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 choice of binary Pseudonoise (PN) sequences with specific properties, having long period high complexity, randomness, minimum cross and auto- correlation which are essential for some communication systems. In this research a nonlinear PN generator is introduced . It consists of a combination of basic components like Linear Feedback Shift Register (LFSR), ?-element which is a type of RxR crossbar switches. The period and complexity of a sequence which are generated by the proposed generator are computed and the randomness properties of these sequences are measured by well-known randomness tests.
To observe the effect of media of the internal pressure on the equivalent stress distribution in the tube, an experimental study is done by constructing a testing rig to apply the hydraulic pressure and three dies are manufactured with different bulging configurations (square, cosine, and conical). In the other part, ANSYS APDL is generated to analyze the bulging process with hydraulic and rubber (natural and industrial) media. It was found that when the media is a rubber, the stress is decreased about 9.068% in case of cosine die and 5.4439% in case of conical die and 2.8544% in case of square die. So, it can be concluded that the internal pressure in the rubber media is much better than in hydraulic media. Also, the force needed for fo
... Show MoreImaging by Ultrasound (US) is an accurate and useful modality for the assessment of gestational age (GA), estimation fetal weight, and monitoring the fetal growth during pregnancy, is a routine part of prenatal care, and that can greatly impact obstetric management. Estimation of GA is important in obstetric care, making appropriate management decisions requires accurate appraisal of GA. Accurate GA estimation may assist obstetricians in appropriately counseling women who are at risk of a preterm delivery about likely neonatal outcomes, and it is essential in the evaluation of the fetal growth and detection of intrauterine growth restriction. There are many formulas are used to estimate fetal GA in the world, but it's not specify fo
... Show MoreSoil water retention curves (SWRCs) are crucial for characterizing soil moisture dynamics and are particularly relevant in the context of irrigation management. A study was carried out to obtain the SWRC, inflection point, S index, pore size distribution curve, macro porosity, and air capacity from samples submitted to saturation and re-saturation processes. Five different-texture disturbed soil samples Sandy Loam, Loam, Sandy Clay Loam, Silt Loam, and Clay were collected. After obtaining SWRC, each air-dried soil samples were submitted to particle size distribution and clay dispersed in water analyses to verify the soil lost clay. The experimental design was completely randomized with three replications using two processes of SWRC (saturat
... Show MoreThe study aims to know the nature of the expected relationship between market share management strategies and the variation in the performance of the shares of a number of Iraqi industrial companies listed in the Iraqi Stock Exchange. For the period (2005-2018) in the light of both the monthly closing prices and sales volume during the research period, the (Panel Data) method was relied on through a stylistic test (fixed effects model and random effects model), and the results determined the need to adopt the fixed effects model method for sample data and test Assumptions, the results showed the positive impact of market share according to its strategies on the performance of stocks according to its studied indicators (Treynor index
... Show MoreThis research set to indicate the role of the opportunity cost in the overall economic development (human and social development) by selecting the most appropriate alternative for the growth of the country in exchange for sacrificing profit limits to achieve this growth and development of the country, especially in the present circumstances of the country and after studying the reality of the economic case for him, as the problem lies with don't selecting the best alternative that enhances the gross domestic product, which extends to promote overall economic development and revive the industrial and agricultural sectors, productivity is more like Impotent, versus sacrifice alternative consumption may bring more financially lucrative than
... Show MoreThe organizational integration forms a necessity according to McKinsey model, especially for service organizations. In the context of various service sector developments, importance adoption of compact mechanisms by these organizations to upgrade their services has increased and senior management must be more aware of environmental, competitive and developmental requirements. It gets more important when it shows in an organization seeking at excellence of making services within its policies and strategies. Subject organizational integration dimensions (strategy, structure, systems, style, staff, shared values, and skills) are effective components in directing behaviors of employees and organization. This motivated both researcher
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