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.
In this research , design and study a (beam expander) for the Nd – YAG laser with (1.06 ?m) Wavelength has been studied at 5X zoom with narrow diversion in the room temperature. by using (ZEMAX) to study the system. Evaluate its performance via (ZEMAX) outputs, as bright Spot Diagram via (RMS), Ray Fan Plot, Geometric Encircled Energy and the value of Focal shift. Then study the effect of field of view on the outputs in the room temperature.
Concentrated research topic in addressing variable vital to the work of offices of inspectors general, construction and scale effectiveness and efficiency is the organizational structure, which are important as is obvious to any researcher in the management and organization and this variable would affect the exercise task supervision and inspection of financial and administrative corruption and combat efficiently, Thus this effect will be placed in the fold ability to achieve goals. That the creation of the organizational structure and requirements to achieve harmony between its properties is creating step towards success. This research aims to analyze the characteristics and style o
THE ACTUAL SOCIETY MODEL
Our society model has been showing signs of exhaustion since the end of the XX century. The recent appearance of the Covid-19 virus is another consequence of humanity's distance from Nature and the environment it inhabits. Also, climate change, environmental deterioration, loss of biodiversity, overexploitation of natural resources, and social inequality are some of the consequences derived from this separation between society and Nature. We must change our operating habits. Inevitably from a society based on the market, hyper consumption, fossil energy and individual enrichment at all costs, we will have to change to another
... Show MoreA computerized investigation has been carried out on the design of six electrodes electrostatic lenses used in electron gun application. The Finite-Element Method (FEM) was used in the solution of Laplace equation for determine the axial potential distribution. The electron trajectory under zero magnification condition. The optical properties, spherical and chromatic aberrations, the object and image focal length and object and image position are calculated. A very good futures for the electron gun with these lenses have been computed where are a beam current of 8.7*10-7A can be supplied using cathode tip of radius 10nm.
Two novel demountable shear connectors for precast steel-concrete composite bridges are presented. The connectors use high-strength steel bolts, which are fastened to the steel beam with the aid of a special locking configuration that prevents slip of bolts within their holes. Moreover, the connectors promote accelerated construction and overcome typical construction tolerances issues of precast structures. Most importantly, the connectors allow bridge disassembly, and therefore, can address different bridge deterioration scenarios with minimum disturbance to traffic flow, i.e. (1) precast deck panels can be rapidly uplifted and replaced; (2) connectors can be rapidly removed and replaced; and (3) steel beams can be replaced, while precast
... Show MoreIn this present paper, we obtain some differential subordination and superordination results, by using generalized operators for certain subclass of analytic functions in the open unit disk. Also, we derive some sandwich results.
Construction is a hazardous industry with a high number of injuries. Prior research found that many industry injuries can be prevented by implementing an effective safety plan if prepared and maintained by qualified safety personnel. However, there are no specific guidelines on how to select qualified construction safety personnel and what criteria should be used to select an individual for a safety position in the United States (US) construction industry. To fill this gap in knowledge, the study goal was to identify the desired qualifications of safety personnel in the US construction industry. To achieve the study goal, the Delphi technique was used as the main methodology for determining the desired qualifications for constructio
... Show MoreThis research includes a study of the ability of Iraqi porcelanite rocks powder to remove the basic Safranine dye from its aqueous process by adsorption. The experiments were carried out at 298Kelvin in order to determine the effect of the starting concentration for Safranin dye, mixing time, pH, and the effect of ionic Strength. The good conditions were perfect for safranine dye adsorption was performed when0.0200g from that adsorbed particles and the removal max percentage was found be 96.86% at 9 mg/L , 20 minutes adsorption time and at PH=8 and in 298 K. The isothermal equilibrum stoichiometric adsorption confirmed, the process data were examined by Langmuir, Freundlich and Temkin adsorption equations at different temperatures
... Show MoreTraffic classification is referred to as the task of categorizing traffic flows into application-aware classes such as chats, streaming, VoIP, etc. Most systems of network traffic identification are based on features. These features may be static signatures, port numbers, statistical characteristics, and so on. Current methods of data flow classification are effective, they still lack new inventive approaches to meet the needs of vital points such as real-time traffic classification, low power consumption, ), Central Processing Unit (CPU) utilization, etc. Our novel Fast Deep Packet Header Inspection (FDPHI) traffic classification proposal employs 1 Dimension Convolution Neural Network (1D-CNN) to automatically learn more representational c
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