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.
Deep learning has recently received a lot of attention as a feasible solution to a variety of artificial intelligence difficulties. Convolutional neural networks (CNNs) outperform other deep learning architectures in the application of object identification and recognition when compared to other machine learning methods. Speech recognition, pattern analysis, and image identification, all benefit from deep neural networks. When performing image operations on noisy images, such as fog removal or low light enhancement, image processing methods such as filtering or image enhancement are required. The study shows the effect of using Multi-scale deep learning Context Aggregation Network CAN on Bilateral Filtering Approximation (BFA) for d
... Show MoreThe national pharmaceutical industry is pivotal for both the health sector and the national economy. This study aims to identify determinants of national drug products acceptance. The objectives of this study were to quantitatively measure the level of patient and community pharmacist acceptance of national drug products available in community pharmacies and to qualitatively explore the barriers facing national pharmaceutical companies and investigate the suggested solutions.
This cross-sectional study used an explanatory mixed method design. It was conducted in Baghdad, Iraq from July through October 2018. The stud
The Twofish cipher is a very powerful algorithm with a fairly complex structure that permeates most data parsing and switching and can be easily implemented. The keys of the Twofish algorithm are of variable length (128, 192, or 256 bits), and the key schedule is generated once and repeated in encrypting all message blocks, whatever their number, and this reduces the confidentiality of encryption. This article discusses the process of generating cipher keys for each block. This concept is new and unknown in all common block cipher algorithms. It is based on the permanent generation of sub keys for all blocks and the key generation process, each according to its work. The Geffe's Generator is used to generate subkeys to make eac
... Show MoreThe question asked by all researchers is when solar panels will replace the national grid, especially in the domestic sector. In this study, a rooftop stand-alone solar electric system is designed to provide all the electrical power to a house in Baghdad-Iraq, using a (How to design PV system) simulation program. The feasibility of this system compared to the performance of the national electric grid and the system of private diesel generators is determined. The proposed solar system capacity is (25 kW), and the space required and the energy payback time are (360 m2 and 7.82 years), respectively. By using the current system, the net CO2 mitigation amount is 499,518.2 tons for 30-year. The kilowatt-hour cost
... Show MoreA cumulative review with a systematic approach aimed to provide a comparison of studies’ investigating the possible impact of the active form of vitamin D3, calcitriol (CTL), on the tooth movement caused by orthodontic forces (OTM) by evaluating the quality of evidence, based on collating current data from animal model studies, in vivo cell culture studies, and human clinical trials. Methods: A strict systematic review protocol was applied following the application of the International Prospective Register of Systematic Reviews (PROSPERO). A structured search strategy, including main keywords, was defined during detailed search with the application of electronic database systems: Medline/Pubmed, EMBASE, Scopus, Web of Science, and
... Show MoreThis study examines experimentally the performance of a horizontal triple concentric tube heat exchanger TCTHE made of copper metal using water as cooling fluid and oil-40 as hot fluid. Hot fluid enters the inner annular tube of the TCTHE in a direction at a temperature of 50, 60 and 70 oC and a flow rate of 20 l/hr. On the other hand, the cooling fluid enters the inner tube and the outer annular tube in the reverse direction (counter current flow) at a temperature of 25 oC and flow rates of 10, 15, 20, 25, 30 and 35 l/hr. The TCTHE is composed of three copper tubes with outer diameters of 34.925 mm, 22.25 mm, and 9.525 mm, and thicknesses of 1.27 mm, 1.143 mm, and 0.762 mm, respectively. TCTHE tube's length was 670
... Show MoreThis article deals with the study of theories about verbal periphrasis as a grammatical construction; the aim of this point it offers good and valid guidelines to improve the linguistic description. The interest in the subject comes from its importance in the process of language teaching for the students of Spanish and to clarify this type of curriculum of this research we analyzed a literary text. From "Zurita"
The main object of this article is to study and introduce a subclass of meromorphic univalent functions with fixed second positive defined by q-differed operator. Coefficient bounds, distortion and Growth theorems, and various are the obtained results.