Background: Acute cholecystitis is common surgical
problem, which was treated previously by conservative
treatment .Later early open has been introduced as an
alternative to interval for treatment of acute cholecystitis.
Early open was found to be a safe, successful with
comparable postoperative complication rate. With the
advent of laparoscopy laparoscopic have been used for
chronic cholecystitis and became the first line of
treatment. New reports have shown that laparoscopic can
be used as an alternative to open for surgical treatment of
acute cholecystitis.
Objectives: to compare the success, safety of early
laparoscopic versus early open as a primary treatment of
acute cholecystitis.
Methods: out of 68 patients were treated for clinical
acute cholecystitis between January 2002 and February
2004 in the department of surgery, at Al – Kindy teaching
hospital. A total of 62 patients underwent early for acute
cholecystitis as soon as possible after diagnosis. The
preferred preoperative imaging technique was ultrasound.
30 (48.3%) of the operations were attempted
laparoscopically, whereas the remaining 32 patients
(51.7%) underwent initial open .
Results: The mean operative time for the open cases
was 75 minutes versus 60 minutes for the laparoscopic
group. There was no perioperative mortality in either
group. The incidence of conversion to open was 10% (3
patients). Surgical complications related to laparoscopic
and open occurred in 2 (6.6%) and 3 (9.3%) cases,
respectively. There was no difference between the open
and laparoscopic groups in regard to the major
postoperative complications.
Conclusion: The current study shows that early
(whether performed by open or laparoscopically) is a
safe and effective treatment for acute cholecystitis. Low
conversion rates can be maintained with strict guidelines
for appropriate patient selection, adequate experience,
and proper laparoscopic technique.
The negotiation phase is gaining great importance in investment loans due to the magnitude of the amounts awarded and the need to obtain adequate lending guarantees and the development of better conditions, and this requires that negotiating policy with fixed principles that balance between meeting the demands of customers and maintain market share and achieve profits and avoid defaults and losses the bank, and so I have touched Find the concept of investment loans and procedures for granting and the concept of the negotiation process for the granting of loans. The practical side to ensure the preparation of examination form consists of questions commensurate with the methodology developed by the researchers, were directed to the officia
... Show MoreInspite of the renovation and development that occurred on the
mathematics curricula and its teaching styles (methods), the teaching methods and the evaluation styles that the teachers of the country
follow are still traditionaL It depends on the normal distribution approach and the principle of individual differences among students in
addition the traditional tests that are used to evaluate student achievement are built on standard-referenced system. These types of tests focus on comparing the student's performance with his peers'
performance. The limitary of this type of evaluation in diagnosing the
students' acquisition of the stu
... Show MoreAsthma is one of the most common chronic, non-communicable diseases affecting children worldwide. The estimated prevalence of pediatric asthma in Iraq is 15.8%. Physiologic, inflammatory and structural factors contribute to the development of asthma. Assessment and monitoring of asthma control can be done by a validated children asthma control test (CACT). Management of asthma must address three components which are an appropriate management plan, the most appropriate medication if necessary, and the use of safe and effective medication. The management plan should consider patient counseling and education about the definition of asthma, signs, and symptoms, the pathophysiology of asthma, common triggers for asthma and how can avoid them,
... Show MoreIn this study, we investigate about the run length properties of cumulative sum (Cusum) and The exponentially weighted moving average (EWMA) control charts, to detect positive shifts in the mean of the process for the poisson distribution with unknown mean. We used markov chain approach to compute the average and the standard deviation for run length for Cusum and EWMA control charts, when the variable under control follows poisson distribution. Also, we used the Cusum and the EWMA control charts for monitoring a process mean when the observations (products are selected from Al_Mamun Factory ) are identically and independently distributed (iid) from poisson distribution i
... Show MoreThe survey showed sample opinions of officials in the general company for vegetable oils industry, and the statement of the order of the effect of these dimensions depending on the degree of importance, the questionnaire was used as a key tool in collecting data and information of the sample consisted of 30 officials, arithmetic mean, standard deviation, percentages, Spearman correlation coefficient and the global statistical analysis as a statistical methods that based on statistical program (SPSS), The researcher came to several conclusions, most important that there is high agreement by the respondents of the importance of the dimensions of building a mental picture of the company and to attract the consumer's attention, Also research
... Show MoreIn this study, the magic nuclei is divided into two groups, one of them is light group and the other is middle group, it was calculated shell corrections for all nuclei, and also it was concluded the relationship between cross sections for nuclear reactions ()α,n and the mass number (A) for all nuclei to incident neutrons (14.5 MeV). We found empirical equations to asymmetry parameter (N-Z)/A as function of mass number and for that two groups: for A=38 to A=40 light nuclei.()0534.10263.0+−=−AAZN for A=50 to A=89 middle nuclei. ()408.00151.00001.02−+=−AAAZN for A=90 to A=144 middle nuclei. ()0711.10221
During the 1970s, communicative view of language teaching began to be incorporated into syllabus design. The central question for the proponents of this view was: what does the learner want/need to do with the target language? This lead to the emergence of a teaching method (or approach) called communicative language teaching (CLT) during the late 1970s and early 1980s focusing on the functions that must be incorporated into a classroom. According to Brown (2001:43) CLT is a unified but broadly based, theoretically well informed set of tenets about the nature of language and of language learning and teaching. Harmer (2001:84) states that the communicative approach is the name which was given to a set of beliefs which included not only a
... Show MoreAbstract
This research aims to analyze the reality of the production process in an assembly line Cars (RUNNA) in the public company for the automotive industry / Alexandria through the use of some Lean production tools, and data were collected through permanence in the company to identify the problems of the line in order to find appropriate to adopt some Lean production tools solutions, and results showed the presence of Lead time in some stations, which is reflected on the customer's waiting time to get the car, as well as some of the problems existing in the car produced such as high temperature of the car, as the company does not take into account customer preferences,
... Show MoreAbstract
Binary polymer blend was prepared by mechanical mixing method of unsaturated polyester resin with Nitrile Butadiene Rubber (NBR) with different weight ratios (0, 5, 10 and 15) % of (NBR). Tensile characteristics and wear rates of these blends were studied for all mixing ratios. The microstructure of fracture surfaces of the prepared samples were investigated by optical microscope. The results were showed that strain rates of the resin material increase after blending it with rubber while the ultimate tensile strength and Young’s modulus values of it will decrease. It is also noticed that the wear rate of resin decreases with increasing of (NBR) content.
Keywords:<
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