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: Pit and fissure sealant have been considered an outstanding adjunct to oral health care in the decrease of occlusal caries onset and low progression. The aims of this in vitro study were to evaluate the marginal microleakage of three different types of fissure sealants (SDI, Tg and tetric N-flow) by time interval, one day and 45 days, in the presence or absence of bonding agent among maxillary and mandibular teeth. Materials and methods: Seventy two sound human maxillary and mandibular first premolar teeth were collected which were free from obvious carious lesions. The teeth were randomly divided into two main equal groups, group (1) and group (2), each group consists of (36) teeth involving equal numbers of maxillary and mandi
... Show MoreHate speech (henceforth HS) has recently spread and become an important issue. This type of speech in children's writings has a particular formulation and specific objectives that the authors intend to convey. Thus, the study aims at examining qualitatively and quantitatively the classism HS and its pragmatic functions via identifying the speech acts used to express classism HS, the implicature instigated as well as impoliteness. Since pragmatics is the study of language in context, which is greatly related to the situations and speaker’s intention, this study depends on pragmatic theoriespeech acts, impoliteness and conversational implicature) to analyze the data which are taken from Katherine Mansfield's short story (The D
... Show MorePurpose: The research aims to build an integrated knowledge framework for the basic research topic. The spirituality of the workplace is through access to the most important scientific proposals on these topics. In management thought framing, the knowledge within them in a serious attempt is to provide the appropriate answers about the intellectual dilemma of research by diagnosing the nature of the relationship with the influential elements and its historical development . Methodology: The study is relied on the analytical survey method. The research sample targeted (88) managers in the center of the Iraqi Ministry of Health exclusively from the researched senior leaders (general manager, assistant general manager, and head of department),
... Show MoreThe results of previous scientific studies showed that knowledge is something and application is something else, that's why teachers' preparation programs focused, in the present time, on special standards for knowledge and performance, i.e., who has knowledge is not necessary able to apply it in his life or in his field of work, which led to the existence of a gap between knowledge and application. Based on that, those interested in (teachers' preparation) reconsidered their work evaluation, thus the concept of competency appeared at the end of the sixties of the past century to address the negative in teachers' preparation.
The following contains a number of competency features in teachers' preparation programs:
Teachers' effec
Kurdish language multifunctional morphemes indicate the different functional morphological, syntactical, and semantic tasks of the morphemes. The present study discusses the multifunctional task of the Morpheme Le in Kurdish Language. The Morpheme Le has marginally been included in other studies, yet up to the present times, there has not been a research inclusively dedicated to thoroughly discuss and clarify its multifunctional aspects. The present study is divided into two chapters:
Chapter one discusses the theoretical aspect of chapter two that is entirely concerned with the practical aspect of the morpheme Le. The first part of chapte
... Show MoreThis study deals with air pollution tolerance index (APTI) and anatomical variation in leaves of two species of terrestrial plants Ficus sp. and Conocarpus sp. that have bee commonly the separated along roadsides in many stations within Babylon province. APTI values of both species were less than 10 during study period which represented sensitivity of these plants to air pollution. There are Anatomical responses to pollution in the leaves of both studied species. Main adaptations included increased thickness of parenchyma cell walls with clear dark deposits in sections of Ficus sp. from sections of stations 2 and 4 which represent polluted stations. Conocarpus sp. main adaptation included stomata increased in density and decreased in size w
... Show MoreMangrove landscaping in the Segara Anakan Lagoon (SAL) is an adaptation pattern of mangrove ecosystems to live and grow in unstable areas. This research aimed to develop a mangrove landscape to mitigate the impacts of ocean waves, currents, and inundation due to climate change. The study was conducted in SAL and Cilacap Coast (CC) using the environmental properties and climate change data. The data obtained were analyzed using mapping and trendline analyses. The results showed that mangrove landscaping in Segara Anakan had four zones with Nypa frutican, Rhizophora styllosa, Aegiceras corniculatum, Rhizophora apiculata, Avicennia marina, Sonneratia alba identified as the best adaptation of mangrove species. Climate change give a high impa
... Show MoreThe regular job of a reservoir engineer is to put a development plan to increase hydrocarbon production as possible and within economic and technical considerations. The development strategy for the giant reservoir is a complex and challenging task through the decision-making analysis process. Due to the limited surface water treatment facility, the reservoir management team focuses on minimizing water cut as low as possible by check the flow of formation and injected water movement through the Mishrif reservoir. In this research, a representative sector was used to make the review of water injection configuration, which is considered an efficient tool to make study in a particular area of the entire field when compared with the ful
... Show MoreThe present study investigates the notion of untranslatability where the concept of equivalence is reconsidered since the misconceptions, related to the said concept, inevitably lead to the emergence of untranslatability. Identifying equivalence as relative, approximate and necessary identity makes the notion of untranslatability a mere theorization. The objectives of the present study are (1) to investigate the notion of untranslatability in terms of the misconceptions associated with the concept of equivalence (2) to examine the possibility of translatability from Arabic into English focusing on culture-bound euphemistic expressions in the Quran as an area of challenge in translation. Data on the translation of culture-bound euphemistic e
... Show MoreVictorian age is known as a time of perpetual change. It is a time of new industrialization, increased urbanization and new technology. Therefore, one of the strongest undercurrents of this is the position of women. Woman at that time was viewed as “an angel in the house” especially this who belongs to the upper-middle class. She is described in such term because she spends much time in her domestic domain. Therefore, she should be passive, obedient and dependent. Despite the Victorian society contains several classes; women are defined under two labels: the angel and the demon or the whore. The angel woman can be any woman from the lower middle class to the aristocracy, while the whore refers to any working class woman. The differen
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