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.
Improving the ability of asphalt pavement to survive the heavily repeated axle loads and weathering challenges in Iraq has been the subject of research for many years. The critical need for such data in the design and construction of more durable flexible pavement in bridge deck material is paramount. One of new possible steps is the epoxy asphalt concrete, which is classified as a superior asphalt concrete in roads and greatly imparts the level of design and construction. This paper describes a study on 40-50 penetration graded asphalt cement mixed with epoxy to produce asphalt concrete mixtures. The tests carried out are the Marshall properties, permanent deformation, flexural fatigue cracking and moisture damage. Epoxy asphalt mixes perf
... Show MorePassive optical network (PON) is a point to multipoint, bidirectional, high rate optical network for data communication. Different standards of PONs are being implemented, first of all PON was ATM PON (APON) which evolved in Broadband PON (BPON). The two major types are Ethernet PON (EPON) and Gigabit passive optical network (GPON). PON with these different standards is called xPON. To have an efficient performance for the last two standards of PON, some important issues will considered. In our work we will integrate a network with different queuing models such M/M/1 and M/M/m model. After analyzing IPACT as a DBA scheme for this integrated network, we modulate cycle time, traffic load, throughput, utilization and overall delay
... Show MoreProtein arginine methyltransferases (PRMTs) play important roles in transcription, splicing, DNA damage repair, RNA biology, and cellular metabolism. Thus, PRMTs have been attractive targets for various diseases. In this study, we reported the design and synthesis of a potent pan-inhibitor for PRMTs that tethers a thioadenosine and various substituted guanidino groups through a propyl linker. Compound II757 exhibits a half-maximal inhibition concentration (IC50) value of 5 to 555 nM for eight tested PRMTs, with the highest inhibition for PRMT4 (IC50 = 5 nM). The kinetic study demonstrated that II757 competitively binds at the SAM binding site of PRMT1. Notably, II757 is selective for PRMTs over a panel of other methyltransferases, w
... Show MoreThere are many images you need to large Khoznah space With the continued evolution of storage technology for computers, there is a need nailed required to reduce Alkhoznip space for pictures and image compression in a good way, the conversion method Alamueja