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.
This study aimed to identify the role of servant leadership in promoting organizational citizenship behaviors in a sample of faculties of the University of Alqadisiya .It tried to answer several questions represented its problem.
The most important questions are the followings:
1- Is there enough perception among administrative leaders in the aforementioned faculties toward the concept of servant leadership? And under what level? &
... Show MoreThe current study aimed to measure the attitudes of female teachers towards the use of digital learning and the degree of possessing their digital education skills. The study sample consisted of (180) workers with disabilities (mental disability، auditory impairment، visual disability، hyperactivity and distraction. To achieve the goals of the study, the transformation measure was used towards digital education for people with disabilities. The study reached the following results: the availability of digital learning skills among workers with disabilities. The study concluded with a series of recommendations including holding Training courses to keep up with the challenges of educational trends and modern technology in this area.
The search consists of four chapters, which are as follows: -First Chapter,The research shows the problem and the importance and its need, its aim and limits are to identify the terms of it consist. The problem of the research has been identified by answering the following question:How to representthe significant displacement of the Crucifixion of Jesus Christ in contemporary drawing? ,The aim of the research also has been discussed around what it represents: The significant displacement of the Crucifixion of Jesus Christ in contemporary drawingshows. As for the research limits .the portress which are taken from a variety of sources, and the period of time of the year (1945-2008).fearst chapter;The theoretical framework and previous stud
... Show MoreThe research tried to show the importance of Administrative Control being one of the important means in administrative work; they work on the review and audit work done and error handling explored in the work and prevent the occurrence and ascertain the extent of implementation of the planned targets, and therefore this is reflected in raising the efficiency of the performance of the tax examiner and complete the work as soon as possible and the highest efficiency and reduce the gaps that may occur between the parties of the tax settling accounts and dealt with in the theoretical side of the search to the research problem, namely with whether operating management oversight to improve the performance and increase the efficiency of t
... 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 purpose of this research is to identify
the effect of the translation of poetic poem into an artistic picture in the achievement of retention among fifth grade students.
In order to verify the research goal, the first two hypotheses were determined. There are no statistically significant differences between the average scores of the experimental group who study (according to the technical picture) ) And the control group (according to the traditional method of art education) at the level of significance (0,05). The second is that there are no statistically significant differences between the average of the experimental group who study (according to the technical picture) and the control group who study (On According to the trad
The current study was carried out to study a high injection dose of the ethanolic extract thymus vulgaris leaf (500 ug /Kg) against the immune response combination with partially purified extracted Lipopolysaccharide ( LPS) from Proteus mirablis.Study groups were included four groups; Group I :treated with normal saline. Group II : treated with LPS antigen, Group III: injected subcutaneously ((500 ug /Kg) from ethanolic extract thymus vulgaris, group IV : injected subcutaneously (500 ug /Kg) from ethanolic extract thymus vulgaris leaf and LPS antigen, the immunological assays were measured through the phagocytic activity as (non specific immunity) after day 8 by using the phagocytic activity index.After day I4 the lymphocyte proliferations
... 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 MoreWhile the impact of the fourth Industrial Revolution on the economy keeps accelerating, the signs of the fifth industrial revolution, whose key is innovation and creativity started to evolve. However, the challenge of achieving sustainable development and its goals remains faced by the global organizations; In this situation, Islamic banks are exposed to many challenges among which is the challenge of keeping themselves abreast of the latest developments in the modern technology which in turn is a tool for continuity and competition. On the flip side, to avoid the negative impact that these changes can have such as an increased gap between financial innovations and the requirements of sustainable development. Islamic banks in the
... Show MoreBackground: University dental students perceived a higher level of stress prior to the final exam associated with raised salivary alpha-amylase levels which could be considered as a useful noninvasive biomarker for measuring acute stress. Using a Helkimo anamnestic and clinical dysfunction scoring for temporomandibular disorders can give a better insight about the association of this marker and temporomandibular disorders. The aim of this study was to evaluation level of salivary alpha-amylase in stressor students with temporomandibular disorders and the relation between the marker in relation to temporomandibular disorders severity. This might give a better understanding to the role of psychological stress as an etiological factor for deve
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