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 research aims to know the availability of supra-cognitive thinking skills in the questions and activities of the computer book for the fifth grade preparatory scientific and literary branches in Iraq for the academic year 2018/2019, as the researcher has prepared a list of supra-cognitive thinking skills included two areas and (6) key skills and (27) A sub - skill, where by the questions and activities of the aforementioned authors were analyzed. The researcher followed the descriptive analytical approach "method of content analysis", and adopted the explicit and implicit unit of analysis, as was verified the validity and stability of the analysis, and the results showed unevenness and imbalance in the distribution of supra-cognitive th
... Show MoreThe tensions and crises and the psychological pressure as well as the rapid changes and great development which is taking place in the present time. And witnessing community of wars and conflicts that give rise to future concern among members of the community in general and students in particular, as it included the current research a number of chapters, the First chapter contains the research problem, the important goal, then set researcher terminology that has defined and contained in the title of research in the form (concern the future, artistic expression, middle school). The Second chapter included three sections, the first included the nature of adolescence and traits, characteristics and pr
... Show MoreEquilibrium and rate of mixing of free flowing solid materials are found using gas fluidized bed. The solid materials were sand (size 0.7 mm), sugar (size0.7 mm) and 15% cast iron used as a tracer. The fluidizing gas was air with velocity ranged from 0.45-0.65 m/s while the mixing time was up to 10 minutes. The mixing index for each experiment was calculated by averaging the results of 10 samples taken from different radial and axial positions in fluidized QVF column 150 mm ID and 900 mm height.
The experimental results were used in solving a mathematical model of mixing rate and mixing index at an equilibrium proposed by Rose. The results show that mixing index increases with inc
... Show MoreThe investment however "was its description and meaning, it remains a resident" in the composition of capital assets located in the forefront of the creation of productive assets, and this means that the investment in the productive sectors is a priority in achieving capital accumulation, on any other investment that takes place with the stages of advanced development of formation , not forgetting "to humans and investment humans as head of real money product, the source of the economic surplus and accumulation, and the source of producing values, and if human labor was the source of value, and the human was the source of work, therefore humanitarian work on different levels and skills presents capital", so the investment in huma
... Show MoreRock failure during drilling is an important problem to be solved in petroleum technology. one of the most causes of rock failure is shale chemical interaction with drilling fluids. This interaction is changing the shale strength as well as its pore pressure relatively near the wellbore wall. In several oilfields in southern Iraq, drilling through the Tanuma formation is known as the most challenging operation due to its unstable behavior. Understanding the chemical reactions between shale and drilling fluid is determined by examining the features of shale and its behavior with drilling mud. Chemical interactions must be mitigated by the selection of suitable drilling mud with effective chemical additives. This study is describing t
... Show MoreGenome sequencing has significantly improved the understanding of HIV and AIDS through accurate data on viral transmission, evolution and anti-therapeutic processes. Deep learning algorithms, like the Fined-Tuned Gradient Descent Fused Multi-Kernal Convolutional Neural Network (FGD-MCNN), can predict strain behaviour and evaluate complex patterns. Using genotypic-phenotypic data obtained from the Stanford University HIV Drug Resistance Database, the FGD-MCNN created three files covering various antiretroviral medications for HIV predictions and drug resistance. These files include PIs, NRTIs and NNRTIs. FGD-MCNNs classify genetic sequences as vulnerable or resistant to antiretroviral drugs by analyzing chromosomal information and id
... Show MoreThe formal investigation of the interior spaces of the residential bedrooms for children with autism is one of the basic tasks that should be known by the interior designer. Achieving an atmosphere compatible with his health condition, which contributes to generating a sense of spatial intimacy through the design dimension provided by the interior designer and his tireless endeavor to meet the needs of the child in an internal environment that achieves the functional dimension and spiritual approaches that enhance the child’s sense of spatial belonging and contribute to improving his mood and this positively reflects on his behavior and social integration. The current research has reached the most important design criteria that must be
... Show MoreAbstract:
The research concerned the study of the railway transport sector in selected countries that sought to raise the efficiency of the railway network and develop it, after realizing the importance of this vital sector, which is a link between it and the rest of the other economic sectors.
The research sought to explain the methods, methods and procedures adopted by these countries for the development of the railway sector, and to benefit from these experiments to improve the efficiency of the railway transport sector in Iraq.
The railway transport sector in Iraq suffers from the erosion of railway lines and mobile units such as locomotives, pas
... Show MoreContemporary management is interested in the process of performance assessment because of its significance in the field of planning and controlling the multiactiveties to attain its goals and uncovering digression of virtual performance after comparing it with the plan or equitable performance.
Digression is analyzed to enable management control centers of authority.
Assessment process significance is closely related by setting definite categories to evaluate the economic activity to know the ability to achieves aims.
This study concentrated on the most important categories that used to evaluate company understudy with ather categories suggested to complete assessment process.
This study is in
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