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.
A pure posteriorly posterior communicating artery (PCoA) aneurysm represents a surgical challenge. This is mainly when there is a need for good exposure of the aneurysmal neck, sac, PCoA, and anterior choroidal arteries. Ruptured pure posteriorly directed PCoA aneurysm imposes significantly extra challenge as the surgeon undergoes dissection through a tight brain. Even with measures commonly used to attain brain relaxation like the lumbar drain and cisternal fenestration. Here, we describe a technique for posterior temporal pole mobilization (TPM) as an integrated part of microsurgical clipping of ruptured pure posteriorly directed PCoA aneurysms. This technique is implicated in twenty-three successive cases of ruptured PCoA aneurys
... Show MoreThe present study aims to detection optimal conditions of production of amylase enzyme from isolate of B. subtillis A4. Nine carbonic sources were represented by starch, maltose, fructose, sucrose, glucose, arabinose, xylose, sorbitol and mannitol) at concentration of 1% for each source. It was found that the best was represented by starch carbonic, which showed higher activity and qualitative activity of 7.647 Unit/ ml and 461.56 Unit/ mg. Ten nitrogen sources were selected, including yeast extract, peptone, trypton, gelatin, urea and meat extract as organic sources Ammonium sulphate, Sodium nitrate, Potassium nitrate and Ammonium chloride as inorganic sources. These sources were added at aconcentration of 0.5% to the production medium. Th
... Show MoreBack ground : The transforming growth factor beta (TGFB) signaling pathway is involved in many cellular processes in both the adult organism and the developing embryo including cell growth, cell differentiation, apoptosis. The interaction between implant material and surrounding tissues is believed to play a fundamental role in implant success and illustrates different expression of growth factors by different cells that involved in the formation of peri-implant tissue. The aim of this study was to localize expression of TGF B by newly formed bone tissue around surface-conditioned implants with placental collagen at different time intervals: 3 ,7,14,28, and 56 days . Materials and Methods: Commercially pure Titanium (CPTi) implants coated w
... Show MoreThe researches discusses the style of acting used by (Sami Abdul-Hameed) in one of the play director (Salah AL-Kassab) production whine he called; Picturesque.
The problem of this research is to discover the differences between the performance of (Sami Abdul-Hameed) in the Picturesque Theatre and the other theatre.
The goal of the research is to get to know the style of acting used in (king Lear) directed by (Salah AL-Kassab).
After defining the term (picturesque theatre), the researcher discusses the elements of the Visual theatre and the components of the stage picture according to (Alexander Dean) and he refers to those well-known director who had emphasized the Visual elements. Such as (Gordon Grieg) and (Franco Zeferrel
The goal of this paper is to show the kinematic characteristics of gaseous stellar dynamics using scaling coefficient relationships (such as Tully-Fisher) in different spiral galaxies. We selected a sample of types of spiral morphology (116 early, 150 intermediate, and 146 late) from previous literature work, and used statistical software (statistic-win-program) to find out the associations of multiple factors under investigation, such as the main kinematic properties of the gaseous-stellar (mass, luminosity, rotational speed, and baryons) in different types of spiral galaxies. We concluded that there is a robust positive connection between Log Vrot.max.) and Log Mstar(B-V), as well as between Log Vrot.max. and Log Mbar (
... Show MoreAnchusa strigosa - prickly alkanet from Boraginaceae grows in roadsides, and fields of a broad range of habitats from mediterranean woodlands, to steppe vegetation, to true desert. It is commonly known as" him him" or "lisan al thawr". Anchusa can withstand hard weather conditions and hence is widely cultivated. The color of its flowers can range from pure white to deep cobalt blue. Various parts of A. strigosa are used in traditional medicine for treating several diseases or symptoms, such as abdominal pain, bronchitis, cough, and diarrhea. The goal of this study was to examine the cytotoxic effect of the crude extract of A. strigosa roots and leaves and their fractions against various tumor cell lines: adenoc
... Show MoreThis study tackles the contribution of the environmental audit in achieving the sustainability of the environmental balance in the Sudanese business environment. The study aimed at clarifying the role of environmental auditing in supporting sustainable development, and to recognize the role of environmental audit in urging businesses to abide by environmental protection. It also shows how effective the environmental audit reports are, in providing the reliable data for the concerned authorities, in order to use it in making the decisions that would help in the sustainability of the environmental balance. To achieve the goals of the study, a questionnaire was developed and distributed to the registered chartered accountants in Sud
... Show More The current research aims to: (know the effectiveness of the harvesting strategy in the achievement of the students of the Institute of Fine Arts in environmental art.
- In order to know this effectiveness, the researcher put a main zero hypothesis and derived six sub-hypotheses from it. the usual way; As the research community reached (120) male and female students of the Fine Arts Institutes for the morning study in Baghdad. As for the research sample, it was chosen by the simple random method, and the number was (75) male and female students for the year 2021-2022 AD. The researcher applied a pre-knowledge test for the four groups of research to find out the level of previous experiences of students in the subject of environmen
The Accommodation industry in Iraq suffers from many problems, especially after 2003, when the Accommodation industry was exposed to many crises due to the security and political situation in Iraq, which negatively affected the administrative operations inside the industry and created many problems, the most important of which are deterioration, high costs and poor performance, so some hotel administrations sought To find alternative solutions that help in the advancement of hotels, one of the proposals is to go to technology, as technology is currently one of the most important solutions to solve large complex problems, as the world has turned to automation to solve complex problems such as increasing production, reducing costs, and rai
... Show MoreThe transfer of training process occupies a great importance in achieving the ultimate goal of participating in the training programs , it is sure that this does not take place without the support of the working environment for trainees, and The research aims to personification role the work environment characteristics of supporting the transfer of training.
The research problem is the weakness transfer of training to the work en
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