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 personality characteristics of the Leader are considered one of the main elements to reach into business organizations entrepreneurship; and because of the development of the organizations of the continuous transformations as result of huge Competition in private High Education sector, there is a great need for Leaders characterized of certain personality capable of managing their organizations and can positively effect on them. Also these organizations' success to reach into entrepreneurship requires a main significant element that is (strategic flexibility) which is considered one of the important elements for success.
Accordingly, this research is trying to fin
... Show MoreImage fusion is one of the most important techniques in digital image processing, includes the development of software to make the integration of multiple sets of data for the same location; It is one of the new fields adopted in solve the problems of the digital image, and produce high-quality images contains on more information for the purposes of interpretation, classification, segmentation and compression, etc. In this research, there is a solution of problems faced by different digital images such as multi focus images through a simulation process using the camera to the work of the fuse of various digital images based on previously adopted fusion techniques such as arithmetic techniques (BT, CNT and MLT), statistical techniques (LMM,
... Show MoreIn this work, silver (Ag) self-metallization on a polyimide (PI) film was prepared through autocatalytic plating. PI films were prepared through the solution casting method, followed by etching with potassium hydroxide (KOH) solution, sensitization with tin chloride (SnCl2), and the use of palladium chloride (PdCl2) to activate the surface of PI. Energy-dispersive X-ray analysis (EDX) showed the highest peak in the (Ag) region and confirmed the presence of AgNPs. The diffraction peaks at 2θ = 38.2°, 44.5°, 64.6°, and 78.2° represented the 111, 200, 220, and 311 planes of Ag, respectively. The FT–IR an
... Show MoreThis paper contains an equivalent statements of a pre- space, where are considered subsets of with the product topology. An equivalence relation between the preclosed set and a pre- space, and a relation between a pre- space and the preclosed set with some conditions on a function are found. In addition, we have proved that the graph of is preclosed in if is a pre- space, where the equivalence relation on is open.
On the other hand, we introduce the definition of a pre-stable ( pre-stable) set by depending on the concept of a pre-neighborhood, where we get that every stable set is pre-stable. Moreover, we obtain that
... Show MoreIn this article, we introduced a new concept of mappings called δZA - Quasi contractive mapping and we study the K*- iteration process for approximation of fixed points, and we proved that this iteration process is faster than the existing leading iteration processes like Noor iteration process, CR -iteration process, SP and Karahan Two- step iteration process for 𝛿𝒵𝒜 − quasi contraction mappings. We supported our analytic proof by a numerical example.
The study aims at showing the role of tax audit in Impact the quality of tax statements. Tax audit is one of the most important means used by tax management to identify taxable revenues in a just, fair manner. The quality of statements relies on the extent to which the information provided by taxpayers is true and accurate. Tax audit works is compatible with the strategy of increasing tax adherence and detecting non-adherence cases and penalizing those who commit such violations. The study reached a number of results and conclusions. One of the most important results is that tax audit helps improve the information content of the taxpayers tax statements. This leads to recalculating taxable incomes and re-fixing t
... Show MoreImage pattern classification is considered a significant step for image and video processing.Although various image pattern algorithms have been proposed so far that achieved adequate classification,achieving higher accuracy while reducing the computation time remains challenging to date. A robust imagepattern classification method is essential to obtain the desired accuracy. This method can be accuratelyclassify image blocks into plain, edge, and texture (PET) using an efficient feature extraction mechanism.Moreover, to date, most of the existing studies are focused on evaluating their methods based on specificorthogonal moments, which limits the understanding of their potential application to various DiscreteOrthogonal Moments (DOMs). The
... Show MoreThe development of human resources training programs can assist in agreat deal in creating products of high quality with quantitive advantage for the economicunit;through the sale of products by prices higher of the peer products price in the arket,or decreasing production costs which lead into increusing the unet profits. for these reasons, the human resources have got great importance for their great role in any economy,and they havestarled to consentrate on accounting these resource.From this point of view, this research has handied human resources accounting and their effect on quality costs. In(MID-Refinery Company),quality costs are determined ,then we have larified the reality of training and development in the o
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