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.
This paper reports a fiber Bragg grating (FBG) as a biosensor. The FBGs were etched using a chemical agent,namely,hydrofluoric acid (HF). This implies the removal of some part of the cladding layer. Consequently, the evanescent field propagating out of the core will be closer to the environment and become more sensitive to the change in the surrounding. The proposed FBG sensor was utilized to detect toxic heavy metal ions aqueous medium namely, copper ions (Cu2+). Two FBG sensors were etched with 20 and 40 μm diameters and fabricated. The sensors were studied towards Cu2+ with different concentrations using wavelength shift as a result of the interaction between the evanescent field and copper ions. The FBG sensors showed
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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
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Sarcasm is conceders one patterns of undesirable communication, which causes social problems in humans relationships because of the contradictory verbal and nonverbal expressions is known sarcasm may defined , statements with intent to belittle others in different situations, dealing with the individual deliberately, to diminish the will or overwhelmed by the recipe stupid, which generate a reaction when a person listener, raising the intentions of ridicule and undermine it, and this may happen is different from the irony interest increased in sarcasm since the development of scientists "Watzlawick '" and Bevin "Jackson's" in 1967 theory interactive and considered the sarcasm one interaction patterns in the social relationship, which use
... Show MoreThe problem motivation of this work deals with how to control the network overhead and reduce the network latency that may cause many unwanted loops resulting from using standard routing. This work proposes three different wireless routing protocols which they are originally using some advantages for famous wireless ad-hoc routing protocols such as dynamic source routing (DSR), optimized link state routing (OLSR), destination sequenced distance vector (DSDV) and zone routing protocol (ZRP). The first proposed routing protocol is presented an enhanced destination sequenced distance vector (E-DSDV) routing protocol, while the second proposed routing protocol is designed based on using the advantages of DSDV and ZRP and we named it as
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Aim To develop a low-density polyethylene–hydroxyapatite (HA-PE) composite with properties tailored to function as a potential root canal filling material. Methodology Hydroxyapatite and polyethylene mixed with strontium oxide as a radiopacifier were extruded from a single screw extruder fitted with an appropriate die to form fibres. The composition of the composite was optimized with clinical handling and placement in the canal being the prime consideration. The fibres were characterized using infrared spectroscopy (FTIR), and their thermal properties determined using differential scanning calorimetry (DSC). The tensile strength and elastic modulus of the composite fibres and gutta-percha were compared, dry and after 1 month storage in
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Fading channel modeling is generally defined as the variation of the attenuation of a signal with various variables. Time, geographical position, and radio frequency which is included. Fading is often modeled as a random process. Thus, a fading channel is a communication channel that experiences fading. In this paper, the proposed system presents a new design and simulate a wireless channel using Rayleigh channels. Rayleigh channels using two approaches (flat and frequency-selective fading channels) in order to calculate some path space loss efforts and analysis the performance of different wireless fading channel modeling. The results show that the bite error rate (BER) performance is dramatically improved in the value of signal to
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