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 goal of this paper is to design a robust controller for controlling a pendulum
system. The control of nonlinear systems is a common problem that is facing the researchers in control systems design. The Sliding Mode Controller (SMC) is the best solution for controlling a nonlinear system. The classical SMC consists from two phases. The first phase is the reaching phase and the second is the sliding phase. The SMC suffers from the chattering phenomenon which is considered as a severe problem and undesirable property. It is a zigzag motion along the switching surface. In this paper, the chattering is reduced by using a saturation function instead of sign function. In spite of SMC is a good method for controlling a nonlinear system b
Computer systems and networks are increasingly used for many types of applications; as a result the security threats to computers and networks have also increased significantly. Traditionally, password user authentication is widely used to authenticate legitimate user, but this method has many loopholes such as password sharing, brute force attack, dictionary attack and more. The aim of this paper is to improve the password authentication method using Probabilistic Neural Networks (PNNs) with three types of distance include Euclidean Distance, Manhattan Distance and Euclidean Squared Distance and four features of keystroke dynamics including Dwell Time (DT), Flight Time (FT), mixture of (DT) and (FT), and finally Up-Up Time (UUT). The resul
... Show MoreIn this paper, first and second order sliding mode controllers are designed for a single link robotic arm actuated by two Pneumatic Artificial Muscles (PAMs). A new mathematical model for the arm has been developed based on the model of large scale pneumatic muscle actuator model. Uncertainty in parameters has been presented and tested for the two controllers. The simulation results of the second-order sliding mode controller proves to have a low tracking error and chattering effect as compared to the first order one. The verification has been done by using MATLAB and Simulink software.
This study was designed to show the advantages of using the combination of metformin and rosiglitazone over using each drug alone in treatment of women with polycystic ovary syndrome (PCOS).Forty four women with PCOS were classified into 3 groups , group 1 received rosiglitazone (4mg/day) for 3 months , group ΙΙ received metformin ( 1500 mg/day)for three months and groupΙΙΙ received the combination ( rosiglitazone 4mg/day + metformin 1500 mg/day) for the same period of treatment . The blood samples were drawn before treatment and after 3 months of treatment . The fasting serum glucose , insulin , progesterone , testosterone , leutinizing hormone were measure
... Show MoreThe state and partial level densities were calculated using the corresponding formulas that are obtained in the frame work of the exciton model with equidistant spacing model (ESM) and non-ESM (NESM). Different corrections have been considered, which are obtained from other nuclear principles or models. These corrections are Pauli Exclusion Principle, surface effect, pairing effect, back shift due to shell effect and bound state effect . They are combined together in a composite formula with the intention to reach the final formula. One-component system at energies less than 100 MeV and mass number range (50-200) is assumed in the present work. It was found that Williams, plus spin formula is the most effective approach to the composite
... Show MoreAbstract
This paper represents a study of the effect of the soil type, the drilling parameters and the drilling tool properties on the dynamic vibrational behavior of the drilling rig and its assessment in the drilling system. So first, an experimental drilling rig was designed and constructed to embrace the numerical work.
The experimental work included implementation of the drill-string in different types of soil with different properties according to the difference in the grains size, at different rotational speeds (RPM), and different weights on bit (WOB) (Thrust force), in a way that allows establishing the charts that correlate the vibration acceleration, the rate of penetration (ROP), and the power
... Show MoreThe specialist researcher fined the relations between economic ideas with economic facts in his theory which called humanity building it is appeared clearly ( in Ibn Khalduons’ Muqaddimah) in a clothe of economic social phenomenon's as a systematical analysis in all fifty chapters of al Muqaddimah ,therefore this paper deal with Ibn Khalduon economic thoughts as important says which describe the society building in its economic subjective and examine the relationship between The dissert and the city within economic says which are cover the social analysis ,and determinate the analysis objects which clearly in this dualism model ,between the state and economic bas
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