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 current study aimed to measure the attitudes of female teachers towards the use of digital learning and the degree of possessing their digital education skills. The study sample consisted of (180) workers with disabilities (mental disability، auditory impairment، visual disability، hyperactivity and distraction. To achieve the goals of the study, the transformation measure was used towards digital education for people with disabilities. The study reached the following results: the availability of digital learning skills among workers with disabilities. The study concluded with a series of recommendations including holding Training courses to keep up with the challenges of educational trends and modern technology in this area.
In the midst of political, cultural and economic fast developments accelerated, the world witnessed, with the accompanied big communication revolutions, many shapes of powers. Those developments were followed by changes in relations of international level.
The most prominent among those developments was the international public relations which became equal to official international relations. Moreover, the international public relations became a complementary element dur to the growth of public opinion and its affection on political regime. Such growth of public opinion pushed the politicians to address it; and try to gain its support.
The US was the first realized the importance of international public relations. Th
... Show Moreإنّ التّأمّل في الدّراسات الأدبيّة النّقديّة الحديثة الّتي تنظر إلى النّصّ أنّه لوحة تتشكّل من مجموعة تداخلات نصّيّة سابقة للنصّ المُنتج أو مُعاصرة له، تدفع القارئ إلى الغوص في أعماق النّصوص وتحليلها والكشف عن الآليّات والإجراءات الّتي اعتمدت في إنتاجه، وإظهار الجماليّات الفنّيّة التي شكلت في مُجملها كائنا حيّا يُعبّر عن حالات إنسانيّة مُستمرة الحدوث رغم تقادم الأزمان.
فالبحث هذا يعمد
... Show MoreBackground: University dental students perceived a higher level of stress prior to the final exam associated with raised salivary alpha-amylase levels which could be considered as a useful noninvasive biomarker for measuring acute stress. Using a Helkimo anamnestic and clinical dysfunction scoring for temporomandibular disorders can give a better insight about the association of this marker and temporomandibular disorders. The aim of this study was to evaluation level of salivary alpha-amylase in stressor students with temporomandibular disorders and the relation between the marker in relation to temporomandibular disorders severity. This might give a better understanding to the role of psychological stress as an etiological factor for deve
... Show MoreObjectives: To assess the pediatric nurses' knowledge about the nosocomial infection owl), and to fud out the
relatiouships between their knowledge about the nosocomial infection and demographic data.
Methodology: A descriptive study was carried out at neonatal intensive care units OVICUs) of Baghdad
Pediatric Teaching Hospitals. It was started from the end of April to the end of October, 2008. A purposive
sample of (28) pediatric nurses were selected. The data were collected by self-administered questiormaire. The
validity of the questionnaire was detemined through a panel of experts, while its reliability was detemined
through the pilot study. The data were analyzed by descriptive and inferential statistics through th
While the impact of the fourth Industrial Revolution on the economy keeps accelerating, the signs of the fifth industrial revolution, whose key is innovation and creativity started to evolve. However, the challenge of achieving sustainable development and its goals remains faced by the global organizations; In this situation, Islamic banks are exposed to many challenges among which is the challenge of keeping themselves abreast of the latest developments in the modern technology which in turn is a tool for continuity and competition. On the flip side, to avoid the negative impact that these changes can have such as an increased gap between financial innovations and the requirements of sustainable development. Islamic banks in the
... Show MoreThrough research and research in the creative composition in the poetry of Zafer-Alhaddad it turned out to be superior in its systems, especially that he chose a linguistic and verbal texture accompanied by a cultural dictionary full of creativity and beauty helped this culture arrangement reflects the poetically wonderful and beautiful custom led to the harmony of colors and bodies painted by the poet brush the creative artist evaluates the metaphorical and metaphorical relations that would explain the poets idea, most of which were inspired by the wonderful spirit of nature, its beautiful landscapes and bright colors, especially that we do not forget the beautiful colors and the aesthetic touch that created a fascinating musical intera
... Show MoreThe purpose of this research is to identify
the effect of the translation of poetic poem into an artistic picture in the achievement of retention among fifth grade students.
In order to verify the research goal, the first two hypotheses were determined. There are no statistically significant differences between the average scores of the experimental group who study (according to the technical picture) ) And the control group (according to the traditional method of art education) at the level of significance (0,05). The second is that there are no statistically significant differences between the average of the experimental group who study (according to the technical picture) and the control group who study (On According to the trad
Football has progressed from being a ritual and a celebration to become an amateur sport, a professional sport, and now, increasingly, a commercial sport. In the analysis of football business model, the systemic approach should be adopted. If sport is regarded as one of the business sectors, then the application of business system methodology can be fully justified. The interest to create strong football business system calls for the search of the ways of popularizing football business model and boosting the economic potential of its participants. In the research literature tend to ignore the business processes within the sports business. Besides, the systemic approach in football business is usually limited to p
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