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 research included four topics: the definition of Imam al-Bazzazi, his scientific life, his sheikhs, his students, his writings, his death, and selected issues of his weight in the book of prayer. The Imam al-Bazazi is the son of Muhammad ibnShihabibn Yusuf. He is known as al-Khardizi al-Khawarizmi. The author did not adopt the definitions of language and terminology, and rarely mention the legal evidence adopted by the scholars in their opinions, and only to mention the views only, and the author, may God have mercy on him in his book on the sources of m The Prophet (peace and blessings of Allaah be upon him) said: "The Prophet (peace and blessings of Allaah be upon him) And fall down the order, the third issue, which is to leave the
... Show MoreIn the period after the collapse of the Soviet Union in 1991, the Federal Republic of Russia witnessed a setback in the overall strategic performance of the country, as it went through a stage of performance flop between the orientation towards Europe in the era of President Boris Yelsen (1991-1999), or the change of direction towards Eurasia, as the Russian Federation managed After President Vladimir Putin assumed power in 2000, from rebuilding the same state and preserving national unity and social cohesion, as well as building a phased military doctrine that made clear moves in Russian strategic thought and future directions towards regions of eternal importance in Russian strategic perception Lack of a set of motivations based on it:
... Show MoreThe Atoms in Molecules (AIM) analysis for triosmium cluster, which contains trihydridede, carbon, carbonyl and 2-methylbenzothiazolide ligands, [Os3(µ-H)3(µ3-ɳ2-CC7H3(2-CH3)NS)(CO)8] is reported. Bonding features in this cluster has been analyzed based on QTAIM ("Quantum Theory of Atoms in Molecules") in this work. The topological indices derived from electron density of relevant interactions in triosmium compound have been studied. The major interesting point of the AIM analyses is that the core of part (Os3H3) reveals the absence of any critical points and bond paths connecting any pairs of O
... Show MoreObjective. This study aimed to evaluate the orthodontic bond strength and enamel-preserving ability of a hydroxyapatite nanoparticles-containingself-etch system following exposure to various ageing methods. Materials and Methods. Hydroxyapatite nanoparticles (nHAp) were incorporated into an orthodontic self-etch primer (SEP, Transbond™ plus) in three different concentrations (5%, 7%, and 9% wt) and tested versus the plain SEP (control) for shear bond strength (SBS), adhesive remnant index (ARI) scores, and enamel damage in range-finding experiments using premolar teeth. The best-performing formulation was further exposed to the following four artificial ageing methods: initial debonding, 24 h water storage, one-month water stora
... Show Morehe current research aims at showing the correlation and effect of the internal environment analysis in the quality of health service in AL_Elwiya Maternity Teaching Hospital, researcher depended on the integral method in the "analytical descriptive method" for the study of the relation between the main variables and the sub-variables throughout data collection required by the theme of this study, a case study" in tackling the data and information related to the financial aspects of the internal environment.
The problem of the study was manifested in the essential question, that is (is there internal struc
... Show MoreSecond language learner may commit many mistakes in the process of second language learning. Throughout the Error Analysis Theory, the present study discusses the problems faced by second language learners whose Kurdish is their native language. At the very stages of language learning, second language learners will recognize the errors committed, yet they would not identify the type, the stage and error type shift in the process of language learning. Depending on their educational background of English as basic module, English department students at the university stage would make phonological, morphological, syntactic, semantic and lexical as well as speech errors. The main cause behind such errors goes back to the cultural differences
... Show MoreLead-acid batteries have been used increasingly in recent years in solar power systems, especially in homes and small businesses, due to their cheapness and advanced development in manufacturing them. However, these batteries have low voltages and low capacities, to increase voltage and capacities, they need to be connected in series and parallel. Whether they are connected in series or parallel, their voltages and capacities must be equal otherwise the quality of service will be degraded. The fact that these different voltages are inherent in their manufacturing, but these unbalanced voltages can be controlled. Using a switched capacitor is a method that was used in many methods for balancing voltages, but their respons
... Show MoreThis study is an approach to assign the land area of Kirkuk city [ a city located in the northern of Iraq, 236 kilometers north of Baghdad and 83 kilometers south of Erbil [ Climatic atlas of Iraq, 1941-1970 ] into different multi zones by using Satellite image and Arc Map10.3, zones of different traffic noise pollutions. Land zonings process like what achieved in this paper will help and of it’s of a high interest point for the future of Kirkuk city especially urban
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