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.
Background: Trauma is one of the most common
clinical problems that confront the maxillofacial
surgeon and radiologist alike. Middle third facial
fractures are diagnosed primarily on the bases of
clinical examination and plain radiographs than can
result in much preoperative speculation.
Objective: To assess the advantages of spiral
computerized tomography over conventional
radiography in the pre-surgical evaluation of middle
third facial fractures.
Methods: Thirty patients with thirty-eight facial
fractures were studied, all patients were examined
clinically, by plain radiography and then by spiral CT.
Results: Of the 38 middle-third fractures, 16
(42.1%) were zygomatic fractures, 8 (21.1%) were
The process of stocks evaluating considered as a one of challenges for the financial analysis, since the evaluating focuses on define the current value for the cash flows which the shareholders expected to have. Due to the importance of this subject, the current research aims to choose Fama & French five factors Model to evaluate the common stocks to define the Model accuracy in Fama& French for 2014. It has been used factors of volume, book value to market value, Profitability and investment, in addition to Beta coefficient which used in capital assets pricing Model as a scale for Fama & French five factors Model. The research sample included 11 banks listed in Iraq stock market which have me
... Show MoreUniversity campuses in Iraq are substantial energy consumers, with consumption increasing significantly during periods of high temperatures, underscoring the necessity to enhance their energy performance. Energy simulation tools offer valuable insights into evaluating and improving the energy efficiency of buildings. This study focuses on simulating passive architectural design for three selected buildings at Al-Khwarizmi College of Engineering (AKCOE) to examine the effectiveness of their cooling systems. DesignBuilder software was employed, and climatic data for a year in Baghdad was collected to assess the influence of passive architectural strategies on the thermal performance of the targeted buildings. The simulations revealed that the
... Show MoreAryl hydrocarbon receptor (AhR) is a ligand-activated transcription factor that regulates T cell function. The aim of this study was to investigate the effects of AhR ligands, 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), and 6-Formylindolo[3,2-b]carbazole (FICZ), on gut-associated microbiota and T cell responses during delayed-type hypersensitivity (DTH) reaction induced by methylated bovine serum albumin (mBSA) in a mouse model. Mice with DTH showed significant changes in gut microbiota including an increased abundance of
The personal drama in particular, and one of the key elements underlying the dramatic structure to convey ideas and visions presented by the author when writing the text of the dramatic fall after that on the way out the submission form that suits the proposals of the text and processors directorial would push the wheel of dramatic structure to the front. So take the maker of the artwork (writer) undertook the transfer of those events and personalities in art presumed sometimes real and sometimes, in order to enrich the art inspired by the human reality through the ages, and full of its themes and ideas that led to the development experiences of peoples experiences of living. Therefore, we find it important to research in the characters
... Show MoreThe consensus algorithm is the core mechanism of blockchain and is used to ensure data consistency among blockchain nodes. The PBFT consensus algorithm is widely used in alliance chains because it is resistant to Byzantine errors. However, the present PBFT (Practical Byzantine Fault Tolerance) still has issues with master node selection that is random and complicated communication. The IBFT consensus technique, which is enhanced, is proposed in this study and is based on node trust value and BLS (Boneh-Lynn-Shacham) aggregate signature. In IBFT, multi-level indicators are used to calculate the trust value of each node, and some nodes are selected to take part in network consensus as a result of this calculation. The master node is chosen
... Show MoreThe alfalfa plant, after harvesting, was washed, dried, and grinded to get fine powder used in water treatment. We used the alfalfa plant with ethanol to make the alcoholic extract characterized by using (GC-Mass, FTIR, and UV) spectroscopy to determine active compounds. Alcoholic extract was used to prepare zinc nanoparticles. We characterized Zinc nanoparticles using (FTIR, UV, SEM, EDX Zeta potential, XRD, AFM). Zinc nanoparticle with Alfalfa extract and alfalfa powder were used in the treatment of water polluted with inorganic elements such as Cr, Mn, Fe, Cu, Cd, Ag by (Batch processing). The batch process with using alfalfa powder gets treated with Pb (51.45%), which is the highest percentage of treatment. Mn (13.18%), which is the
... Show MoreTransformations of the actor when acting many characters are the product of joint work between the actor and the director through the instructions and the exercises that facilitate the reach for the desired goal.
The method or way has often been used which is Stanislavsky premises in his work with the actor in the role. The first section consists of two parts under the heading of the actor's work with himself. The two parts are preparing the actor in creative suffering (internal), and in coexistence and embodiment (outside). The second section is the book of the actor's work with the role. The current research aims at identifying the mechanism of the acting performance transformations among many characters of the same actor.
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