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.
BMMAM Saleh, EUROPEAN ACADEMIC RESEARCH, 2016
Data <span>transmission in orthogonal frequency division multiplexing (OFDM) system needs source and channel coding, the transmitted data suffers from the bad effect of large peak to average power ratio (PAPR). Source code and channel codes can be joined using different joined codes. Variable length error correcting code (VLEC) is one of these joined codes. VLEC is used in mat lab simulation for image transmission in OFDM system, different VLEC code length is used and compared to find that the PAPR decreased with increasing the code length. Several techniques are used and compared for PAPR reduction. The PAPR of OFDM signal is measured for image coding with VLEC and compared with image coded by Huffman source coding and Bose-
... Show MoreThe right of the patient to know the medical risks surrounding the medical intervention is one of the most prominent rights based on the principle of "physical safety", which has undergone several stages of development until it reached the development of the patient's independence in making medical decision without relying on the doctor, The patient's prior informed consent is informed of his / her medical condition. We will study this development in accordance with the French March 4, 2002 legislation on the rights of patients in the health system, whether it was earlier and later. We will highlight the development of the patient's right to "know the medical risks surrounding medical intervention" The legislation and its comparison with th
... Show MoreAbstract:
The current research aims to distinguish the talent for the kindergarten
children and its relation with some changes . The research included ( 170 )
child (male , female ) from the kindergarten children on the year 2009 – 2010
the researcher had used PRED meter to achieve the goals of this research
after being sure from the honesty and the prove and the ( person ) connection
coefficient had been used to discover the relation between the talent and the
changes which had been mentioned in the research . The result proved that
the children had talents the toys and the educational scientifically scholarship
finally the researcher had presented some recommendations and suggestions
for other studies .<
In this article, we introduce and study two new families of analytic functions by using strong differential subordinations and superordinations associated with Wanas differential operator/. We also give and establish some important properties of these families.
This study aims to suggest an alternative to the use of quality agricultural soil in the brick industry (Iraq). The Late Miocene claystone bed in the Injana Formation in central Iraq was targeted through the study of 18 exposed sections that were sampled by using the trench sampling method. The claystones are characterized by quartz (36.4%) followed by calcite (32.8%), quartz (36.4%) feldspar (2.6%), gypsum (1.3%) and dolomite (0.7%), kaolinite (10.5%), illite (7.7%), chlorite (6.7%), palygorskite (6.0%) and montmorillonite (0.7%). New thermal mineral phases were formed at 950°C, including diopside (62.9%), quartz (18.4%), wollastonite (8.28%), akermanite (7.6%), Anorthite (6.25%), Nosean (4.9%), gehlenite (3.75%) and Lazurite (3.1
... Show MoreThe main objective of this paper is to determine an acceptable value of eccentricity for the satellites in a Low Earth Orbit LEO that are affected by drag perturbation only. The method of converting the orbital elements into state vectors was presented. Perturbed equation of motion was numerically integrated using 4th order Runge-Kutta’s method and the perturbation in orbital elements for different altitudes and eccentricities were tested and analysed during 84.23 days. The results indicated to the value of semi major axis and eccentricity at altitude 200 km and eccentricity 0.001are more stable. As well, at altitude 600 km and eccentricity 0.01, but at 800 km a
The detection and estimation of weathering conditions have become a very important daily necessity in our life. For this purpose, several satellites of low resolution imagery were launched by the weathering and environmental agencies. The important weather paremeters are temperuter, wind direction, velocity, clould and humidity, etc. The low resolution images often deal with large-scale phenomena and the interpretation and projection of the produced data requires continuous development of tools and criteria. In this paper, the low spatial resolution data generated by the moderate resolution imaging spectroradiometer (MODIS) were used to monitor the cloud density and direction above Iraq and i
... Show MoreManufacturing high-efficiency polymeric materials to moderate fast neutrons by converting them into slow or thermal neutrons. These materials absorb thermal neutrons as well as gamma rays associated with neutrons. Materials of small mass number are used to slow down fast neutrons because neutrons have a high cross-section when they interact with these materials. Materials of high mass number absorb gamma rays. Polyurethane and epoxy were mixed in various ratios to create a blend to serve as neutrons shield, lead (Pb) was then added to the blend at weight percentages of 20%, 30%, 40%, 50%, and 70% to produce a polymer composite.
Polymeric materials reinforced with lead in various ratios were tested to select the best
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