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.
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
... Show MoreReprehensible during the period of human life ,particular in child hood and after weaning
baby,analmeating habits have acquired his remaining life time and here high Iights,the role of
the mother in the childs education,dietar habits, and health methods and what is beneficial to
his health and in sufficien quantities for the baby .brooze trails are learned by the childin the
home with animportant and significant role in the future,inacht.aaralgame course wisely,after
becoming more in dependent in its delision-making an choices beyond the control of parents.
The present study aimed to message measure the awareness of food the mother and her role in
the development of food awareness sons, and its relation ship with som
In modern hydraulic control systems, the trend in hydraulic power applications is to improve efficiency and performance. “Proportional valve” is generally applied to pressure, flow and directional-control valves which continuously convert a variable input signal into a smooth and proportional hydraulic output signal. It creates a variable resistance (orifice) upstream and downstream of a hydraulic actuator, and is meter in/meter out circuit and hence pressure drop, and power losses are inevitable. If velocity (position) feedback is used, flow pattern control is possible. Without aforementioned flow pattern, control is very “loose” and relies on “visual” feed back by the operator. At this point, we should examine how this valv
... Show MoreThe current research aims to reveal the strength of education and the direction of the relationship between the formal thinking and learning methods of Kindergarten department students. To achieve this objective, the researcher developed a scale of formal thinking according to the theory of (Inhelder & Piaget 1958) consisting of (25) items in the form of declarative phrases derived from the analysis of formal thinking skills based on a professional situation that students are expected to interact with in a professional way. The research sample consisted of (100) female students selected randomly who were divided into four groups based on the academic stages, the results revealed that The level of formal thinking of the main sample is
... Show MoreConservative pipes conveying fluid such as pinned-pinned (p-p), clamped–pinned (c-p) pipes and clamped-clamped (c-c) lose their stability by buckling at certain critical fluid velocities. In order to experimentally evaluate these velocities, high flow-rate pumps that demand complicated fluid circuits must be used.
This paper studies a new experimental approach based on estimating the critical velocities from the measurement of several fundamental natural frequencies .In this approach low flow-rate pumps and simple fluid circuit can be used.
Experiments were carried out on two pipe models at three different boundary conditions. The results showed that the present approach is more accurate for est
... Show MoreA lower extracellular pH is one of the few well-documented physiological differences between tumour and normal tissues. On the other hand, elevated glutathione (GSH) level has been detected in many tumours compared with healthy surrounding tissues. The compound II: 3-(9H-purin-6-yl-thio) carbonothionyl methyl-8-oxo-7-(2-thiophen-2-yl) acetamido-5-thia-1-azabicyclo-4-octo-ene-carboxylic acid was a cephalothin derivative contain 6-mercaptopurine (6-MP). Compound II react with general base catalysis in slightly acidic pH or with sulfhydryl nucleophiles to release the chemotherapeutic drug 6-MP. The generation of compound II was accomplished following multistep reaction procedures. The structure of compound II and its intermediate was confir
... Show MoreThis paper presents a method of designing and constructing a system capable of acquiring
the third dimension and reconstructs a 3D shape for an object from multi images of that object using
the principle of active optical triangulation. The system consists of an illumination source, a photo
detector, a movement mechanism and a PC, which is working as a controlling unit for the hard ware
components and as an image processing unit for the object multi view raw images which must be
processed to extract the third dimension. The result showed that the optical triangulation method
provides a rapid mean for obtaining accurate and quantitative distance measurements. The final
result's analysis refers to the necessity of usin
In this paper, the human robotic leg which can be represented mathematically by single input-single output (SISO) nonlinear differential model with one degree of freedom, is analyzed and then a simple hybrid neural fuzzy controller is designed to improve the performance of this human robotic leg model. This controller consists from SISO fuzzy proportional derivative (FPD) controller with nine rules summing with single node neural integral derivative (NID) controller with nonlinear function. The Matlab simulation results for nonlinear robotic leg model with the suggested controller showed that the efficiency of this controller when compared with the results of the leg model that is controlled by PI+2D, PD+NID, and F
... Show MoreThe development of a meaningful dissolution procedure for drug products with limited water solubility has been a challenge to both the pharmaceutical industry and the agencies that regulate them. Natural surfactants aid in the dissolution and subsequent absorption of drugs with limited aqueous solubility. In vitro, various techniques have been used to achieve adequate dissolution of the sparingly water – soluble or water insoluble drug products such as the use of mechanical methods (i.e., increased agitation and the disintegration method) or hydro alcoholic medium or large volumes of medium. The necessity of assuring the quality of drugs , especially those with low aqueous solubility and in vivo absorption , has led to the development and
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