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.
The negotiation phase is gaining great importance in investment loans due to the magnitude of the amounts awarded and the need to obtain adequate lending guarantees and the development of better conditions, and this requires that negotiating policy with fixed principles that balance between meeting the demands of customers and maintain market share and achieve profits and avoid defaults and losses the bank, and so I have touched Find the concept of investment loans and procedures for granting and the concept of the negotiation process for the granting of loans. The practical side to ensure the preparation of examination form consists of questions commensurate with the methodology developed by the researchers, were directed to the officia
... Show MoreAA wahid, journal mustansiriyah of sports science, 2023
Abstract
This study aims to identify the extent to which the criteria of the American Council for Teaching Foreign Languages (ACTFL) are included in the English language books for the fifth and sixth graders. To achieve the objective of the study, a content analysis card was prepared, where the classification of language proficiencies was divided into five main levels (beginner, intermediate, advanced, superior, and distinguished) of the four language skills (listening, speaking, reading, and writing), The content analysis card consisted of (89) indicators distributed at the four levels of language skills as follows: Listening (17), speaking (33), reading (15), and writing (26). The study sample consisted of Engl
... Show MoreThe survey showed sample opinions of officials in the general company for vegetable oils industry, and the statement of the order of the effect of these dimensions depending on the degree of importance, the questionnaire was used as a key tool in collecting data and information of the sample consisted of 30 officials, arithmetic mean, standard deviation, percentages, Spearman correlation coefficient and the global statistical analysis as a statistical methods that based on statistical program (SPSS), The researcher came to several conclusions, most important that there is high agreement by the respondents of the importance of the dimensions of building a mental picture of the company and to attract the consumer's attention, Also research
... Show MoreDuring the 1970s, communicative view of language teaching began to be incorporated into syllabus design. The central question for the proponents of this view was: what does the learner want/need to do with the target language? This lead to the emergence of a teaching method (or approach) called communicative language teaching (CLT) during the late 1970s and early 1980s focusing on the functions that must be incorporated into a classroom. According to Brown (2001:43) CLT is a unified but broadly based, theoretically well informed set of tenets about the nature of language and of language learning and teaching. Harmer (2001:84) states that the communicative approach is the name which was given to a set of beliefs which included not only a
... Show MoreThe basic skills (defensive & offensive) in basketball it is a base for completion and decide the level of the team and the rank, in same time considers the axel of the researchers when putting tests and forming new groups so close from real situation games to create real vision and estimate for skill state and a method to recorrect & presenting positive resolutions, the problem of research were indicate to variables may happen in training operation it demand tests matches with these variables and forming new standards, and another way the researchers find a few patterns for measuring basic skills (defensive & offensive) also application these tests on samples it differs from the originals one that the tests designed for it. The sample repr
... Show MoreThis work presents a novel technique for the detection of oil aging in electrical transformers using a single mode optical fiber sensor based on surface plasmon resonance (SPR). The aging of insulating oil is a critical issue in the maintenance and performance of electrical transformers, as it can lead to reduce insulation properties, increase risk of electrical breakdown, and decrease operational lifespan. Many parameters are calculated in this study in order to examine the efficiency of this sensor like sensitivity (S), signal to noise ratio (SNR), resolution (refractive index unit) and figure of merit (FOM) and the values are for figure of merit is 11.05, the signal to noise ratio is 20.3, the sensitivity is 6.63, and the resolution is 3
... Show MoreIn this study, we investigate about the run length properties of cumulative sum (Cusum) and The exponentially weighted moving average (EWMA) control charts, to detect positive shifts in the mean of the process for the poisson distribution with unknown mean. We used markov chain approach to compute the average and the standard deviation for run length for Cusum and EWMA control charts, when the variable under control follows poisson distribution. Also, we used the Cusum and the EWMA control charts for monitoring a process mean when the observations (products are selected from Al_Mamun Factory ) are identically and independently distributed (iid) from poisson distribution i
... Show MoreAbstract
This research aims to analyze the reality of the production process in an assembly line Cars (RUNNA) in the public company for the automotive industry / Alexandria through the use of some Lean production tools, and data were collected through permanence in the company to identify the problems of the line in order to find appropriate to adopt some Lean production tools solutions, and results showed the presence of Lead time in some stations, which is reflected on the customer's waiting time to get the car, as well as some of the problems existing in the car produced such as high temperature of the car, as the company does not take into account customer preferences,
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