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.
Banks are considered the main basis of financial sector ,so they must be submitted to sound and strict regulatory system and so as to ensure their operations and according to instructions and regulations , in order to maintain the integrity of the banking sector and financial sector in general .One of the importance regulatory tools that are adopted by the Iraqi Central Bank to control over the banks an financial and periodic statements that are provided by the banks in accordance with planned schedules .The financial statements of the banks must reflect clearly and accurately financial situation and the result of their activities during the period in which they represent to achiveing its purposes.So it has the goal of Search is statemen
... Show MoreThe research deals with the important and modern two subjects, strategic leadership which have six demotions and knowledge management
(four demotions') . the gools & the research is to know the relation & the effect them in the oil ministry (project department) , the sample was (50) persons who works in the department the questionnaire was the tool of data gathering .
The research divided to four parties, the first to the theotical review of the research variables, the second to the research methrology, the third to analysis and discoed the empirical results the last to the conclusions and recommendations .
The research aims to identify the elements of performance supervisory good and effective and availability in the Governmental council through examination and analysis of the reality and practice of censorship in this Council through study and evaluate the characteristics of the regulatory effective upon which the Governmental council in the performance of his work and knowledge of their adequacy by comparing the established criteria , and determine the effect of characteristics supervisory the performance standards for the Governmental council, Based search to two assumptions key to check the level of the relationship and the influence of the dimensions of the con
... Show MoreThe current research seeks to identify the role of the marketing intelligence system in its dimensions (customer intelligence, market intelligence, competitor intelligence, insurance product intelligence, sales representatives) and its reflection on improving the quality of the insurance service provided by the National Insurance Company represented in its dimensions (reliability, response, tangibility, Safety, the spirit of empathy, communication) adopted in the current research, and based on that, the research came as an attempt to find out the extent to which the research sample company can apply the approach of the marketing intelligence system and its impact on improving the quality of the insurance service provided to custo
... Show MoreThe research deals with metaphors as being one of the primary means used by Lyudmila Ulitskaya when writing the novel " Sincerely Yours Shurik ", to form diverse and multifaceted collective female images of representatives of the classic psychological patterns presented in the work. This research reflects the results of the study related to the work of Lyudmila Yevkinevna Ulitskaya, an actress of modern Russian prose. The novel "The Sincerely to You Shorek" is one of Ludmila Ulitskaya's creations (the year of writing - 2003), which, like her other works, is distinguished by a unique presentation style, rich vocabulary, lexical and semantic diversity, and a special style of writing. writer. The main objective of the research is to look at th
... Show MoreThe influence of culture on accounting systems and practices, including financial reports and accounting information through the values identified by Gray and derived from social-cultural values, and the four accounting values were derived from generally accepted accounting principles represented by (Conservatism, Uniformity, Secrecy, and Professionalism). Important and significant in maximizing financial performance, and measuring the extent of the role of these values in improving financial performance through attention to the values of accounting culture, this research
... Show MoreThis study aims to identify the role of satellite channels in imparting behavior to children from the point of view of their parents in Tulkarm city. The researcher used a descriptive technique. A sample of (18000) males and females married couples was used above 20 years old in the city of Tulkarm. The study sample size is (201) married couples. It took place in September 2020. The questionnaire was the main tool for collecting data. The study found that the total degree of satellite channels contribution in imparting negative behaviors to children was high, as it reached (72.20%). The total degree of the role of satellite channels in imparting positive behaviors to children was medium, reaching (69.20%). Moreover, the results also indi
... Show MoreEthnographic research is perhaps the most common applicable type of qualitative research method in psychology and medicine. In ethnography studies, the researcher immerses himself in the environment of participants to understand the cultures, challenges, motivations, and topics that arise between them by investigating the environment directly. This type of research method can last for a few days to a few years because it involves in-depth monitoring and data collection based on these foundations. For this reason, the findings of the current study stimuli the researchers in psychology and medicine to conduct studies by applying ethnographic research method to investigate the common cultural patterns language, thinking, beliefs, and behavior
... Show MoreMaximum values of one particle radial electronic density distribution has been calculated by using Hartree-Fock (HF)wave function with data published by[A. Sarsa et al. Atomic Data and Nuclear Data Tables 88 (2004) 163–202] for K and L shells for some Be-like ions. The Results confirm that there is a linear behavior restricted the increasing of maximum points of one particle radial electronic density distribution for K and L shells throughout some Be-like ions. This linear behavior can be described by using the nth term formula of arithmetic sequence, that can be used to calculate the maximum radial electronic density distribution for any ion within Be like ions for Z<20.