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.
Generalized multivariate transmuted Bessel distribution belongs to the family of probability distributions with a symmetric heavy tail. It is considered a mixed continuous probability distribution. It is the result of mixing the multivariate Gaussian mixture distribution with the generalized inverse normal distribution. On this basis, the paper will study a multiple compact regression model when the random error follows a generalized multivariate transmuted Bessel distribution. Assuming that the shape parameters are known, the parameters of the multiple compact regression model will be estimated using the maximum likelihood method and Bayesian approach depending on non-informative prior information. In addition, the Bayes factor was used
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Among the different passive techniques heat pipe heat exchanger (HPHE) seems to be the most effective one for energy saving in heating ventilation and air conditioning system (HVAC). The applications for nanofluids with high conductivity are favorable to increase the thermal performance in HPHE. Even though the nanofluid has the higher heat conduction coefficient that dispels more heat theoretically but the higher concentration will make clustering .Clustering is a problem that must be solved before nanofluids can be considered for long-term practical uses. Results showed that the maximum value of relative power is 0.13 mW at nanofluid compared with other concentrations due to the low density of nanofluid at this concentration. For highe
... Show MoreTodays, World is faced an energy crisis because of a continuous increasing the consumption of fuels due to intension demand for all types of vehicles. This study is one of the efforts dealing with reduce the weight of vehicles by using a new material of sandwich steel, which consists of two skin steel sheets with core of a polymer material. Resistance spot welding (RSW) can be easily implemented on metals; however a cupper shunt tool was designed to perform the resistance welding of sandwich steel with DP800 cover sheets to resolve a non-conductivity problem of a polymer core. Numerical simulations with SORPAS®3D were employed to test the weldability of this new material and supported by many practical experiments. In conclus
... Show MoreNanostructural cupric oxide (CuO) films were prepared on Si and glass substrate by pulsed laser deposition technique (PLD) using laser Nd:YAG, using different laser pulses energies from 200 to 600 mJ. The X-ray diffraction pattern (XRD) of the films showed a polycrystalline structure with a monoclinic symmetry and preferred orientation toward (111) plane with nano structure. The crystallite size was increasing with increasing of laser pulse energy. Optical properties was characterized by using UV–vis spectrometer in the wave lengthrange (200-1100) nm at room temperature. The results showed that the transmission spectrum decreases with the laser pulses energy increase. Sensitivity of NO2 gas at different operating temperatures, (50°C,
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Variable selection in Poisson regression with high dimensional data has been widely used in recent years. we proposed in this paper using a penalty function that depends on a function named a penalty. An Atan estimator was compared with Lasso and adaptive lasso. A simulation and application show that an Atan estimator has the advantage in the estimation of coefficient and variables selection.
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Solid waste is considered to be one of the rescuers of pollution in case of neglecting conditions and procedures relating to specific processes of laws, systems, and contracts requirements in addition to recommendations of organizations concerned with environment issue. The environments auditing groups of intosai have taking into account the environments control by various conference and recommended that the Board of supreme audit have and environments controlling taking into consideration auditing procedures on waste management ,and also offered on evidences for experiences of members of countries in order to exchange their knowledge's and experiments .the definition of solid waste and their resources ,risks ,man
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