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.
Obiovisly that the holy thresholds are directly related to Islam and Muslims and related to the general culture of the Islamic peoples. In terms of architecture, it is considered a distinctive architectural scene that reviews the history of this origin and its architectural styles. Recently, with the increase in the number of pilgrims and visitors to the holy shrines, there is a need to develop and expand the buildings and provide them with services and introduce modern technology. The building of the holy thresholds consists of a number of functional design indicators: The general problem of research is that there is no clear theoretical framework for the design indicators for the development of the holy shrines according to the functio
... Show MoreThe research aimed to identify the causal relationship between forgiveness and psychological hardness for university students, by answering the following questions: Does forgiveness cause psychological hardiness? Does psychological hardiness cause forgiveness? Is the relationship between the two variables a reciprocal relationship? The research sample consisted of (300) male and female students from the universities of Baghdad and Al-Mustansiriya University. To extract the psychometric properties of the two scales: forgiveness and psychological hardiness, a sample of (50) male and female students employed to repeat the test, making the six connections between the two research variables. To determine the causal relationship, The Pearson c
... Show MorePurpose: The research seeks to develop the implications of intellectual human capital, and social capital in business organizations, and will be accomplished on three levels, the first level (the level of description) to identify, diagnose and display content philosophical Strategic Human Resource Management at the thought of modern administrative represented by human capital and Ras social capital. The second level (level of analysis) and the analysis of the extent of the impact of alignment between human capital, and social capital in the organizational strength of the organizations. The third level (Level predict) the formulation of a plan to strengthen the organizational strength in business organizations and to develop speci
... Show MoreIncreased downscaling of CMOS circuits with respect to feature size and threshold voltage has a result of dramatically increasing in leakage current. So, leakage power reduction is an important design issue for active and standby modes as long as the technology scaling increased. In this paper, a simultaneous active and standby energy optimization methodology is proposed for 22 nm sub-threshold CMOS circuits. In the first phase, we investigate the dual threshold voltage design for active energy per cycle minimization. A slack based genetic algorithm is proposed to find the optimal reverse body bias assignment to set of noncritical paths gates to ensure low active energy per cycle with the maximum allowable frequency at the optimal supply vo
... Show MoreA new data for Fusion power density has been obtained for T-3He and T-T fusion reactions, power density is a substantial term in the researches related to the fusion energy generation and ignition calculations of magnetic confined systems. In the current work, thermal nuclear reactivities, power densities of a fusion reactors and the ignition condition inquiry are achieved by using a new and accurate formula of cross section, the maximum values of fusion power density for T-3He and TT reaction are 1.1×107 W/m3 at T=700 KeV and 4.7×106 W/m3 at T=500 KeV respectively, While Zeff suggested to be 1.44 for the two reactions. Bremsstrahlung radiation has also been determined to reaching self- sustaining reactors, Bremsstrahlung values are 4.5×
... Show MoreThis current study aims to:
1st: The recognizing of Alexithymia level for 6th grade students (Study Specimen) through the next Zero Hypothesis:1. There are no statistically significant differences at (0.05) level between the arithmetic mean of the specimen degrees as a whole and the central assumption for the scale of the lack in emotions expression
2. There are no statistically significant differences at (0.05) level between the arithmetic mean of the male students specimen and the arithmetic meanc of the female students specimen for the scale of Alexithymia.
2nd: ldentification the level of the emotional intelligence among 6th grade students (Study Specimen) through the next Zero Hypothesis:
1) There are no statistically si
Introduction to Medical Physics for Pharmacy Students and Medical Groups - ISBNiraq.org
In this modern Internet era and the transition to IPv6, routing protocols must adjust to assist this transformation. RIPng, EIGRPv6 and OSPFv3 are the dominant IPv6 IGRP (Interior Gateway Routing Protocols). Selecting the best routing protocol among the available is a critical task, which depends upon the network requirement and performance parameters of different real time applications. The primary motivation of this paper is to estimate the performance of these protocols in real time applications. The evaluation is based on a number of criteria including: network convergence duration, Http Page Response Time, DB Query Response Time, IPv6 traffic dropped, video packet delay variation and video packet end to end de
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