire or not. The experimental program involves casting and testing 9 NPRC beams divided into 3 main groups. These groups were categorized according to heating temperature (ambient temperature, 400°C, and 700°C), with each group containing 3 NPRC beams (solid beams and beams with 6 and 8 trapezoidal openings). For beams with similar geometry, increasing the burning temperature results in their deterioration as reflected in their increasing mid-span deflection throughout the fire exposure period and their residual deflection after cooling. Meanwhile, the existing ope
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