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.
High vehicular mobility causes frequent changes in the density of vehicles, discontinuity in inter-vehicle communication, and constraints for routing protocols in vehicular ad hoc networks (VANETs). The routing must avoid forwarding packets through segments with low network density and high scale of network disconnections that may result in packet loss, delays, and increased communication overhead in route recovery. Therefore, both traffic and segment status must be considered. This paper presents real-time intersection-based segment aware routing (RTISAR), an intersection-based segment aware algorithm for geographic routing in VANETs. This routing algorithm provides an optimal route for forwarding the data packets toward their destination
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The aim of this study was to prepare rebamipide ocular inserts in order to extend its release on the ocular surface for dry eye treatment. Solubility study was applied to the drug with or without l-arginine using different solvents. Solvent casting technique was used to prepare the inserts; l-arginine was used to solubilize the drug, hydroxypropyl methylcellulose grades (E5 and K15M) and poly ethylene glycol 200 were used as excipients. The inserts were evaluated for their physical and mechanical properties, moisture loss% and absorption %, surface pH, and in-vitro drug release. The use l-arginine exhibited an enhancement of rebamipide solubility in both deionized water and phosphate buffer (pH 7.4) by a
... Show MoreSome relations of inclusion and their properties are investigated for functions of type " -valent that involves the generalized operator of Srivastava-Attiya by using the principle of strong differential subordination.
Due to the great evolution in digital commercial cameras, several studies have addressed the using of such cameras in different civil and close-range applications such as 3D models generation. However, previous studies have not discussed a precise relationship between a camera resolution and the accuracy of the models generated based on images of this camera. Therefore the current study aims to evaluate the accuracy of the derived 3D buildings models captured by different resolution cameras. The digital photogrammetric methods were devoted to derive 3D models using the data of various resolution cameras and analyze their accuracies. This investigation involves selecting three different resolution cameras (low, medium and
... Show MoreClassification of imbalanced data is an important issue. Many algorithms have been developed for classification, such as Back Propagation (BP) neural networks, decision tree, Bayesian networks etc., and have been used repeatedly in many fields. These algorithms speak of the problem of imbalanced data, where there are situations that belong to more classes than others. Imbalanced data result in poor performance and bias to a class without other classes. In this paper, we proposed three techniques based on the Over-Sampling (O.S.) technique for processing imbalanced dataset and redistributing it and converting it into balanced dataset. These techniques are (Improved Synthetic Minority Over-Sampling Technique (Improved SMOTE), Border
... Show MoreBMMAM 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-
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