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.
With the increasing integration of computers and smartphones into our daily lives, in addition to the numerous benefits it offers over traditional paper-based methods of conducting affairs, it has become necessary to incorporate one of the most essential facilities into this integration; namely: colleges. The traditional approach for conducting affairs in colleges is mostly paper-based, which only increases time and workload and is relatively decentralized. This project provides educational and management services for the university environment, targeting the staff, the student body, and the lecturers, on two of the most used platforms: smartphones and reliable web applications by clo
There is no doubt that teachers are the leaders of positive changing in community where they directed the students and build their brains. In our current generation that characterized by accelerated technological development that communication changes, economic and politics, needs from the teacher an active leadership skills that match with the soul of our generation and contribute in confrontation the current challenges and the future challenges in the form that lead to create a conscious generation where they will be a basic brick for the future community where the listeners looking forward the education where they support the continuity communication of develop process, economy, scientifically and in all life fields. In our study we take
... Show MoreBackground: The disc prolapse is a common condition especially in young adults. Different levels are affected in the lumber region; the L4/L5 disc is more susceptible to longitudinal load and is the most common site of lumbar disc prolapse. The L5/S1 disc is protected from torsion load by strong ilio-lumbar ligaments but it is more susceptible to axial compressive forces. Many factors affect the result and outcome of surgery in these levels.Objective: The aim of this study is to correlate operative data, short-term results, complications, and prognostic factors (age, gender, mobility, hospital stay, and level of pain) for one-level lumber discectomybetween different levels (L4–L5 vs. L5–S1).Methods In this prospective study, 32 patie
... Show MoreA load flow program is developed using MATLAB and based on the Newton–Raphson method,which shows very fast and efficient rate of convergence as well as computationally the proposed method is very efficient and it requires less computer memory through the use of sparsing method and other methods in programming to accelerate the run speed to be near the real time.
The designed program computes the voltage magnitudes and phase angles at each bus of the network under steady–state operating conditions. It also computes the power flow and power losses for all equipment, including transformers and transmission lines taking into consideration the effects of off–nominal, tap and phase shift transformers, generators, shunt capacitors, sh
Human beings have an innate and natural aim to achieve their self-interests and to show their ability to overcome challenges in a better way, therefore the move towards self determination is expressed by intrinsic motivation. The desire of absorbing in this task is to enjoy the task in it self and benefitting from it such a motivation is the desire rooted in human nature to judge and choose in which individual is conscious in his self, abilities and adequacy that help him in control the different situations of life passed by him. His choices and actions are voluntary and non-restricted to intervention or external control because control is inner and subjective, while his behavior is self-regulated with the feeling of
... Show Moreالذات والتحصيل الدراسي . وقد استخدمت الباحثة المنهج الوصفي التحليلي، وبلغت عينة الدراسة (500) طالبًا وطالبة، تم اختيارهم بالطريقة الطبقية العشوائية وهي تمثل (15%) من مجتمع الدراسة البالغ (3328) طالباً وطالبة من طلبة المرحلة الإعدادية واستخدمت الباحثة مقياسين تم بناء مقياس لقياس الجوهر والمظهر وتبني مقياس فاعلية الذات بعد إن قامت بترجمته وتعريبه وجعله ملائم للبيئة العراقية، كم تم استخراج درجات التحصيل الدراسي للع
... Show MoreIn the present article, we implement the new iterative method proposed by Daftardar-Gejji and Jafari (NIM) [V. Daftardar-Gejji, H. Jafari, An iterative method for solving nonlinear functional equations, J. Math. Anal. Appl. 316 (2006) 753-763] to solve two problems; the first one is the problem of spread of a non-fatal disease in a population which is assumed to have constant size over the period of the epidemic, and the other one is the problem of the prey and predator. The results demonstrate that the method has many merits such as being derivative-free, overcome the difficulty arising in calculating Adomian polynomials to handle the nonlinear terms in Adomian Decomposition Method (ADM), does not require to calculate Lagrange multiplier a
... Show MoreNimodipine (NMD) is a dihydropyridine calcium channel blocker useful for the prevention and treatment of delayed ischemic effects. It belongs to class ? drugs, which is characterized by low solubility and high permeability. This research aimed to prepare Nimodipine nanoparticles (NMD NPs) for the enhancement of solubility and dissolution rate. The formulation of nanoparticles was done by the solvent anti-solvent technique using either magnetic stirrer or bath sonicator for maintaining the motion of the antisolvent phase. Five different stabilizers were used to prepare NMD NPs( TPGS, Soluplus®, HPMC E5, PVP K90, and poloxamer 407). The selected formula F2, in which Soluplus
has been utilized as a stabilizer, has a par
... Show MoreThe research seeks to identify the impact of fraud detection skills in the settlement of compensatory claims for the fire and accident insurance portfolio and the reflection of these skills in preventing and reducing the payment of undue compensation to some who seek profit and enrichment at the expense of the insurance contract. And compensatory claims in the portfolio of fire and accident insurance in the two research companies, which show the effect and positive return of the detection skills and settlement of the compensation on the amount of actual compensation against the claims inflated by some of the insured, The research sample consisted of (70) respondents from a community size (85) individuals between the director and assistan
... Show More