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.
E-Learning packages are content and instructional methods delivered on a computer
(whether on the Internet, or an intranet), and designed to build knowledge and skills related to
individual or organizational goals. This definition addresses: The what: Training delivered
in digital form. The how: By content and instructional methods, to help learn the content.
The why: Improve organizational performance by building job-relevant knowledge and
skills in workers.
This paper has been designed and implemented a learning package for Prolog Programming
Language. This is done by using Visual Basic.Net programming language 2010 in
conjunction with the Microsoft Office Access 2007. Also this package introduces several
fac
The differential protection of power transformers appears to be more difficult than any type of protection for any other part or element in a power system. Such difficulties arise from the existence of the magnetizing inrush phenomenon. Therefore, it is necessary to recognize between inrush current and the current arise from internal faults. In this paper, two approaches based on wavelet packet transform (WPT) and S-transform (ST) are applied to recognize different types of currents following in the transformer. In WPT approach, the selection of optimal mother wavelet and the optimal number of resolution is carried out using minimum description length (MDL) criteria before taking the decision for the extraction features from the WPT tree
... Show MoreDielectric barrier discharges (DBD) can be described as the presence of contact with the discharge of one or more insulating layers located between two cylindrical or flat electrodes connected to an AC/pulse dc power supply. In this work, the properties of the plasma generated by dielectric barrier discharge (DBD) system without and with a glass insulator were studied. The plasma was generated at a constant voltage of 4 kV and fixed distance between the electrodes of 5 mm, and with a variable flow rate of argon gas (0.5, 1, 1.5, 2 and 2.5) L/min. The emission spectra of the DBD plasmas at different flow rates of argon gas have been recorded. Boltzmann plot method was used to calculate the plasma electron temperature (Te), and Stark broadeni
... Show MoreThe objective of this article is to delve into the intricate dynamics of marriage relationships, exploring the impact of emotions such as fear, love, financial considerations and likability. In our investigation, we adopt a perspective that acknowledges the nonlinear nature of interactions among individuals. Diverging from certain prior studies, we propose that the fear element within the context of marriage is not a singular, isolated factor but rather a manifestation resulting from the amalgamation of numerous social issues. This, in turn, contributes to the emergence of strained and unsuccessful relationships. Unlike conventional approaches, we extensively examine the conditions essential for the existence of all socially signifi
... Show MoreThis paper present a simple and sensitive method for the determination of DL-Histidine using FIA-Chemiluminometric measurement resulted from oxidation of luminol molecule by hydrogen peroxide in alkaline medium in the presence of DL-Histidine. Using 70?l. sample linear plot with a coefficient of determination 95.79% for (5-60) mmol.L-1 while for a quadratic relation C.O.D = 96.44% for (5-80) mmol.L-1 and found that guadratic plot in more representative. Limit of detection was 31.93 ?g DL-Histidine (S/N = 3), repeatability of measurement was less that 5% (n=6). Positive and negative ion interferances was removed by using minicolume containing ion exchange resin located after injection valve position.
Ping message focused on highlighting the fact commodity trading in Iraq, and increased exposure to world merchandise trade imbalance, which dominate Iraq's foreign trade major commodity is oil, and therefore the inability of Iraq to control financial revenue as a result of the fluctuations in the international market, the shortage of commodity products will lead inevitably to the weakness in the ability of the local market to meet the internal demand and due to the lack of flexible production machine For agricultural, industrial and economic sectors are responding to changes in the domestic or external demand which will open the door to merchandise imports to invade these markets, since the adoption of the Iraq oil exports,
... Show MoreReliable data transfer and energy efficiency are the essential considerations for network performance in resource-constrained underwater environments. One of the efficient approaches for data routing in underwater wireless sensor networks (UWSNs) is clustering, in which the data packets are transferred from sensor nodes to the cluster head (CH). Data packets are then forwarded to a sink node in a single or multiple hops manners, which can possibly increase energy depletion of the CH as compared to other nodes. While several mechanisms have been proposed for cluster formation and CH selection to ensure efficient delivery of data packets, less attention has been given to massive data co
The most important function of a prosthetic hand is their ability to perform tasks in a manner similar to a natural hand, so it is necessary to perform kinematic analysis to determine the performance and the ability of the prosthetic human finger design to work normally and smoothly when it's drive by two sets of links that embedded in its structure and pulled by a servomotor, so the Denvit-Hartenberg method was used to analyse the forward kinematics for the prosthetic finger joints to deduction the trajectory of the fingertip and the velocity of the joints was computed by using the Jacobian matrix. The prosthetic finger was modelled by the Solidwork - 2018 program and the results of kinematics were verified using MATLAB. The analys
... Show MoreLost circulation or losses in drilling fluid is one of the most important problems in the oil and gas industry, and it appeared at the beginning of this industry, which caused many problems during the drilling process, which may lead to closing the well and stopping the drilling process. The drilling muds are relatively expensive, especially the muds that contain oil-based mud or that contain special additives, so it is not economically beneficial to waste and lose these muds. The treatment of drilling fluid losses is also somewhat expensive as a result of the wasted time that it caused, as well as the high cost of materials used in the treatment such as heavy materials, cement, and others. The best way to deal with drilling fluid losses
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