Background The traditional management of appendicular mass is an initial conservative treatment followed by interval appendectomy. Recently interval appendicectomy has been questioned.
Objective: The purpose of this study was to clarify the need and the role of interval appendicectomy after successful initial conservative treatment.
Method: This is a prospective study conducted in a major hospital in Basra from April 2006 to Septemper2010, included 65 patients with appendicular mass which subsequently proved postinflammmatory (phlegmonous) changes of the appendix were treated conservatively.
Results: Routine interval appendicectomy was not performed and needed after successful treatment in the majority of the patients (84.6%). Four patients (6.1%) developed abscess formation and operation
was necessary to drain the abscess. Four patients were readmitted with recurrent appendicitis after 2 months. During the 2 years follow up period another 2 patients presented with recurrent symptoms of acute appendicitis and appendectomy were arranged. The recurrence rate after successful conservative treatment was 10%.
Conclusion routine interval appendectomy after initial
successful conservative treatment is of questionable
benefit and needs further assessment.
The last ten years observed a shift enormous scientific in the method and way that it deals professional with the cost accounting and reflected the result those shift enormous scientific of increase the competitive environmental that accompanied the emergence of a modern manufacturing environmental on surface the long roductive life and emergence advanced information technology that give a central focus of his important on client with growing global markets growth on a large scale.
The research aim to define the concept of cost awareness, the concept and methods of strategic cost management and the role of cost awareness for managers of industrial units in strategic of cost managem
... Show MoreThe research problem is that most of the construction projects exceed the planned value, due to the failure to implement the plans on time. The current study aims to monitor the implementation of the project and for each of the executed tasks of the table of quantities in order to detect deviations at the time they occur, evaluate the time and cost performance, and then identify the areas of waste and analyze the implementation of each task in order to diagnose the underlying problems and find possible and applicable solutions in the environment Iraqi. The research was applied in one of the companies specialized in the field of construction projects, and one of the most important conclusions reached is the possibility of applying
... Show MoreThe present study aims to reveal the extent of the influence of the acquired organizational immune through its dimensions (organizational vaccination, organizational learning, organizational memory, and benchmarking) in the application of knowledge management strategies in its two dimensions (codification strategy, personalization strategy) as well as clarifying that influential relationship between the study variables Because of its importance in reducing resistance to change by responding to the requirements of the environment. A set of main and sub-hypotheses emerged from the study, which was formulated in view of the hypothesis scheme of the study, and i
... Show MoreThe administration on the basis of the activities designed to evaluate the performance of activities in terms of cost, time and quality by identifying activities that add value and those that are no add value and enables the administration of making up their own continuous improvement in production, through lower costs and reduce the time and improve the quality and reduce the incidence of spoilage and waste, y based search Ally premise that (the continuous improvement of the adoption of management style on the basis of the activities helps management in decision-making wise to reduce costs) to prove the hypothesis has sought research to achieve its goal of Alkadivh and Alkoppelan &nb
... Show MoreThe important factor in the success of construction projects is its ability to objective estimate of the cost of the project and adapt to the changes of the external environment, which is affected by a lot of elements and the requirements of the competitive environment. The faces of those projects are several problems in order to achieve particular goals. To overcome these difficulties has been the development of research in the last two decades and turn the focus on the role of the cost of project management, by providing information and assist management in planning and control of the budget among the main elements of the project, namely, (time-cost-quality),The research aims at the possibility of developing and implementing mechanisms
... Show MoreBackground: Acute appendicitis is the most common surgical abdominal emergency with a life time prevalence of 1 to 7 individuals. Because the clinical diagnosis of acute appendicitis remains a challenge to surgeons, so different aids were introduced like different scoring systems, computer aided programs, ultrasonography, computerized tomography, Magnetic resonance imaging, Gastrointestinal tract contrast studies and laparoscopy to improve the diagnostic accuracy.
Objective: To evaluate ultrasound in the diagnosis of acute appendicitis in those patients clinically diagnosed with histopathology as gold standard.
Methods: A cross sectional study carried in Al-kindy Teaching
... Show MoreBackground: Acute appendicitis is the most common abdominal surgical emergency. The diagnosis of this condition is still essentially clinical and there is difficulty in the clinical diagnosis, especially among elderly, children and patients with a typical presentation, so early and accurate diagnosis of acute appendicitis is important to avoid its complications.Objectives: To evaluate the degree of accuracy of Alvarado scoring system in the diagnosis of acute appendicitis.Method: Two hundred patients were admitted to the Alkindy Teaching Hospital from January 2011 to april 2014- presented with symptoms and signs suggestive of acute appendicitis. After examination and investigations all patients were given a score according to Alvarado sc
... Show MoreThe diagnosis of acute appendicitis (AA) sometimes is illusive and the accompanying clinical and laboratory manifestations cannot be used for definitive diagnosis. Objective: This study aimed to evaluate the diagnostic value of neutrophil/lymphocyte ratio (NLR) in detection of AA. Materials and Methods: This is a cross-sectional study that included a total of 80 adult patients with AA and 62 age- and gender-matched patients with abdominal pain due to causes other than AA. Three milliliter of peripheral blood were collected from each participant. The NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. Receiver operating characteristic curve was used to assess the diagnostic value of NLR in detection
... Show MoreBackground: Acute appendicitis is a common surgical
problem that is associated with an acute-phase reaction.
Previous studies have shown that cytokines and acutephase proteins are activated and may serve as indicators for
appendicitis.
Objective: The aim of this study was to evaluate of serum
levels of interleukin-6 (IL-6) in correlation to the severity
to acute appendicitis.
Methods: This is a prospective study from December 2008
to March 2009 of patients who had appendectomy in
Department of Surgery, Al-Kindy Teaching Hospital -
Baghdad/Iraq. Serum for estimating levels of interleukin-6
(IL-6) was taken pre-operatively. Depending on the
macroscopic evidence during the operation and the
histopathol