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.
background
Background : It has been suggested that pretreatment with a statin agent prior to
myocardial infarction limits myocardial
creatine kinase release, and thus may act to
limit myocardial infarct size in humans.
Objective : To examine the effect of very
early statin initiation for acute myocardial
infarction (AMI), to the extent of
myonecrosis as manifested by peak serum
creatine kinase levels.
Methods : Patients with AMI admitted to AlKindy teaching hospital cardiac care unit
from 1st February 2007 to 28th February
2008, who fulfilled the inclusion criteria
cited in the present study, were randomly
assigned into two study groups. The statin
group patients have received a single oral
dose of 40 mg
In the years recently city planning projects have been confirmed sustainable high concentration on planning streets and pedestrian paths being the most prominent component of the urban structure in the city and these me and diverse departments link the city’s sectors and serve as a space for economic, service, and social activities. On the other hand, pedestrian traffic is an essential component of the various means of transportation within the city. Suffer cities in the Middle East and Arab cities in particular are neglecting pedestrian paths in the vital urban environment. Vehicle control mechanisms on roads, and changing the uses of pedestrian paths as result of encroaching on the sidewalks designated for pedestrians. Which leads to a
... Show MorePeriodontitis is a multifactorial chronic inflammatory disease that affects tooth-supporting soft/hard tissues of the dentition. The dental plaque biofilm is considered as a primary etiological factor in susceptible patients; however, other factors contribute to progression, such as diabetes and smoking. Current management utilizes mechanical biofilm removal as the gold standard of treatment. Antibacterial agents might be indicated in certain conditions as an adjunct to this mechanical approach. However, in view of the growing concern about bacterial resistance, alternative approaches have been investigated. Currently, a range of antimicrobial agents and protocols have been used in clinical management, but these remain largely non-v
... Show MoreBackground: Gray-scale sonography is generally
considered as a first-line diagnostic tool for patient with
suspected acute cholecystitis. It is suggested by gallstones,
Murphy's sign, thickening of the gallbladder wall and bile
sludging, but the specificity of these sonographic findings
are not as high as their sensitivity. Blood flow of the
gallbladder wall is increased in acute inflammation.
Objective: To evaluate the sensitivity and specificity of
power Doppler sonography and compared with conventional
color Doppler and gray-scale sonography in diagnosing
patients with acute cholecystitis.
Type of the study: This was a cross sectional study.
Patients and methods: The study was conducted t
The modern business environment has witnesses tremendous developments as a result of the globalization of markets and economic openness and technological as well as the acquisition of the issue of corporate governance of great importance regarding it as one of the global innovations trends of control provisions on the management of companies as result of these developments ,increasing on competition between economic unit ,thus a decrease in market share because they do not take into account the response to the requirements of customers ,which kept her to search a modern management accounting methods to help them keep up with the changes and the availability of information for the various adminis
... Show MoreBackground: Laparoscopic colectomy is performed in an increasing number of institutions as a minimally invasive treatment for benign and malignant large bowel disease. Laparoscopic rectal surgery enables more accurate visualization of the anatomical structure in the pelvic cavity for selected patients with tumors in the middle and low rectum.
Objectives: To determine the early outcome of patient who underwent laparoscopic low anterior resection using radial reload stapler.
Patients and methods: This is a prospective study of 8 patients with low or mid rectal cancer who underwent a laparoscopic low anterior resection between January 2017 till June 2017 at Saint Raphael hospital.
Results: Eight patients underwent elective laparosc
Background: To study prevalence and method of diagnosis of acute rubella Infection during early pregnancy in Iraq.
Patients and Methods: Clinical signs and symptoms of acute rubella infection were looked for in (170) pregnant women looked before (12) weeks of gestation .Serial rubella specific IgG and IgM serological testing was done in these (170) women before (12) weeks of pregnancy, after (3) weeks, and again at (18-20) weeks of gestation.
Results: Three woman had clinical signs and symptoms of rubella infection from (26) woman were IgM positive at (9) weeks of pregnancy; (94) were IgG +ve but IgM –ve initially and also on repeat sampling after (3) weeks; while (50) women were nonimmune (IgG and I
Background: To study prevalence and method of diagnosis of acute rubella Infection during early pregnancy in Iraq.
Patients and Methods: Clinical signs and symptoms of acute rubella infection were looked for in (170) pregnant women looked before (12) weeks of gestation .Serial rubella specific IgG and IgM serological testing was done in these (170) women before (12) weeks of pregnancy, after (3) weeks, and again at (18-20) weeks of gestation.
Results: Three woman had clinical signs and symptoms of rubella infection from (26) woman were IgM positive at (9) weeks of pregnancy; (94) were IgG +ve but IgM –ve initially and also on repeat sampling after (3) weeks; while (50) women were nonimmune (IgG and I