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 problem of present study is determined by answering the following questions:
1) What is the effect of using the oral open- ended questions on Students' achievement in the third-stage of Arabic department in the college of Education? 2) What is the effect of the oral open-ended questions on developing the creative thinking of students in
... Show Moreيعد علم التدريب الرياضي الحديث عملية تربوية علمية مبنية على اسس صحيحة هدفها وصول اللاعبين الى التكامل في الاداء الفني وهذا يتم عن طريق التأثير المنظم والدقيق بواسطة استعمال التمارين البدنية التي تحدث تغيرات خاصة في عمل اعضاء واجهزة جسم الرياضي والتي بدورها تؤدي الى رفع كفاءة الاعضاء والاجهزة لتحقيق الانجازات الرياضية العالية ولقد استعملت الباحثتان اسلوب حديث من اساليب التدريب الرياضي من اجل تطوير تحم
... Show MoreInfrared photoconductive detectors working in the far-infrared region and room temperature were fabricated. The detectors were fabricated using three types of carbon nanotubes (CNTs); MWCNTs, COOH-MWCNTs, and short-MWCNTs. The carbon nontubes suspension is deposited by dip coating and drop–casting techniques to prepare thin films of CNTs. These films were deposited on porous silicon (PSi) substrates of n-type Si. The I-V characteristics and the figures of merit of the fabricated detectors were measured at a forward bias voltage of 3 and 5 volts as well as at dark and under illumination by IR radiation from a CO2 laser of 10.6 μm wavelengths and power of 2.2 W. The responsivity and figures of merit of the photoconductive detector
... Show MoreThe behavior and shear strength of full-scale (T-section) reinforced concrete deep beams, designed according to the strut-and-tie approach of ACI Code-19 specifications, with various large web openings were investigated in this paper. A total of 7 deep beam specimens with identical shear span-to-depth ratios have been tested under mid-span concentrated load applied monotonically until beam failure. The main variables studied were the effects of width and depth of the web openings on deep beam performance. Experimental data results were calibrated with the strut-and-tie approach, adopted by ACI 318-19 code for the design of deep beams. The provided strut-and-tie design model in ACI 318-19 code provision was assessed and found to be u
... Show MoreThe objective of this study is to attempt to provide a quantitative analysis to the causes of unemployment in Iraq and its mechanisms of generation, as well as a review of the most important types of both visible and invisible unemployment, and an attempt to measure the disguised unemployment and analyze the causes. The problem of the research lies in the fact that the Iraqi Economy has been suffered for a long time although its characterized by abundant physical and natural resources, from the existence of the phenomenon of unemployment in the previous two types. Causing a lot of economic problems, represented by the great waste of resources and
... Show MoreThe event of crossing the barriers is one of the Power Games activities that have received great attention in the field of researches. Which led to ma..
The tourism industry has undergone exponential transformation, reshaped by online travel agencies (OTAs), shifting consumer preferences, and technological advancements. Established OTAs like TripAdvisor and Travelocity face pressures to adapt their strategies to capitalize on these disruptive landscape changes. This research involves a comparative analysis examining the key challenges confronting TripAdvisor and Travelocity, with a focus on opportunities to leverage artificial intelligence (AI) in enhancing personalization and the traveler experience. The study utilizes publicly available data on the companies and academic literature on AI innovation diffusion. Findings reveal that while TripAdvisor has actively developed AI-based trip plan
... Show MoreThermal energy storage is an important component in energy units to decrease the gap between energy supply and demand. Free convection and the locations of the tubes carrying the heat-transfer fluid (HTF) have a significant influence on both the energy discharging potential and the buoyancy effect during the solidification mode. In the present study, the impact of the tube position was examined during the discharging process. Liquid-fraction evolution and energy removal rate with thermo-fluid contour profiles were used to examine the performance of the unit. Heat exchanger tubes are proposed with different numbers and positions in the unit for various cases including uniform and non-uniform tubes distribution. The results show that
... Show MoreThis study examined the effect of elements of internal marketing activities on customer satisfaction through an exploratory study of banking services in the city of Baghdad, if the research problem crystallized by asking a group of questions, the most important (is there a correlation and impact between the dimensions of internal marketing and customer satisfaction, this study aims to determine The effect of internal communication, training and internal market research on customer satisfaction, represented by the quality of service, loyalty and market share, and embodied the objective of this study to identify the level of availability of internal marketing activities and programs in the research banks, data were collected using
... Show MoreThis research aims to identify the effective role of self-managed teams in the quality of service performance in the directorate of Ramadi municipality. The problematic nature of our research involves this main question of the effective role of self-managed teams in the Municipality of Ramadi in improving the services of performance quality to the beneficiaries from the Directorate service. The importance of this study lies in the role played by the work teams in the organizations that excel in their field, the attendant of the changes in the leadership, administrative roles of the institutions, and teams leaders, will be achieved by the self-managed teams in improving the quality of the service provided by the institution to whi
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