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.
In light of accelerating environmental degradation, the transition to a green economy is an imperative for achieving sustainable development. This study provides a critical analysis of the international legal and institutional framework governing this transition, revealing a significant gap between normative developments and the institutional framework on one hand, and their practical implementation on the other. The transition faces legal obstacles, including reliance on non-binding voluntary commitments and conflicts between environmental obligations and global trade and investment rules. It also reveals a significant financing gap, as financial flows to developing countries continue to lag behind commitments, in add
... Show MoreBroyden update is one of the one-rank updates which solves the unconstrained optimization problem but this update does not guarantee the positive definite and the symmetric property of Hessian matrix.
In this paper the guarantee of positive definite and symmetric property for the Hessian matrix will be established by updating the vector which represents the difference between the next gradient and the current gradient of the objective function assumed to be twice continuous and differentiable .Numerical results are reported to compare the proposed method with the Broyden method under standard problems.
Abstract: Word sense disambiguation (WSD) is a significant field in computational linguistics as it is indispensable for many language understanding applications. Automatic processing of documents is made difficult because of the fact that many of the terms it contain ambiguous. Word Sense Disambiguation (WSD) systems try to solve these ambiguities and find the correct meaning. Genetic algorithms can be active to resolve this problem since they have been effectively applied for many optimization problems. In this paper, genetic algorithms proposed to solve the word sense disambiguation problem that can automatically select the intended meaning of a word in context without any additional resource. The proposed algorithm is evaluated on a col
... Show MoreThis work is a trial to ensure the absolute security in any quantum cryptography (QC) protocol via building an effective hardware for satisfying the single-photon must requirement by controlling the value of mean photon number. This was approximately achieved by building a driving circuit that provide very short pulses (≈ 10 ns) for laser diode -LD- with output power of (0.7-0.99mW) using the available electronic components in local markets. These short pulses enable getting faint laser pulses that were further attenuated to reach mean photon number equal to 0.08 or less.
Longer follow-up defense , one of basketball skills that require the team collective action involving active part and consistent to acquire bouncing balls even not be a chance for members of the team striker acquisition rebounding from the target area and bring it back again , which reduces the chances of scoring, and it enables team members defender of the performance of fast attack and score points for being the increase your chances of success.In light of the foregoing, reflected the importance of research in achieving the objective basis of skill tests that require a circumstance similar to the circumstances of the game with the standard operating procedures for the registration, and that the validity judged by consistency between tests
... Show MoreIn this work, electrodialysis (ED) has been demonstrated to be appropriate technique for reducing the electrical conductivity of real wastewater from fuel washing unit, which has been previously treated by other electrochemical technology (electrocoagulation and electrooxidation). A five cell electrodialysis stack, with an active membrane area of 60 cm2 per cell was employed. During a batch recirculation mode ED system, the effects of parameters such as electrical potential applied (6-18 V) and flow rate of streams (0.5-1.7 L/min.) on the performance of the total dissolved solids (TDS) separation and specific power consumption (SPC) were studied. The results indicate that the process of ED under potential (15 V) and flow
... Show MoreThis paper reports a fiber Bragg grating (FBG) as a biosensor. The FBGs were etched using a chemical agent,namely,hydrofluoric acid (HF). This implies the removal of some part of the cladding layer. Consequently, the evanescent field propagating out of the core will be closer to the environment and become more sensitive to the change in the surrounding. The proposed FBG sensor was utilized to detect toxic heavy metal ions aqueous medium namely, copper ions (Cu2+). Two FBG sensors were etched with 20 and 40 μm diameters and fabricated. The sensors were studied towards Cu2+ with different concentrations using wavelength shift as a result of the interaction between the evanescent field and copper ions. The FBG sensors showed
... Show MoreHigh cost of qualifying library standard cells on silicon wafer limits the number of test circuits on the test chip. This paper proposes a technique to share common load circuits among test circuits to reduce the silicon area. By enabling the load sharing, number of transistors for the common load can be reduced significantly. Results show up to 80% reduction in silicon area due to load area reduction.