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.
Abstract
The aim of this research is to concentrate on the of knowledge management activities, initial activities: (Acquisition, Selection, Generation, Assimilation, Emission) knowledge, and support activities: (Measurement, Control, Coordination, Leadership) that is manipulate and controlling in achieving knowledge management cases in organization, that’s is leads to knowledge chain model, then determining the level of membership for these activities to knowledge chain model in a sample of Iraqi organization pushed by knowledge (Universities). The research depends on check list for gaining the data required, theses check list designed by apparently in diagnosing research dimensions and measurem
... Show MoreThe study consisted in the development and use of a practical method to detect and
monitor, analyze and produce maps of changes in land use and land cover in the district of
Mahmudiya in Baghdad during the period 1990-2007 using the applications of remote sensing
techniques and with the assisstant of geographic information systems (GIS),as a valuable
contribution to land degradation studies.
This study is based maiuly on the processing on two subsets of landsat5 TM images picked up
in August 1990 and 2007 respectively in order to facilitate comparision and were thengeometrically and radiometrcally calibrated ,to used for digital classification purposes using
maximum liklihoods classification or six spectral bands of
It is known that energy subiect has ocuppied a lot of scientests minds about
how to treat the traditional energy and the renewing energy . we know that
most traditional energy coal , oil , Natural gas, neuclear fuel , are limited
guantiy and alsow subjected to be ended .Statics studies refer to reserve
of oil in world will exhausted btween ( 2075- 2100) and alsow cosl too .
While neuclear fuerl which the world seek today through explod the uranium
atom ( 233) the therum atom (239) and neuclear mxied through ruemlear
mixing , These energy have effect on environment and humanity speciaty if
they are used in militery purposes .
For all theses scientests srarch for resources of renewing enery through
researches
This study aimed at revealing the degree of availability of standards of word problems in mathematics books for the first three grades of the basic stage in Palestine. For this purpose, the researcher prepared an analysis tool and a list of criteria consisting of two areas: linguistic formulation and mathematical content. Every area had seven items. The results of the study showed that the third-grade mathematics book has the highest degree of availability of the standards with 85.75%, and then came the second-grade mathematics book with 83.12%. Finally, the first-grade mathematics book came with 80.13%. In the light of the previous results, the researcher recommended to develop the language of word problems, to take into account their i
... Show MoreField trial was conducted with the aim of utilizing extract of allelopathic crop to reduce the use of synthetic herbicides in wheat fields. Sorghum extract at 12 L /ha, sunflower extract at 12 L /ha, combination of sorghum and sunflower extracts at 12 L /ha and chevalier at 25, 50 and 100% of recommended dose were applied alone or in combination with each other. Weed free and weedy check treatments were included for comparison. The experiment was conducted in a randomized complete block design with three replications. The results showed that the recommended dose of chevalier treatment recorded lowest means of weed density 15.7, 23.7, 25.3 and 27.9 weeds m-2and weeds dry weight 13.4, 16.4, 23.3 and 29.2 g m-2 and gave
... Show MoreDue to the importance of the relationship between the phenomenon of inflation and the exchange rate in the formulation of monetary policy in Iraq, the exchange rate plays a strategic role in limiting the inflation caused by the monetary expansion due to government spending, as a point of a view, the inefficiency of interest to achieve the monetary market balance and stability of the general level of prices as an overall goal of monetary policy in Iraq, the exchange rate has emerged as a brake on inflation in Iraq, as the research found that the monetary authority in the period 2003-2018 provided a methodical development in the formulation of monetary policy towards realizing the effects of inf
... Show MoreIt is often needed in demographic research to modern statistical tools are flexible and convenient to keep up with the type of data available in Iraq in terms of the passage of the country far from periods of war and economic sanctions and instability of the security for a period of time . So, This research aims to propose the use of style nonparametric splines as a substitute for some of the compounds of analysis within the model Lee-Carter your appreciation rate for fertility detailed variable response in Iraq than the period (1977 - 2011) , and then predict for the period (2012-2031). This goal was achieved using a style nonparametric decomposition of singular value vehicles using the main deltoid , and then estimate the effect of time-s
... Show MoreThe expenditures of the general budget, in its operational and investment divisions, are a basic factor in the economic and social growth of any country, and its impact on various economic activities such as income, employees , and the standard of living of members of society. This was based on a basic premise: Does increasing or decreasing investment expenditures have an effect on increasing or decreasing the tax proceeds, What is the level of relationship between them? and to achieve the goal of the research, an inductive and analytical method was chosen to measure the impact of the investment budget expenditures on the tax outcome quantitatively using the financial data obtained from The General Authority for Taxes, Ministry of Financ
... Show MoreAbstract The Object of the study aims to identify the effectiveness of using the 7E’s learning cycle to learn movement chains on uneven bars, for this purpose, we used the method SPSS. On a sample composed (20) students on collage of physical education at the university of Baghdad Chosen as two groups experimental and control group (10) student for each group, and for data collection, we used SPSS After collecting the results and having treated them statistically, we conclude the use 7E’s learning cycle has achieved remarkable positive progress, but it has diverged between to methods, On this basis, the study recommended the necessity of applying 7E’s learning cycle strategy in learning the movement chain on uneven bar
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