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.
Background. “Polyetheretherketone (PEEK)” is a biocompatible, high-strength polymer that is well-suited for use in dental applications due to its unique properties. However, achieving good adhesion between PEEK and hydrophilic materials such as dental adhesives or cement can be challenging. Also, this hydrophobicity may affect the use of PEEK as an implant material. Surface treatment or conditioning is often necessary to improve surface properties. The piranha solution is the treatment of choice to be explored for this purpose. Methods. PEEK disks of 10 mm diameter and 2 mm thickness were used in this study. Those samples were divided into five groups (each group has five samples). The first is the control group, in which no
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The flexible joint robot (FJR) typically experiences parametric variations, nonlinearities, underactuation, noise propagation, and external disturbances which seriously degrade the FJR tracking. This article proposes an adaptive integral sliding mode controller (AISMC) based on a singular perturbation method and two state observers for the FJR to achieve high performance. First, the underactuated FJR is modeled into two simple second-order fast and slow subsystems by using Olfati transformation and singular perturbation method, which handles underactuation while reducing noise amplification. Then, the AISMC is proposed to effectively accomplish the desired tracking performance, in which the integral sliding surface is designed to reduce cha
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Abstract:
The research aims to clarify the impact of adopting the IFRS16 financial reporting standard on lease contracts in insurance companies on audit procedures. The change in the classification of lease contracts in the case of adopting the IFRS16 financial reporting standard necessarily requires audit procedures that are compatible with this change. A proposed audit program was prepared, guided by international auditing standards, based on the study of the client's environment and analysis of external and internal risks in the light of financial and non-financial indicators. The researchers reached a set of concl
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This paper proposes a new structure of the hybrid neural controller based on the identification model for nonlinear systems. The goal of this work is to employ the structure of the Modified Elman Neural Network (MENN) model into the NARMA-L2 structure instead of Multi-Layer Perceptron (MLP) model in order to construct a new hybrid neural structure that can be used as an identifier model and a nonlinear controller for the SISO linear or nonlinear systems. Weight parameters of the hybrid neural structure with its serial-parallel configuration are adapted by using the Back propagation learning algorithm. The ability of the proposed hybrid neural structure for nonlinear system has achieved a fast learning with minimum number
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Soil is the cardinal resource for agricultural crops. Healthy soil will produce healthy plants. Since healthy soil is the important goal for the farmers, they need to select the best tillage system to achieve that goal. There are two main types of tillage systems. Conservation tillage (no-tillage farming) uses agricultural machinery that performs a double function; tillage and seed farming simultaneously. In contrast, conventional tillage farming uses multiple agricultural machines to till and seed the soil. The farmers in the northern governorates of Iraq have used the conservation farming system for a long time. However, the farmers who live in the middle and southern governorates in Iraq use conventional tillage farming. Because most of
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The present study aims at knowing the effect of discussion method for students of fifth grade in preparatory school.
Methodology of the Study:
In order to achieve the objective of the study, the researcher chooses non-randomly the preparatory school affiliated to the District Chamchamal \ Suliemnaniya. The sample attained 64 students in 32 per group (control and experimental) groups. The researcher used the discussion method which was applied on experimental group. She uses the traditional method on the control group.
The researcher matched the two group in ago, intelligence, marks at the Kurdish Language in the previous year , pretest and posts for the indepe
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