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.
General propositions have dealt with various indicators and features that frame and describe basic architectural concepts, and from those concepts, the concept of identity will be presented here, which represents the nerve of intellectual vision of the state of architecture development, transformation and change. Due to its deep intellectual basis, it was necessary to study multiple features, especially the achievement feature that was considered a major stage describing the nature of change and shift related to the achievement of concept and its role in the development of the architectural field . &nb
... Show MoreThe aim of this paper, is to discuss several high performance training algorithms fall into two main categories. The first category uses heuristic techniques, which were developed from an analysis of the performance of the standard gradient descent algorithm. The second category of fast algorithms uses standard numerical optimization techniques such as: quasi-Newton . Other aim is to solve the drawbacks related with these training algorithms and propose an efficient training algorithm for FFNN
The population density of the insect on Alorat and fruits located in the lower part of the tree more than the middle part of the plant and insect in one place and demonstrates that there is a nest there were conducted laboratory and field studies on citrus Hsasahanwaa and the Alvdaúaa distribution of cortical insect yellow ....
Antimagic labeling of a graph with vertices and edges is assigned the labels for its edges by some integers from the set , such that no two edges received the same label, and the weights of vertices of a graph are pairwise distinct. Where the vertex-weights of a vertex under this labeling is the sum of labels of all edges incident to this vertex, in this paper, we deal with the problem of finding vertex antimagic edge labeling for some special families of graphs called strong face graphs. We prove that vertex antimagic, edge labeling for strong face ladder graph , strong face wheel graph , strong face fan graph , strong face prism graph and finally strong face friendship graph .
Virtual organization is similar to traditional organization in principles, but is different in the ways it operates. It requires small creation costs compared to the traditional and it uses electronic commerce as the market place and distribution channel for its products and services.The aim of this article is to applying electronic commerce for a proposed virtual organization. The tools used to build an effective web application for virtual organization to provide virtual environment to the customers to do the transaction activities online include PHP, MySQL and Apache. HTML is used for displaying forms and tables and JavaScript is used for verification in client side. Finally, connecting it to 2Checkout.com company as a third party to per
... Show MoreA niger, a fungus which doesn't have high ability to production lipid, this fungus has been select to investigate the non oleaginicity. In this search, there are explorations about: i) growth profile ii) enzymes profile iii) isoforms. Growth profile shows that this fungus doesn't have ability to accumulate lipid more than 6% while bio mass are around 10g/l in spite of the presence of glucose in the media till the end of cultivation time and excision of nitrogen within 24 hrs. In enzyme study, we investigate all lipogenic enzymes Malic enzyme (ME), Fatty acid synthase (FAS), ATP: Citrate lays (ACL), NAD+ isocitrate dehydrogenase (NAD+ICDH), Glucose-6-phosphate (G6PD), and 6-phosphogluconate dehydrogenase (6PGD), all these enzymes show, ac
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