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.
The semiotic trend of recent monetary trends task that took a wide range of attention of critics and readers alike, especially after the deployment, which accompanied him after widespread acts critic Grimas and powers applicable to the literary texts and is thus expanded its care circle, hence the choice of the novel (absent) woman Iraqi novelist (Mahdi ‘Issa falcon) model to be applied to the study chose to be a semiotic approach through the use of procedural mechanisms for its critical tool (Paris School of semiotics), cash and views of its founder critic Grimas.The research in the introduction and pave came we made it a vision for literary semiotic and its impact trend in cash and cash is and what it desire to clarify some poked suc
... Show MoreThe diseases presence in various species of fruits are the crucial parameter of economic composition and degradation of the cultivation industry around the world. The proposed pear fruit disease identification neural network (PFDINN) frame-work to identify three types of pear diseases was presented in this work. The major phases of the presented frame-work were as the following: (1) the infected area in the pear fruit was detected by using the algorithm of K-means clustering. (2) hybrid statistical features were computed over the segmented pear image and combined to form one descriptor. (3) Feed forward neural network (FFNN), which depends on three learning algorithms of back propagation (BP) training, namely Sca
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This paper follows the growing interest and continuity of Islamic finance products worldwide, which has encouraged the formulation of financial institutions based on the concepts of Islamic Sharia in many countries of the world and is no longer limited to Islamic countries only, and Not exclusive to Muslims which is due to Islamic finance services and their ability to apply in non-Islamic societies, and perhaps what encouraged the development and progress of this industry Islamic history, which was attended by many different models With the development of trade's share between different countries as well as trips carried out by Muslims
... Show MoreIn this article, the partially ordered relation is constructed in geodesic spaces by betweeness property, A monotone sequence is generated in the domain of monotone inward mapping, a monotone inward contraction mapping is a monotone Caristi inward mapping is proved, the general fixed points for such mapping is discussed and A mutlivalued version of these results is also introduced.
Data generated from modern applications and the internet in healthcare is extensive and rapidly expanding. Therefore, one of the significant success factors for any application is understanding and extracting meaningful information using digital analytics tools. These tools will positively impact the application's performance and handle the challenges that can be faced to create highly consistent, logical, and information-rich summaries. This paper contains three main objectives: First, it provides several analytics methodologies that help to analyze datasets and extract useful information from them as preprocessing steps in any classification model to determine the dataset characteristics. Also, this paper provides a comparative st
... Show MoreThe goal of this research is to use optical emission spectroscopy to investigate the parameters of exploding silver wire plasma. The silver discharge plasma's emission spectra were recorded and studied. For silver wire of diameter 0.4 mm and different currents 75,100, and 125A in deionized water, the plasma electron temperature ( ) was calculated by Boltzmann plot and container plasma medium temperature by thermal camera, and the electron density ( ) was computed by Stark broadening using the hydrogen (H line) at 656.279 nm With increasing current from 75 to 125 A, the electron density (ne) increased from 3.160× to 8.762× , while electron temperatures increased from 0.571 to 1.334 eV under the same conditions.
... Show MoreSteganography is defined as hiding confidential information in some other chosen media without leaving any clear evidence of changing the media's features. Most traditional hiding methods hide the message directly in the covered media like (text, image, audio, and video). Some hiding techniques leave a negative effect on the cover image, so sometimes the change in the carrier medium can be detected by human and machine. The purpose of suggesting hiding information is to make this change undetectable. The current research focuses on using complex method to prevent the detection of hiding information by human and machine based on spiral search method, the Structural Similarity Index Metrics measures are used to get the accuracy and quality
... Show MoreA huge potential from researchers was presented for enhancing the nonlinear optical response for materials that interacts by light. In this work, we study the nonlinear optical response for chemically prepared nano- fluid of silver nanoparticles in de-ionized water with TSC (Tri-sodium citrate) protecting agent. By the means of self-defocusing technique and under CW 473 nm blue laser, the reflected diffraction pattern were observed and recorded by CCD camera. The results demonstrate that, the Ag nano-fluid shows a good third order nonlinear response and the magnitude of the nonlinear refractive index was in the order of 10−7 cm2/W. We determine the maximum change of the nonlinear refractive index and the related phase shift for the mat
... Show MoreThe current research seeks to identify the most important humanitarian issues of a sacred and very important group in all the heavenly religions and human societies, namely the elderly, to identify their significant problems and health problems, and What are the effects of these problems on their mental health and which is the ultimate goal of human resources in All parts of the world? The study relied on what is available from the sources in the literature starting from the messages of heaven and the Islamic religion followed with humanitarian, social, legal and psychological postulates. The research included four systematic chapters included the definition research and identification of the problem, importance, objectives and terminolo
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