Background: Delayed interval cholecystectomy can be performed to overcome the logistical difficulties in performing ‘early urgent’ laparoscopic cholecystectomy (LC) within 72 hours of
admission with acute cholecystitis (AC), and to avoid earlier re-admission with recurrent AC in patients waiting ‘delayed interval’ cholecystectomy.
Objectives: To evaluate the safety and feasibility of ‘delayed urgent’ LC performed beyond 72 hours.
Methods: Patients admitted with AC were scheduled for urgent LC. Patients who underwent ‘early urgent’ LC were compared with those who had ‘delayed urgent’ surgery.
Results: Fifty consecutive patients underwent urgent LC for AC within 2 weeks of admission. There were no conversions and no bile duct injuries. Delayed surgery (n=36) neither prolonged operating time (90 vs. 85 minutes) nor increased operative morbidity (9.7% vs. 7.7%) or mortality (2.4% vs. 7.7%) compared with early surgery (n=14). Although delayed surgery was associated with shorter postoperative hospital stay (1 vs. 2 days, p=0.029), it prolonged total hospital stay (9 vs. 5 days, p<0.0001).
Conclusions: Delay of LC beyond 72 hours neither increases operative difficulty nor prolongs recovery. It might be more cost effective to schedule patients who could not undergo ‘early urgent’ LC but are responding to conservative treatment for an ‘early interval’ LC within 2 weeks of presentation with AC.
In view of the importance of the educational act, and the effective role played by the school in building the society on the basis of solidarity and equal opportunities, as well as the rehabilitation of emerging generations to exercise their rights and duties, as well as integration into the world of knowledge, communication and in different social and environmental circles[1]. The process of integrating special needs children, in regular or integrated classes within regular public schools or specialized rehabilitation educational centers, is of great importance to these groups of society, their families and society in general[2]. Based on the above, the research will start by answering the followingquestions:
How can the parents
... Show MoreAn experimental study was performed to estimate the forced convection heat transfer performance and the pressure drop of a single layer graphene (GNPs) based DI-water nanofluid in a circular tube under a laminar flow and a uniform heat flux boundary conditions. The viscosity and thermal conductivity of nanofluid at weight concentrations of (0.1 to 1 wt%) were measured. The effects of the velocity of flow, heat flux and nanoparticle weight concentrations on the enhancement of the heat transfer are examined. The Nusselt number of the GNPs nanofluid was enhanced as the heat flux and the velocity of flow rate increased, and the maximum Nusselt number ratio (Nu nanofluid/ Nu base fluid) and thermal performance factor
... Show Moreבמחקר הזה ניתחנו מספר נאומים של שמעון פרס, אנחנו התמקדנו בהשפעה והשכנוע אצל שמעון פרס ואיך הוא יכול להעביר את המסרים של נאומיו בסגנון פרגמטי כדי להגיע ללבו של הציבור.
גם כן, התמקדנו בסגנון הפוליטי שהוא חושב כי התחום הזה צריך להיות ברור מול הציבור וגם כן מול דעת הקהל הבינלאומי מתוך השימוש במונחים בעלי השפעה ושכנוע להגיע למטרות המבוקשות.
במלים אחרות, שמעון פרס, לעתים, מתמקד בשפה מליצית ויעמוד הרב
... Show MoreA new ligand type (O2) [2,3-O-diacetyl-5,6-O-benzylidene L- ascorbic acid] [L] and its complexes of general formula [M(L)2(X)(Y)]Cln (where: M=CrIII ,X=Y=H2O, n=3; CoII, X = Y = 0, n= 2; NiII and CuII, X = Cl, Y = H2O, n= 1; ZnII, X = Y = H2O,n = 2) are reported. The ligand was prepared in two steps; first step involved the synthesis of [5,6-O-benzylidene-L-ascorbic acid] (A). In second step derivative-A was then reacted with acetyl chloride and anhydrous pyridine as a base to give the titled ligand. Metal complexes of the ligand with CrIII,CoII
... Show MoreThe study aims to identify the degree of implementation of the coronavirus prevention standards (covid-19) in the kingdom of Saudi Arabia and compare it with the families of intellectual disabilities. The study population consisted of all families residing in the Kingdom of Saudi Arabia. To achieve the objectives of the research, the analytical descriptive approach was employed. The study sample consisted of (372) families, among them (84) families with intellectual disabilities, and (288) families without intellectual disabilities. They were chosen from the Saudi community according to what is available for collection in a simple random way, using the standard criteria for the prevention of coronavirus (Covid- 19) Prepared by the resear
... Show MoreThis research aims to:
1 – Make a proposed module for (aesthetics) for the second stage - Department of Art Education under education theories.
2 - Verification from the effect of the proposed module on student achievement and motivation towards learning aesthetics material.
To verification the second goal we wording these two hypotheses:
1- There are no individual differences with statistically significant at level (0.05) between the student's scores average. (Experimental group ) who studied according to the proposed module and the average student's scores (control group) who studied in the usual way for the achievement test for the Aesthetics material.
2- There are no individual differences with statistically signifi