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.
According to the importance of the subject of research, and the importance of the surveyed organization as a dynamic sector of the country in general , The research attempts to suggest to service organizations in general reconsidering the currently adopted mechanisms in the redesign of its functions , and in the services provided industry . The data was collected from (98) Director Mangers , head of department and head of division . The research tool is the questionnaire , which included (50) items . The results show Significant Effect & Correlation relationship between the two variables due to their dimensions . These lead to he application of job enrichment technology will increase the organization's ability to possess efficient hu
... Show MoreVerbs are an important material in the construction of the sentence, as they are among the requirements of every sophisticated language, and in this regard, Ibn Al-Gothic (d. 367 AH): “Know that verbs are the origins of the buildings of most speech, and thus scholars called them buildings.” Verbs are the source of expression of the speakers’ ideas to represent the element of activity and movement, and with their knowledge We infer the meanings of Arabic words, and Ibn Al-Sarraj (d. 316 AH) defined it: “The verb denotes a meaning and a time, and that time is either past, present, or future.” Its letters are original and does not drop from its construction a letter in the conjugation of its conjugations, and it is in Arabic two type
... Show MoreAfter baking the flour, azodicarbonamide, an approved food additive, can be converted into carcinogenic semicarbazide hydrochloride (SEM) and biurea in flour products. Thus, determine SEM in commercial bread products is become mandatory and need to be performed. Therefore, two accurate, precision, simple and economics colorimetric methods have been developed for the visual detection and quantitative determination of SEM in commercial flour products. The 1st method is based on the formation of a blue-coloured product with λmax at 690 nm as a result of a reaction between the SEM and potassium ferrocyanide in an acidic medium (pH 6.0). In the 2nd method, a brownish-green colored product is formed due to the reaction between the SEM and phosph
... Show MoreCloud computing offers a new way of service provision by rearranging various resources over the Internet. The most important and popular cloud service is data storage. In order to preserve the privacy of data holders, data are often stored in cloud in an encrypted form. However, encrypted data introduce new challenges for cloud data deduplication, which becomes crucial for big data storage and processing in the cloud. Traditional deduplication schemes cannot work on encrypted data. Among these data, digital videos are fairly huge in terms of storage cost and size; and techniques that can help the legal aspects of video owner such as copyright protection and reducing the cloud storage cost and size are always desired. This paper focuses on v
... Show More(Sepak takraw) is a game that mixes football and volleyball, it is played on a court similar to a badminton court, in which players have the right to play the ball with any part of the body except the arm and hand. The object of the game is to return the ball to the opponent's court and score a point. Since it is a newly emerging game, all aspects related to it must be studied and covered in order to reach the highest levels, and it is known that each game or sporting activity has its own physical and motor capabilities, which is important to determine the level of technical performance, as the game's abilities contribute to mastering the skills. The importance of research in determining standard levels of physical and motor abilities for y
... Show MoreThe Research aims to investigate into reality in terms of planning and scheduling management process for sake the implementation and maintenance of irrigation and drainage projects in the Republic of Iraq, with an indication of the most important obstacles that impede the planning and scheduling management process for these projects and ways of addressing them and minimizing their effects. For the purpose of achieving the goal of the research, a sci
... Show MoreSensibly highlighting the hidden structures of many real-world networks has attracted growing interest and triggered a vast array of techniques on what is called nowadays community detection (CD) problem. Non-deterministic metaheuristics are proved to competitively transcending the limits of the counterpart deterministic heuristics in solving community detection problem. Despite the increasing interest, most of the existing metaheuristic based community detection (MCD) algorithms reflect one traditional language. Generally, they tend to explicitly project some features of real communities into different definitions of single or multi-objective optimization functions. The design of other operators, however, remains canonical lacking any inte
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