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.
Hall effect measurements have been made on a-As2Te3 thin films different thickness film in the range (200-350) nm. The Hall mobility in a-As2Te3 thin films decreases with increasing annealing temperature but the carrier concentration increases. When increasing the film thickness increases the Hall mobility decreases, while the carrier concentration increases.
The ancient Iraqis in the Mesopotamian civilization practiced various sports activities and physical exercises to develop their physical fitness until these practices became a part of their lives and accompanied their religious, social, and military celebrations. Music had a presence in many sports scenes, and the presence of musicians and musical instruments with the armies indicated its great role. In the military scene, the research aims to shed light on the archaeological evidence and evidence of the integration of music with the sports and military scene in Mesopotamian civilization and to explore the impact of music in the sports and military scene of Mesopotamian civilization. The historical approach was adopted in collecting and des
... Show MoreThis study aimed to find out the impact of work-life balance on employee satisfaction in five-star hotels in Amman, Jordan based on a descriptive analytical approach. The questionnaire of the survey was designed and distributed to a sample of participants in order to collect the necessary data for this study and they were analyzed later through the SPSS V22 program. The study population was the hotel sector in Jordan, while the study sample included the five-star hotels in the capital, Amman, and the sampling unit included the employees of the middle and lower levels of management in the five-star hotels in Amman. The study showed a number of results, including the existence of a good level of work-life balance by employees in top manage-me
... Show MoreThe laser micro-cutting process is the most widely commonly applied machining process which can be applied to practically all metallic and non-metallic materials. While this had challenges in cutting quality criteria such as geometrical precision, surface quality and numerous others. This article investigates the laser micro-cutting of PEEK composite material using nano-fiber laser, due to their significant importunity and efficiency of laser in various manufacturing processes. Design of experiential tool based on Response Surface Methodology (RSM)-Central Composite Design (CCD) used to generate the statistical model. This method was employed to analysis the influence of parameters including laser speed,
... Show MoreProcessed and red The Western diet, a modern dietary pattern, typically consists of meat, sugar-filled beverages, candies, chocolates, fried foods, prefabricated meals, refined cereals, conventionally produced animal products, high-fat dairy products, and high-fructose items. The goal of this review is to outline how the Western pattern diet affects gut microbiota and mitochondrial fitness, as well as metabolism, inflammation, and antioxidant status. Cancer, mental health, and cardiovascular health; We offer a thorough analysis of how the westernized diet and related nutrients affect immune cell responses as well as the hygienic costs of the Western diet. A consensus critical evaluation utilizing primary sources, including scientifi
... Show MoreDie Zusammenfassung :
In der Forschung „ Die Wirkungen der Nachkriegliteratur „ findet man einen Überblick über die Wirkungen der Literatur im Allgemeinen und besonders über die Wirkungen der Nachkriegliteratur in Deutschland. Das Kurzgeschichte „ das Brot“ von Wolfgang Borchert „ wird in dieser Forschung als Beispiel analysiuert, weil sie die Nachteile des Kriegs und ihre Wirkungen auf die Familienbeziehungen behandelt. Die Hauptfiguren der Kurzgeschichte sind ein alter Mann und seine Frau. Der Schriftsteller bestimmt die Rolle der Frauen in Deutschland. Die Frau in dieser Geschichte ist stärker als ihren Mann , denn er war lügner und schwach.
Post-war Literature has an e
... Show MoreThe instant global trend towards developing tight reservoir is great; however, development can be very challenging due to stress and geomechanical properties effect in horizontal well placement and hydraulic fracturing design. Many parameters are known to be important to determine the suitable layer for locating horizontal well such as petrophysical and geomechanical properties. In the present study, permeability sensitivity to stress is also considered in the best layer selection for well placement. The permeability sensitivity to the stress of the layers was investigated using measurements of 27 core sample at different confining stress values. 1-D mechanical earth model (MEM) was built and converted to a 3-D full-field geomechanical mode
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