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.
There are many images you need to large Khneh space With the continued evolution of storage technology for computers, there is a continuing need and are required to reduce Alkhoznip space Pictures Zguet pictures in a good way, the way conversion Alamueja to Purifiers
This paper proposes a self organizing fuzzy controller as an enhancement level of the fuzzy controller. The adjustment mechanism provides explicit adaptation to tune and update the position of the output membership functions of the fuzzy controller. Simulation results show that this controller is capable of controlling a non-linear time varying system so that the performance of the system improves so as to reach the desired state in a less number of samples.
Been using a pv system program to determine the solar window for Baghdad city . the solar window for any location can be determine by deviating left and right from the geographical south as well as deviation according to the amount of tilt angle with the horizon for fixed panel so that will not change the average of solar radiation incident over the whole year and this lead to help in the process of installation of fixed solar panel without any effect on annual output .the range of solar window for Baghdad city between two angles ( -8 - +8 ) degrees left to right of the geographical south and tilt angle that allowed for the horizon range between angles (21- 30) degrees so that the amount of solar radiation that falling on the solar pan
... Show MoreThe flow in a manifolds considered as an advanced problem in hydraulic engineering applications. The objectives of this study are to determine; the uniformity qn/q1 (ratio of the discharge at last outlet, qn to the discharge at first outlet, q1) and total head losses of the flow along straight and rectangular loop manifolds with different flow conditions. The straight pipes were with 18 m and 19 m long and with of 25.4 mm (1.0 in) in diameter each. While, the rectangular close loop configuration was with length of 19 m and with diameter of 25.4 mm (1.0 in) also. Constant head in the supply tank was used and the head is 2.10 m. It is found that outlets spacing and manifold configuration are the main factors aff
... Show MoreA multivariate multisite hydrological data forecasting model was derived and checked using a case study. The philosophy is to use simultaneously the cross-variable correlations, cross-site correlations and the time lag correlations. The case study is of two variables, three sites, the variables are the monthly rainfall and evaporation; the sites are Sulaimania, Dokan, and Darbandikhan.. The model form is similar to the first order auto regressive model, but in matrices form. A matrix for the different relative correlations mentioned above and another for their relative residuals were derived and used as the model parameters. A mathematical filter was used for both matrices to obtain the elements. The application of this model indicates i
... Show MoreIn this research, the preparation of a chemically activated carbon from date stones by using electric and microwave assisted K2CO3 activation was studied. The effect of radiation power, radiation time, and impregnation ratio on the yield and Iodine number on the activated carbons was investigated. The activated carbon characterizations were examined by its surface area, pore structure analysis, bulk density, moisture content, ash content, iodine number, FTIR, and scanning electron microscopy (SEM). The adsorption capacity was also studied by adsorption of fluoroquinolones antibiotics, CIP, NOR, and LEVO, by the prepared activated carbon.
... Show MoreMany carbonate reservoirs in the world show a tilted in originally oil-water contact (OOWC) which requires a special consideration in the selection of the capillary pressure curves and an understanding of reservoir fluids distribution while initializing the reservoir simulation models.
An analytical model for predicting the capillary pressure across the interface that separates two immiscible fluids was derived from reservoir pressure transient analysis. The model reflected the entire interaction between the reservoir-aquifer fluids and rock properties measured under downhole reservoir conditions.
This model retained the natural coupling of oil reservoirs with the aquifer zone and treated them as an explicit-region composite system
Background: Nursing interventions tailored to the smoking triggers in patients with non-communicable chronic diseases are essential. However, these interventions are scant due to the nature of factors associated with smoking cessation and the poor understanding of the effect of nurse-led intervention in Iraq.Purpose: This study aimed to determine the dominant smoking triggers and examine the effects of a tailored nursing intervention on smoking behavior in patients with non-communicable chronic diseases.Methods: Convenience samples of 128 patients with non-communicable chronic diseases, male and female patients, who were 18-70 years old, were recruited in this quasi-experimental, randomized comparative trial in the outpatient clinic
... Show MoreThe spectrum of clinical efficacy of Methotrexate (MTX) is broad in that MTX is used in the treatment of certain cancers, severe psoriasis and rheumatoid arthritis.Various mechanisms by which cancer cells grown in tissue culture become resistant to anticancer drugs. The use of multiple drugs with different mechanisms of entry into cells and different cellular targets allows for effective chemotherapy and high cure rates. In an efforts to develop effective strategies that increase the therapeutic potential of anticancer drugs with less systemic toxicity ,are being directed towards the investigation of dietary supplements and other phytotherapeutic agents for their synergistic efficacy in combination with anticancer drugs. A promi
... Show More