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 addresses the use of adaptive sliding mode control for the servo actuator system with friction. The adaptive sliding mode control has several advantages over traditional sliding mode control method. Firstly, the magnitude of control effort is reduced to the minimal admissible level defined by the conditions for the sliding mode to exist. Secondly, the upper bounds of uncertainties are not required to be known in advance. Therefore, adaptive sliding mode control method can be effectively implemented. The numerical simulation via MATLAB 2014a for servo actuator system with friction is investigated to confirm the effectiveness of the proposed robust adaptive sliding mode control scheme. The results clarify, after
... Show MoreAbstract: Israel formulated its security theory, which it established on the "pretext of war", meaning converting any Arab action that Israel deems a threat to its security, into a pretext to ignite the fuse of war, considering this a violation of an existing situation, and then it initiates preventive and pre-emptive attacks, then immediately turns into transfer the war to the enemy's land, to achieve a quick solution by (destroying the enemy), occupying its lands, and benefiting of the advantage of working on (internal lines against an enemy) working on external lines, and ending the war quickly, before the major powers intervene to impose a ceasefire
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The research paper deals with the role of the place making in eco-tourism through a review of international experiences in the eco-tourism industry and its contribution to advancing the reality of tourism there, and attracting the largest number of tourists. The study is divided into five axes: the first is a study of related concepts, and the second is a study of global experiences, which included three countries: (South Bank (Gabriel's Wharf) - London, Rotterdam in the Netherlands, and dealt with each of Happy Streets and Kendrick Mills, and then the Perak River tourist corridor - Malaysia). As for the third axis, it is concerned with analyzing these experiences to reach th
... Show MoreMoisture damage is one of the most significant troubles that destroy asphaltic pavement and reduces road serviceability. Recently, academics have noticed a trend to utilize fibers to enhance the efficiency of asphalt pavement. This research explores the effect of low-cost ceramic fiber, which has high tensile strength and a very high thermal insulation coefficient, on the asphalt mixture's characteristics by adding three different proportions (0.75%, 1.5%, and 2.25%). The Marshall test and the Tensile Strength Ratio Test (TSR) were utilized to describe the impact of ceramic fiber on the characteristics of Marshall and the moisture susceptibility of the hot mix asphalt mixture. The Field Emission Scanning Electron Microsc
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<span lang="EN-US">The use of bio-signals analysis in human-robot interaction is rapidly increasing. There is an urgent demand for it in various applications, including health care, rehabilitation, research, technology, and manufacturing. Despite several state-of-the-art bio-signals analyses in human-robot interaction (HRI) research, it is unclear which one is the best. In this paper, the following topics will be discussed: robotic systems should be given priority in the rehabilitation and aid of amputees and disabled people; second, domains of feature extraction approaches now in use, which are divided into three main sections (time, frequency, and time-frequency). The various domains will be discussed, then a discussion of e
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Decision making is vital and important activity in field operations research ,engineering ,administration science and economic science with any industrial or service company or organization because the core of management process as well as improve him performance . The research includes decision making process when the objective function is fraction function and solve models fraction programming by using some fraction programming methods and using goal programming method aid programming ( win QSB )and the results explain the effect use the goal programming method in decision making process when the objective function is
fraction .
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The current research deals with practical studies that explain to the Iraqi consumer multiple instances about the phenomenon of water hammer which occur in the water pipeline operating with pressure. It concern a practical study of the characteristics of this phenomenon and economically harmful to the consumer the same time. Multiple pipe fittings are used aimed to reduce this phenomenon and its work as alternatives to the manufactured arresters that used to avoid water hammer in the sanitary installations, while the consumer did not have any knowledge as to the non-traded for many reasons, including the water pressure decreases in the networks and the use of consumer pumps to draw water directly from the network. Study found a number of
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L1 adaptive controller has proven to provide fast adaptation with guaranteed transients in a large variety of systems. It is commonly used for controlling systems with uncertain time-varying unknown parameters. The effectiveness of L1 adaptive controller for position control of single axis has been examined and compared with Model Reference Adaptive Controller (MRAC). The Linear servo motor is one of the main constituting elements of the x-y table which is mostly used in automation application. It is characterized by time-varying friction and disturbance.
The tracking and steady state performances of both controllers have been assessed fo
... Show MoreThe multiple linear regression model is an important regression model that has attracted many researchers in different fields including applied mathematics, business, medicine, and social sciences , Linear regression models involving a large number of independent variables are poorly performing due to large variation and lead to inaccurate conclusions , One of the most important problems in the regression analysis is the multicollinearity Problem, which is considered one of the most important problems that has become known to many researchers , As well as their effects on the multiple linear regression model, In addition to multicollinearity, the problem of outliers in data is one of the difficulties in constructing the reg
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