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.
Oil industry played a major role in delineating the course and type o development in both imported and exported Arabic countries alike where its revenues has perform an essential role in forming programs and plans of development on both national and international level in addition to anticipation of future consuming.
Iraq, as an oil producer country with a revenues –based economy depends on oil in building its economy totally including its infrastructure having a the greatest conformed reservoir which make the government budget depends largely on oil revenues where its strategic importance lies in funding all aspects of expenders as it is considered the prime source of foreign currency. The chall
... Show MoreMany of researchers have written about social responsibility and business strategy and competitive advantage, and they have given particular attention to the relationship between economic and social responsibility , but what is missing in this aspect is how the economic units that use their core competencies to advance social responsibility initiatives so that they can achieve a significant competitive advantage and create value for it ?
The current research aims to verify the view that "the economic and social objectives in the long term is not contradictory in nature but complementary objectives essential", as well as make sure that the s
... Show MoreThe research dealt with the topic ' the aesthetics of design shape of interior spaces for the syndicate of physicians' as it reflects visions evolving to the level of tasting and positive interpretation for the space of work to be on a high design level.The research consisting of four chapters as follow; The first chapter examined the problem of the research contracted in the following question: Have the design shapes any role in achieving and showing the aesthetic side for the syndicate of physicians? so the goal of the research was showing the aesthetics of design shape of interior spaces for the syndicate of physicians, The chapter also included the objective spatial and temporal limits of research .Finally the terms were specified. T
... Show MoreG-system composed of three isolates G3 ( Bacillus),G12 ( Arthrobacter )and G27 ( Brevibacterium) was used to detect the mutagenicity of the anticancer drug, cyclophosphamide (CP) under conditions similar to that used for standard mutagen, Nitrosoguanidine (NTG). The CP effected the survival fraction of isolates after treatment for 15 mins using gradual increasing concentrations, but at less extent comparing to NTG. The mutagenic effect of CP was at higher level than that of NTG when using streptomycin as a genetic marker, but the situation was reversed when using rifampicin resistant as a report marker. The latter effect appeared upon recording the mutagen efficiency (ie., number of induced mutants/microgram of mutagen). Measuring the R
... Show MoreThe objective of this work is to study the influence of end milling cutting process parameters, tool material and geometry on multi-response outputs for 4032 Al-alloy. This can be done by proposing an approach that combines Taguchi method with grey relational analysis. Three cutting parameters have been selected (spindle speed, feed rate and cut depth) with three levels for each parameter. Three tools with different materials and geometry have been also used to design the experimental tests and runs based on matrix L9. The end milling process with several output characteristics is solved using a grey relational analysis. The results of analysis of variance (ANOVA) showed that the major influencing parameters on multi-objective response w
... Show MoreThe γ- mixing ratios of γ- transitions from levels of 56Fe populated in reaction are calculated using least square fitting program for the first time in the case of pure and mixed transitions the results obtained have been compound with γ Values determined by other methods .The comparison shows that the agreement is good this confirmed the valilety of this method in calculating of values for such γ- transitions key word: γ- transition ,Multipole mixing ratios ,Least square fitting method.
unacceptable social behaviors, particularly withdrawal behavior that appears in children with autism represent a major problem hindering the process of communication with those around them and therefore the process of mergence with them be difficult.
The withdrawal causes a real affect deficit for children with autism limits the possibility of development of their intellectual and mental growth due to their solitude and the weakness of their focus in the acquisition of pedagogical skills and lack the necessary social skills to maintain the relations of friendship and enjoyment of them.
withdrawal children fail to participate
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