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.
Porous asphalt paving is a modern design method that differs from the usual asphalt pavements' traditional designs. The difference is that the design structure of porous pavements allows the free passage of fluids through their layers, which controls or reduces the amount of runoff or water accumulated in the area by allowing the flow of rain and surface runoff. The cross-structure of this type of paving works as a suitable method for managing rainwater and representing groundwater recharge. The overall benefits of porous asphalt pavements include environmental services and safety features, including controlling the build-up of contaminated metals on the road surface, rainwater management, resistance to slipping ac
... Show More- The sandy soil with high gypsum content (usually referred to as gypseous soil) covers vast area in south, east, middle and west regions of Iraq, such soil possess a type of cohesive forces when attached with optimum amount of water, then compacted and allowed to cure, but losses its strength when flooded with water again. Much work on earth reinforcement was published which concentrate on the gain in bearing capacity in the reinforced layer using different types of cohesive or cohesion less soil and various types of reinforcement such as plastic, metal, grids, and synthetic textile. Little attention was paid to there enforce gypseous soil. The objective of this work is to study the interaction between such soil and reinforcement strips
... Show MoreThe necessity of addressing global economic prosperity has garnered significant attention from recent studies and policymakers. This article analyses the effects of the digital economy, business synergies, and trade policies on the economic prosperity of China and India. The study examines the impact of political support on the digital economy, business synergies, trade policies, and global economic prosperity in China and India. The study collects data from prominent economists in India and China using questionnaires. The article utilised the SPSS-AMOS software to analyse the relationship between variables. The results showed that the digital economy, business synergies, and trade policies are positively linked to global economic prosperit
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The internal control is the tool through which it is possible to verify and ensure the implementation of tasks in accordance with the established plans and programs and to evaluate the level of performance that is implemented within the different companies.
A guarantee from the supplier with the absence of a specialized technical committee that follows up the stages of implementing the contract and disbursing all amounts of financial dues to the supplier before completing the implementation of the contract and overlooking the non-implementation of some clauses of the contract by the committee in charge of
... Show MoreExperts of Psychology and education emphasized that childhood is one of the most important stages in the formation of human personality, and the most influential in his public life, especially the stage in which he lives within his family, which must provide him with the requirements of healthy growth of physical, emotional, moral and social. Emotional-social connection of the child to his family, is especially important in determining the characteristics of his social character, in accordance with the norms and values prevailing in society. This requires the child to be cared for and cared for, and to deal with him in a healthy social manner. So as to achieve positive growth and harmony in the process of social control in internal
... Show MoreThe State company for vegetable oils industry one of the most dynamic
companies in the Iraqi economy and is one of the companies manufacturing(food) that takes astrategic dimension and production within the concept of food security, this as well as to reduce dependence on imports and operation of national manpower.This study aims to describe the performance of the State company for vegetable oils industry for the period (2003-2007) which was characterized by economic and security instability of the country and give an accurate picture of their efficiency and their capacity to produce during this Period.
This paper presents experimental results regarding the behaviours of eight simply supported partially prestressed concrete beams with internally unbonded tendons, focusing particularly on the effect of three different variables: concrete compressive strength,
There are a lot of measures for Post Traumatic Stress Disorder (PTSD), but what distinguishes it from other measures is the number of short paragraphs and concise depending on the classification of American Psychiatric Association (APA), which can be applied by the researchers on a large number, Because the Iraqi society suffered from psychological trauma due to wars, conflicts and occupation and the resulting psychological disorders of the members of Iraqi society, especially post-traumatic stress disorder, as mentioned by many studies and researches.
Therefore, the aim of this study was to standardize the PTSD scale for students at Baghdad University. For the Psychologist Fua . E. which was applied in many foreign studies.
This research aims to Measurement provide the service from Two perspectives The first perspective Service Provider (doctors) and the second recipient of the service (patients) in Numan General Hospital, and represented the research problem in perceptions of medical staff in the hospital assigned to them responsibility by providing superior services satisfy customers, and how they maintained ready to assist customers and provide services that exceed their perceptions of these services through the use of the developer scale by (Frimpong and Wilson, 2012), includes orientation to provide the service scale four dimensions (Internal cooperative behaviors, service Competence, Service Responsiveness and Enhanced service) and includes do
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