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.
A Factorial Study for separation anxiety in students, of Baghdad City
Recently, all over the world mechanism of cloud computing is widely acceptable and used by most of the enterprise businesses in order increase their productivity. However there are still some concerns about the security provided by the cloud environment are raises. Thus in this our research project, we are discussing over the cloud computing paradigm evolvement for the large business applications like CRM as well as introducing the new framework for the secure cloud computing using the method of IT auditing. In this case our approach is basically directed towards the establishment of the cloud computing framework for the CRM applications with the use of checklists by following the data flow of the CRM application and its lifecycle. Those ch
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... Show MoreThis paper presents on the design of L-Band Multiwavelength laser for Hybrid Time Division Multiplexing/ Wavelength Division Multiplexing (TDM/WDM) Passive Optical Network (PON) application. In this design, an L-band Mulltiwavelength Laser is designed as the downstream signals for TDM/WDM PON. The downstream signals ranging from 1569.865 nm to 1581.973 nm with 100GHz spacing. The multiwavelength laser is designed using OptiSystem software and it is integrated into a TDM/WDM PON that is also designed using OptiSystem simulation software. By adapting multiwavelength fiber laser into a TDM/WDM network, a simple and low-cost downstream signal is proposed. From the simulation design, it is found that the proposed design is suitable to be used
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... Show MoreThis research aims to improve the radiation shielding properties of polymer-based materials by mixing PVC with locally available building materials. Specifically, two key parameters of fast neutron attenuation (removal cross-section and half-value layer) were studied for composite materials comprising PVC reinforced with common building materials (cement, sand, gypsum and marble) in different proportions (10%, 30% and 50% by weight). To assess their effectiveness as protection against fast neutrons, the macroscopic neutron cross-section was calculated for each composite. Results show that neutron cross-section values are significantly affected by the reinforcement ratios, and that the composite material PVC + 50% gypsum is an effect
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