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.
Early childhood Is the of the important stages in the life of man and initiated full on others
reliability has been rise in growth toward independence and self-reliance, as is the transition
from the home environment to the kindergarten environment (kindergarten) (4-6) years where
starts in the interaction with the external environment, it is an essential stage in the
construction of sound personal to the child, and choose proper clothes at this age is one of the
important aspects in building the child's personality, as it reflects the clothing behavior and
taste his parents, especially his mother, she is the first responsible for providing clothes for
her children. Children at this stage are dependent the mothers in
Theoretical and experimental investigations of free convection through a cubic cavity with sinusoidal heat flux at bottom wall, the top wall is exposed to an outside ambient while the other walls are adiabatic saturated in porous medium had been approved in the present work. The range of Rayleigh number was and Darcy number values were . The theoretical part involved a numerical solution while the experimental part included a set of tests carried out to study the free convection heat transfer in a porous media (glass beads) for sinusoidal heat flux boundary condition. The investigation enclosed values of Rayleigh number (5845.6, 8801, 9456, 15034, 19188 and 22148) and angles of inclinations (0, 15, 30, 45 and 60 degree). The numerical an
... Show MoreIn this paper, the linear system of Fredholm integral equations is solving using Open Newton-Cotes formula, which we use five different types of Open Newton-Cotes formula to solve this system. Compare the results of suggested method with the results of another method (closed Newton-Cotes formula) Finally, at the end of each method, algorithms and programs developed and written in MATLAB (version 7.0) and we give some numerical examples, illustrate suggested method
The topic of the research tagged (narrative structure and its impact on building open and closed endings in the fictional film) is summarized by studying the mechanism of employing closed and open endings in the fictional film. novelist, then the need for it, as well as the objectives of the research and clarifying its limits as well as its importance. Then moving to the theoretical framework, which included three topics, where the first topic was entitled (the cinematic construction of the film narrative), either the second topic (the structure of complexity and narrative solutions), or the third topic dealt with the subject (the structure of the end and its relationship to the construction of the narrative). After completing the theore
... Show MoreThe hydraulic behavior of the flow can be changed by using large-scale geometric roughness elements in open channels. This change can help in controlling erosions and sedimentations along the mainstream of the channel. Roughness elements can be large stone or concrete blocks placed at the channel's bed to impose more resistance in the bed. The geometry of the roughness elements, numbers used, and configuration are parameters that can affect the flow's hydraulic characteristics. In this paper, velocity distribution along the flume was theoretically investigated using a series of tests of T-shape roughness elements, fixed height, arranged in three different configurations, differ in the number of lines of roughness element
... Show MoreThis study introduces a highly sensitive trapezium-shaped PCF based on an SPR refractometric sensor with unique design features. The structure of a sensor was designed and analyzed using COMSOL Multiphysics v5.6 based on Finite Element Method (FEM) with a focus on investigating the influence of various geometric parameters on its performance. The two channels were coated with a metallic gold layer to provide chemical stability, and a thin layer of TiO₂ improved the gold's adhesion to the fiber. The findings indicate that the proposed sensor achieves maximum amplitude and wavelength sensitivities of 1,779 RIU⁻¹ and 30,500 nm/RIU, respectively, with corresponding resolutions of 3.2
Background: The role of prophylactic antibiotics remains controversial. It is clear that actively facial fractures are considered as clean contaminated and should be treated with therapeutic antibiotics; however, there is widespread variability in the use, type, timing, and duration of prophylactic antibiotic administrated in practice today. There is an adverse effect of increased antibiotic resistance, as well as costs, it is important to review the current evidence for the role of prophylactic antibiotics in compound facial fractures. The purpose of this study is to evaluate the role and significance of preoperative, perioperative and postoperative antibiotic prophylaxis for patients when there is already an infective focus, such as co
... Show MoreBackground: Acute appendicitis is regarded as one of the most common inflammation that needs surgical intervention. Different scoring systems have been used for diagnosing of acute appendicitis. ALVARADO score is one of the most widely used score in diagnosing of acute appendicitis, but the accuracy of the latter is insufficiently low in Middle-East patients. Thus a new scoring system called RIPASA score has been designed for diagnosing of acute appendicitis in those patients. The aim of this study is to use RIPASA score and compare its result with ALVARADO score in diagnosing of acute appendicitis.
Subjects and Methods: The study includes 200 patients with symptoms and signs of
... Show MoreObjective: evaluation of Acute Flaccid Paralysis Surveillance (AFP) System's Structure at Al-Russafa Health directorate in Baghdad City. Methodology: descriptive study using evaluation approach conducted to measure the efficiency of AFP Surveillance System structure for period from November 27th 2014 to June 30th 2015. The study adopted the non-probability multi-stage sampling approach. As nineteen health facilities under surveillance are chosen and interview is conducted with a total of 50 health worker how are involved in the AFP Surveillance System. The data are gathered from sample by using question