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 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
... Show MoreThis study aimed at comparing the performance of vertical, horizontal and hybrid subsurface flow systems in secondary treatment for the effluent wastewater from the primary basins at Al-Rustumia wastewater treatment plant, Baghdad, Iraq. The treatments were monitored for six weeks while the testsduration were from 4 to 12 September 2018 under continuous wastewater feeding for chemical oxygen demand (COD), total suspended solid (TSS),ammonia-nitrogen(NH4-N) and phosphate (PO4-P) in comparison with FAO and USEPA standards for effluent discharge to evaluate the suitability of treated water for irrigation purposes. Among the systems planted with Phragmites Australia, the hybrid subsurface flow system which cons
... 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
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 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 MoreEvaluation of the Antibacterial Efficacy of Electrolyzed Oxidizing Water as an Irrigant against Enterococcus faecalis (An In vitro Study), Noor A Khait*, Muna Saleem Kalaf
In a world of limited space, the owners are always surrounded by others next to them, and, consequently, there is hardly any activity which the owner may exercise on his land which would not affect the other owners. If he builds a building, that building may block the sun's rays or the air from the buildings next to it and owned by other people. And if he runs a business, the lands adjacent to that business may be overburdened with the accompanying noise or traffic. If oil is prospected in a land, the neighboring lands may be deprived of oil or their owners may be exposed to toxic fumes. Hence the importance of researching the intention of harming others, as it is one of the most important forms of abuse in the use of the right (especially
... Show MoreInfluential, organized groups with natural antimicrobial and anti-biofilm broad-spectrum power exist within the food chain, like a hidden dormant mimic hygienic bio life nanobodies that can terminate multiple opportunistic disease entities owing multi-stress resistant forbidden recalcitrant power, such as Candida albicans. These wonderful dynamic forces created by ALLAH Almighty are the Mycophages or fungi-eating state of fungi foodborne phages, and this project was redirected to be a dare to leap from us towards the future. Multi-stress resistant C. albicans that are resistant to different antifungal agents with their genetic tolerance plasticity to thermal pasteurization decontamination module as well as to ultraviolet irradiation
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