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 purpose of the current research is to identify the reality and applicability of the entrepreneurial approach in its dimensions (creative, proactive, independent, risk tolerant, offensive) and its impact on the success factors of the project (organizational commitment, communication, project team, project monitoring) Access to information, treatment, storage), which is a significant and important link in the success and development of industrial projects with the possibility of studying and analyzing the provision of the appropriate environment for this.
the research started from a problem expressed by a number of intellectual and practical questions aimed at answering them as well as To answer a
... Show MoreMultimedia is one of the most important elements of modern educational media and must be used in educational websites in order to disseminate knowledge on a large scale and should be used to provide scientific information to all, as the current research tried to explore the possibilities of employing them in the design of educational websites and highlight their role in promoting the scientific aspects of the user. This study included four axes, the first of which was devoted to the introduction which includes the problem of research, its importance, objectives and its objective, temporal and spatial limitations, which were limited to the study of the main pages of Arabic educational websites published in 2019. The second axis cont
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This Study aimed to investigate the reality of the application of the degree of management practice by Walking Around, namely (discovery of facts, improvement of communication, motivation, development, creativity and feedback) and Its role in achieving organizational justice (procedural justice, distributive justice, Interactional Justice),The availability of the core principles of this system from the point of view of the senior management personnel in the Directorate of Anbar Education, and the importance of research in the philosophical rooting of the nature of the variables as a modern administrative terminology, the research dealt with a problem expressed by a number of intellectual and appl
... Show MoreThis research aims at building a proposed training program according to the self-regulated strategies for the mathematics teachers and to identify the effect of this program on relational Mathematics of teachers. The sample of the research was (60) Math teachers; (30) teachers as experimental group and (30) teachers as control group. The results of the current research reacheded that the proposed training program according to some self-managed learning strategies, meets the needs of trainees with remarkable effectiveness to improve the level of their teaching performance to achieve the desired goals. Training teacher according to self-managed learning strategies is effective in bringing about the transition of training to their students
... Show MoreBiodiesel can be prepared from various types of vegetable oils or animal fats with the aid of a catalyst.
Calcium oxide (CaO) is one of the prospective heterogeneous catalysts for biodiesel synthesis. Modification
of CaO by impregnation on silica (SiO2) can improve the performance of CaO as catalyst. Egg shells and rice
husks as biomass waste can be used as raw materials for the preparation of the silica modified CaO catalyst.
The present study was directed to synthesize and characterize CaO impregnated SiO2 catalyst from biomass
waste and apply it as catalyst in biodiesel synthesis. The catalyst was synthesized by wet impregnation
method and characterized by x-ray diffraction, x-ray fluorescence, nitr
The current research aims to identify the effect of the Bransford and Stein model on the achievement of fifth-grade literary students for geography and their reflective thinking. To achieve the objective of the research, the following two null hypotheses were formulated:
- There is no statistically significant difference at the significance level (0.05) between the average scores of the experimental group students who studied geography using the Bransford and Stein model and the average scores of the control group students who studied the same subject in the usual way in the achievement test. 2- There is no statistically significant difference at the significance level (0.05) between the average scores of the experimental gr
Allowing Iraqi companies to use multiple systems and policies leads to varying levels of disclosure and no high symmetry between report preparers and users, and that the adoption of integrated reporting can reduce information asymmetry. The theoretical side addressed the concepts of these variables, and in the practical side the binary variable (0, 1) was used. To compensate for the value of the independent variable (integrated reporting) based on the Central Bank of Iraq’s classification of banks according to the (CAMLES) index, and the dependent variable (information asymmetry) was measured through two measures (price difference, unusual return), the research community was represented by (5) Banks out of the total of banks li
... Show MoreThe adsorption process of 5-Fluorouracil (5FU) drugs on Aluminum nitride nanotubes surface (AlNNTs) have been evaluated through density functional theory (DFT). The DFT results show that the interaction of AlNNTs with the F atoms of 5FU drugs is strong due to the fact that the amount of adsorption energy was about − 29.65 kcal.mol−1. Conversely, the interaction of the 5FU through O atoms with the AlNNTs was weaker due to the lower value of adsorption energy. Also, based on the values of Gibbs free energy, the 5FU adsorption on the surfaces of AlNNTs was spontaneous. In addition, based on natural bond orbital (NBO) analysis, the direction of charge transfer was from fluorine’s σ orbitals of the drug to nitrogen’s and aluminum’s n*
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