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.
Integrated project delivery is collaboratively applying the skills and knowledge of all participants to optimize the project's results, increase owner value, decrease waste, and maximize efficiency during the design, fabrication, and construction processes. This study aims to determine IPD criteria positively impacting value engineering. To do this, the study has considered 9 main criteria according to PMP classification that already covers all project phases and 183 sub-criteria obtained from theoretical study and expert interviews (fieldwork). In this study, the SPSS (V26) program was used to analyze the main criteria and sub-criteria priorities from top to bottom according to their values of the Relative Importance In
... Show MoreThe research aimed at designing teaching program using jigsaw in learning spiking in volleyball as well as identifying the effect of these exercises on learning spring in volleyball. The researchers used the experimental method on (25) students as experimental group and (27) students as controlling group and (15) students as pilot study group. The researchers conducted spiking tests then the data was collected and treated using proper statistical operations to conclude that the strategy have a positive effect in experimental group. Finally, the researchers recommended using the strategy in making similar studies on other subjects and skills.
There are many applied Economic studies that have found positive nexus between financial development and poverty reduction in developing countries. Iraq has witnessed an increasing rate of poverty during the period 1980-2010 due to many internal and external factors such as wars, economic sanctions, inflation, a high rate of unemployment, and political and security instability. Therefore, the investigation about the solutions to reduce poverty becomes very necessary, and enhancing the financial development in Iraq is one of these options. This is due to that the financial development could reduce the poverty rates through two channels: the first is direct via the offering of the loans and other financial facilities to the poor, a
... Show MoreAbstract:
The purpose of this research is measuring relationship level and impact between Organizational Factors and their Dimensions (Leadership, Organizational Structure, Organizational Culture), and Talent Management Strategies (Talent Recruitment,Talent performance management, Talent Development, Talent Retention ). it was relied on the Questionnaire form as a basic instrument in collecting the Data by using (Likert) instrument ,which was distributed on the research Sample which number was (100) individual included (Managers of schools, assistants (scientific and Administration ) and teachers in Four schools of Talents in Iraq (Baghdad , AL-Nagaf , AL-Basra, Mesan). All fo
... Show MoreAbstract
The aim of the research is to identify the role of ethical leadership in achieving comprehensive quality standards in public education schools in the Al-Ardha governorate. To achieve this goal, the descriptive approach was used, the researcher developed a questionnaire consisting of (35) items, divided into two sections: the first one is related to ethical leadership includes (17) items, and the second section relates to total quality management includes (18) items. The research sample consisted of (405) teachers from the stages of public education. The results showed that the level of ethical leadership practice (ethical personal characteristics, ethical administrative features, teamwork, and human rela
... Show MoreThe study aims at studying and analyzing the subject of marketing vigilance as it is one of the modern approaches in the marketing field that can be used to face changes in the competitive and strategic environment and that represents quick reactions on the part of the institution to ensure its survival and distinctiveness other aims are: Consolidating the strength of the marketing organization and its success continuously, represented by changes in the market share, awareness of the institution's position in the market and its relations with competing tourism companies, diversification of tourism services, as well as an analysis of the competitive strategic position of tourism institutions for the purpose of conducting a r
... Show MoreAbstract
The leases, are regarded as one of the most controversial accounting issues in recent years, since they represents one of the important sources of funding, which may be exploited by the tenant as off- Balance sheet Financing , which negatively affects the quality of financial reporting. The Financial Accounting Standards Board (FASB) and the International Accounting Standards Board (IASB) have "significant" interest in accounting for leases . FASB issued Statement of Financial Accounting Standards 13 on lease contracts in 1976 and IASB issued IAS 17 in 1980, which was amended in 1997 and IFRS 16, issued in January 2016, which will be effective on January 1, 2019 , to solve
... Show MoreThe reason behind choosing this topic " internal marketing (IM) of human resource management (HRM)" is to highlight the advantages of using IM in the organization framework. The problem of the research paper lies in not paying enough attention to employees genuine needs as they interact with each other in the sake of organization prosper. This research paper can be used as indictor to expose the weaknesses that the organization encounters daily. The current research paper attempts at examining the possibility of developing philosophy of internal marketing of human resources and its most practices, empowering staff, training courses, motivations and recognitions, and within departments communication, in order to reach targeted res
... Show MoreThe introduction of the research on the science of training and the physiology of sports was addressed from important sciences, where the physical effort drew the attention of scientists since the past centuries when they studied how the body performs its functions when performing physical exertion and observe the changes that occur in it and write down and study especially the positive effects of the practice of daily sports The aim of the study was to investigate the effect of plank exercises on the lipid component and the metabolic rate (bmr) of the female students of the Higher Institute for Security and Management Development. As for the third chapter, the two researchers used the experimental method on a sample of the female s
... Show More