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.
Construction contractors usually undertake multiple construction projects simultaneously. Such a situation involves sharing different types of resources, including monetary, equipment, and manpower, which may become a major challenge in many cases. In this study, the financial aspects of working on multiple projects at a time are addressed and investigated. The study considers dealing with financial shortages by proposing a multi-project scheduling optimization model for profit maximization, while minimizing the total project duration. Optimization genetic algorithm and finance-based scheduling are used to produce feasible schedules that balance the finance of activities at any time w
Measurement of construction performance is essential to a clear image of the present situation. This monitoring by the management team is necessary to identify locations where performance is exceptionally excellent or poor and to identify the primary reasons so that the lessons gained may be exported to the firm and its progress strengthened. This research attempts to construct an integrated mathematical model utilizing one of the recent methodologies for dealing with the fuzzy representation of experts’ knowledge and judgment considering hesitancy called spherical fuzzy analytic hierarchy process (SFAHP) method to assess the contractor’s performance per the project performance pa
Aggregate production planning (APP) is one of the most significant and complicated problems in production planning and aim to set overall production levels for each product category to meet fluctuating or uncertain demand in future. and to set decision concerning hiring, firing, overtime, subcontract, carrying inventory level. In this paper, we present a simulated annealing (SA) for multi-objective linear programming to solve APP. SA is considered to be a good tool for imprecise optimization problems. The proposed model minimizes total production and workforce costs. In this study, the proposed SA is compared with particle swarm optimization (PSO). The results show that the proposed SA is effective in reducing total production costs and req
... Show MoreElectronic Health Record (EHR) systems are used as an efficient and effective method of exchanging patients’ health information with doctors and other key stakeholders in the health sector to obtain improved patient treatment decisions and diagnoses. As a result, questions regarding the security of sensitive user data are highlighted. To encourage people to move their sensitive health records to cloud networks, a secure authentication and access control mechanism that protects users’ data should be established. Furthermore, authentication and access control schemes are essential in the protection of health data, as numerous responsibilities exist to ensure security and privacy in a network. So, the main goal of our s
... Show MoreThe inhibitory effect of acetone, ethanol, and aqueous extracts of ten medicinal plants on β-lactamase from Staphylococcus sciuri and Klebsiella pneumoniae was investigated in vitro by starch-iodine agar plate method. The results revealed the success of starch-iodine method for the detection of the inhibition of β-lactamase activity by the various extracts of each individual plant. The acetone extracts of Catharanthus roseus, Eucalyptus camaldulensis, and Schinus terebinthifolius induced an inhibitory effect on β-lactamase from Staphylococcus sciuri. On the other hand, acetone extracts from only Eucalyptus camaldulensis, and Schinus
... Show Morein this article, we present a definition of k-generalized map independent of non-expansive map and give infinite families of non-expansive and k-generalized maps new iterative algorithms. Such algorithms are also studied in the Hilbert spaces as the potential to exist for asymptotic common fixed point.
Objective(s): To assess nurses' practices for neurological unconscious patients in intensive care units.
Methodology: A descriptive study was conducted that included (50) nurse who are working in intensive care
units in hospitals and departments of the nervous system in (4) hospitals (neuroscience hospital, teaching
neurosurgical hospital, surgical specialist hospital, and sheck zaied hospital) in Baghdad city from March, 30th
,
2009 to July, 30th 2009 for the purpose of assessing their skills towards unconscious patients. A purposive "nonprobability
sample" was selected that consisted of (50) nurse who are working in intensive care units. A
questionnaire format and observational checklist were used which consist of
Abstract: Objectives: The lowest dose of bromocriptine, necessary for suppression of lactation in rats, was estimated in this investigation. Methodology: Fifty healthy lactating rats were treated with different doses of bromocriptine. Cessation of lactation was assessed clinically and histologically. Results: Revealed that the lowest dose capable of lactation suppression is 4 mg bromocriptine / kg body wt. / day. It is very important to know the exact dose, which can suppress lactation in rats because these laboratory animals are commonly employed in experiments concerning this topic. Key words: Bromoci