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.
Summary of the discussion of the jurisprudential aspects of Imam Abu Al-Fayyad Al-Basri, and their impact on the Shafi’i school, on the provisions of transactions, personal status, janaabah, limits, and others
Praise be to God, Lord of the Worlds, and prayers and peace be upon the Master of the Messengers, our master Muhammad, and upon his pure family, and his ignorant and ignorant companions, and those who followed them in goodness until the Day of Judgment.
Then:
The many jurisprudential aspects that the Shafi’i imams said are of great importance, because these aspects are nothing but the opinions of venerable jurists who have reached a high degree of knowledge unti
... Show MoreThe results shows existence of metals such as copper, iron, Cadmium, lead and zinc in most of examined samples , the highest concentration are up to (2.26, 40.82, 282.5, 31.02, 19.26, 4.34) Part per million) ppm) in pasta hot (Zer brand), Indomie with chicken, granule (Zer brand), brand (Zer brand), and rice (mahmood brand) respectively, with presence nickel in spaghetti( Zer brand), granule, Zer brand with concentration reached to 4.34 ppm and 1.06 ppm respectively.
The results of cereals group and its products show that two kinds of fungi, Aspergillus spp. and Penicillin spp. were found in rice (Mahmood brand) with numbers got to 1.5×103 Colony Forming Unit/ gram (c.f.u./g),while Bacillus cereus and Staphylococcus aureus were isola
Renewal is generally considered an urgent requirement of life, and a section of its continuation, because renewal means that life exists and continues, and just as renewal is in life, renewal is in science, and in this research the issue of renewal in the science of interpretation, and showed through research that renewal in This science was an urgent demand throughout the Islamic ages, as the research showed the necessity of renewal in the material of interpretation, its method and methods, and the researcher presented the opinions of schools about renewal in the interpretation of the Noble Qur’an inferred by living models that refer to their owners.
The negotiation phase is gaining great importance in investment loans due to the magnitude of the amounts awarded and the need to obtain adequate lending guarantees and the development of better conditions, and this requires that negotiating policy with fixed principles that balance between meeting the demands of customers and maintain market share and achieve profits and avoid defaults and losses the bank, and so I have touched Find the concept of investment loans and procedures for granting and the concept of the negotiation process for the granting of loans. The practical side to ensure the preparation of examination form consists of questions commensurate with the methodology developed by the researchers, were directed to the officia
... Show MoreThis work presents a novel technique for the detection of oil aging in electrical transformers using a single mode optical fiber sensor based on surface plasmon resonance (SPR). The aging of insulating oil is a critical issue in the maintenance and performance of electrical transformers, as it can lead to reduce insulation properties, increase risk of electrical breakdown, and decrease operational lifespan. Many parameters are calculated in this study in order to examine the efficiency of this sensor like sensitivity (S), signal to noise ratio (SNR), resolution (refractive index unit) and figure of merit (FOM) and the values are for figure of merit is 11.05, the signal to noise ratio is 20.3, the sensitivity is 6.63, and the resolution is 3
... Show MoreArts acts to reduce and exclude everything that is not necessary in the delivery of meaning, especially representative performance, which is based on the intensification of the physical and vocal actions, and in drawing the dimensions of the character. And because that, the artistic staff, among others in the ministry of education, are considered the cornerstone, in the development of theatrical activities in schools, this research came to find out the extent to which teachers in primary schools, in secondary schools and artistic supervisors rely on shorthand mechanisms in the representative performance.
The current research relied on the descriptive approach, in analyzing his sample, which was deliberately chosen, Among the most imp
The research aims to achieve a set of objectives, the most important of which is to educate the management of companies operating in the private sector about the advantages and risks of using creative accounting practices, as on the one hand they serve the interests of the company and improve its image, and on the other hand it exposes it to the risks of non-compliance with tax laws and legislation or the risks of default and bankruptcy as a result of exploiting gaps and flexibility in the application Accounting standards, and in line with the objectives and through the research problem that was formulated in the form of a question (Are their creative accounting practices that are reflected in the honesty and fairness of financia
... Show MoreActive learning is a teaching method that involves students actively participating in activities, exercises, and projects within a rich and diverse educational environment. The teacher plays a role in encouraging students to take responsibility for their own education under their scientific and pedagogical supervision and motivates them to achieve ambitious educational goals that focus on developing an integrated personality for today’s students and tomorrow’s leaders. It is important to understand the impact of two proposed strategies based on active learning on the academic performance of first-class intermediate students in computer subjects and their social intelligence. The research sample was intentionally selected, consis
... Show MoreIn the midst of rapid changes and difficultiesand the tough competition faced by the Iraqi banks, it has become necessary to focus on a significant aspect of administrative work; that is strategic planning and the key role of implementation within this process in improving the banking service quality. It has emerged as a critical and main competitive weapon for distinguishing the services provided by banks from each other in an effort to participate in increasing market share of the bank in question in question; in its growth, continuation and profit increase.
The research has addressed the relation between the independent variable (implementation within strategic planning), and the dependent variable (banking service quality and
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