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.
Authentic materials are the most important tools that the teacher could use in class in order to make teaching go smoothly and effectively in transmitting the necessary knowledge to all students. This research has investigated experimentally the effect of using authentic materials in teaching English as a foreign Language, because a number of studies point out that the use of authentic materials is regarded a useful means to motivate learners, arouse their interest and expose them to the real language they will face in real life situations.
It is hypothesis that there is no statistical significance difference between the experimental group who taught English as a foreign language by using the authentic materials with those
... Show MoreThe purpose of the study is to identify the need to improve health services in Iraq by determining the efficiency of service in health care centres and working on exploiting limited resources through choosing the most efficient technological art represented by using precast concrete technology to fill the shortfall in the establishment health centres for primary care and to explain the impact of this on saving resources, time, and increasing production efficiency. To achieve this, the quantitative analysis adopted as a methodology in the study by determining the size of the deficit in the infrastructure of health centres for primary care according to the standard of a he
... Show MoreA simple, fast, inexpensive and sensitive method has been proposed to screen and optimize experimental factors that effecting the determination of phenylephrine hydrochloride (PHE.HCl) in pure and pharmaceutical formulations. The method is based on the development of brown-colored charge transfer (CT) complex with p-Bromanil (p-Br) in an alkaline medium (pH=9) with 1.07 min after heating at 80 °C. ‘Design of Experiments’ (DOE) employing ‘Central Composite Face Centered Design’ (CCF) and ‘Response Surface Methodology’ (RSM) were applied as an improvement to traditional ‘One Variable at Time’ (OVAT) approach to evaluate the effects of variations in selected factors (volume of 5×10-3 M p-Br, heating time, and temperature) on
... Show MoreSimultaneous determination of Furosemide, Carbamazepine, Diazepam, and Carvedilol in bulk and pharmaceutical formulation using the partial least squares regression (PLS-1 and PLS-2) is described in this study. The two methods were successfully applied to estimate the four drugs in their quaternary mixture using UV spectral data of 84synthetic mixtures in the range of 200-350nm with the intervals Δλ=0.5nm. The linear concentration range were 1-20 μg.mL-1 for all, with correlation coefficient (R2) and root mean squares error for the calibration (RMSE) for FURO, CARB, DIAZ, and CARV were 0.9996, 0.9998, 0.9997, 0.9997, and 0.1128, 0.1292, 0.1868,0.1562 respectively for PLS-1, and for PLS-2 were 0.9995, 0.9999, 0.9997, 0.9998, and 0.1127, 0.
... Show MoreThe modern teaching methods, and their importance in achieving the desired learning goals for the individual and the society, have been addressed, as it is necessary to develop the methods, ways and strategies used in the process of teaching the intermediate stages in the various fields in general and the field of physical education in particular, the importance of research is the effect of using the strategy of similarities in teaching some basic skills of basketball for students of the second intermediate. As for the problem of research, the researcher mentioned the lack of use of teachers’ strategy method similarities in the educational units because of its importance, and after study and analysis the researcher found it necessary to i
... Show MoreThis study concerns the role of activated carbon (AC) from palm raceme as a support material for the enhancement of lipase-catalyzed reactions in an aqueous solution, with deep eutectic solvent (DES) as a co-solvent. The effects of carbonization temperature, impregnation ratio, and carbonization time on lipase activity were studied. The activities of Amano lipase from Burkholderia cepacia (AML) and lipase from the porcine pancreas (PPL) were used to investigate the optimum conditions for AC preparation. The results showed that AC has more interaction with PPL and effectively provides greater enzymatic activity compared with AML. The optimum treatment conditions of AC samples that yield the highest enzymatic activity were 0.5 (NaOH (
... Show MoreMonetary policy occupies a prominent role in achieving monetary stability by adjusting the growth rates of the number of available means of payment in line with changes in the size of the gross domestic product in the country and expressed by the monetary stability coefficient agreed upon by the International Monetary Fund, a term that hides the fact that there is a rate of change in the volume of commodity or real production which expresses the levels of aggregate supply in the economy, which corresponds to the quantities of cash in circulation, which represent a net purchasing power and stimulate aggregate demand, which completes the picture of the existence of the market mechanism, expressed by the monetary or economic stability
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